Geriatric Care Management Exam
Solutions
Course Introduction
Geriatric Care Management explores the principles and practices involved in caring for older adults, focusing on the unique physical, psychological, and social needs of the aging population. This course covers assessment strategies, care planning, interdisciplinary team coordination, ethical considerations, and effective communication with elderly clients and their families. Students will develop skills in advocating for seniors, navigating complex healthcare systems, managing chronic illnesses, and accessing community resources to promote wellness, independence, and quality of life for older adults.
Recommended Textbook
Toward Healthy Aging Human Needs and Nursing Response 7th Edition by Priscilla Ebersole
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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) A nursing student on her obstetrical nursing rotation hands an infant girl to the infant's mother,who asks the student what life expectancy is these days.The nursing student bases her response on her knowledge that,for this child,life expectancy can reasonably be expected to be:
A) 72.9 years.
B) 74 years.
C) 79.7 years.
D) 81.2 years.
Answer: C
Q2) A gerontological nurse visits a local grade school to talk with the children about her career.A fourth grade boy asks,"Why do you work there? Old people are all stupid!" His comments probably indicate that he:
A) has had limited contact with the well elderly.
B) lacks intelligence.
C) probably was abused by an elderly family member.
D) had a negative experience with grandparents.
Answer: A
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3
Chapter 2: Theories of Aging
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Sample Questions
Q1) In your discharge teaching of your client with diabetes,you use concepts from the activity theory of aging when you instruct your client to:
A) continue her daily walking routine.
B) curtail further increases in physical activity.
C) limit contact with children.
D) avoid exposing herself to crowds.
Answer: A
Q2) The family member of a patient asks you if vitamin C will prevent aging.In formulating your response,you are considering what biological theory of aging?
A) Free radical theory
B) Immunity theory
C) Clinker theory
D) Continuity theory
Answer: A
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4
Chapter 3: Health and Wellness
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Sample Questions
Q1) Which is the best example of a wellness-based nursing intervention?
A) Providing the Internet address of support groups and resources to the computer-literate,Internet-proficient daughter of your oncology client
B) Lecturing your client with diabetes that he would not have been admitted this time if he had listened to your discharge instructions last time
C) Ignoring the ice cream treat and cappuccino you saw your cardiac client's visitors bring into her hospital room
D) Responding to your elderly client's request to be ambulated by stating,"You should take it easy and rest.You're 90 years old-you deserve it!"
Answer: A
Q2) What best describes nutritional alterations with aging?
A) Caloric needs and nutritional needs decrease.
B) Caloric needs increase,but nutritional needs decrease.
C) Caloric and nutritional needs increase.
D) Caloric needs decrease,but nutritional needs remain constant.
Answer: D
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Chapter 4: Physiological Changes with Aging
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Sample Questions
Q1) As you enter your patient's room,you find her sitting up in bed,reading the large print edition of Reader's Digest.She asks you if it is possible to increase the amount of lighting in the room for her while she reads.She says to you,"I don't know what it is.It just seems that I need more light for everything as I get older." In your verbal response to her,you explain what age-related changes?
A) Slower ability of the pupil to adjust to changes in lighting is age related.
B) The gray-yellow ring around her cornea,arcus senilis,interferes with visual acuity.
C) The cornea becomes flatter and thinner with aging.
D) The retina begins to degenerate with aging,and detachment is an age expected change.
Q2) You are teaching a health promotion class at a senior center.The topic is promoting healthy skin while aging.The following topics should be included in the program except:
A) the importance of using sunscreen.
B) the importance of adequate hydration.
C) the importance of using moisturizing lotions.
D) the importance of using antibacterial soaps when bathing.
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6
Chapter 5: Laboratory Values and Diagnostics
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Sample Questions
Q1) 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
Q2) 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.
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Chapter 6: Health Assessment in Gerontological Nursing
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7 Verified Questions
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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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Sample Questions
Q1) Older adults with sleep apnea:
A) experience excessive deep sleep.
B) are often slim and underweight.
C) have an increased risk for sudden death and stroke.
D) experience excessive tension in the muscles of the throat and soft palate.
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) When beginning an exercise program,an elderly client should first be assessed.What is important to include in the initial assessment for older adults of all ages?
A) Exercise tolerance testing (ETT)
B) Echocardiogram
C) Medical history and physical examination
D) Pulmonary function tests (PFTs)
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9
Chapter 8: Biological Maintenance Needs
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Sample Questions
Q1) An older woman tells the nurse her husband seldom brushes his teeth as he did in the past.One reason for this might be:
A) decreased manual dexterity.
B) loss of some of his natural teeth.
C) decrease in taste acuity.
D) lack of dental insurance.
Q2) An 81-year-old woman complains of pain in the right upper posterior thoracic area and has an elevated temperature (101° F).She subsequently develops clusters of fluid-filled vesicles in the same area where she reported the pain.It is likely that she has:
A) seborrheic keratoses.
B) rosacea.
C) herpes zoster.
D) stasis dermatitis.
Q3) What skin preparations should the nurse instruct the older adult to use with caution?
A) Moisturizing soaps
B) Emollients to keep the skin moist
C) Steroid-based ointments and creams
D) Sun block
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Chapter 9: Nutritional Needs
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Sample Questions
Q1) A major cause of weight loss in residents of long-term care facilities is:
A) delirium.
B) depression.
C) dementia.
D) social isolation.
Q2) A 74-year-old woman is seen in the geriatrician's office.She is prescribed calcium supplements.The nurse knows that the recommended daily dosage of calcium for older adult females is:
A) 1500 mg/day.
B) 1000 mg/day.
C) 2500 mg/day.
D) 3000 mg/day
Q3) Interventions to include when developing a care plan for a patient with gastroesophageal reflux disease include:
A) eating three large meals daily and avoiding eating between meals.
B) elevating the head of the bed or placing a wedge.
C) napping for 30 to 60 minutes following meals.
D) eating a high-fat diet.
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11
Chapter 10: Chronic Disease in Late Life
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Sample Questions
Q1) Type 2 diabetes mellitus is often difficult to diagnoses in older adults because:
A) presenting symptoms occur very quickly.
B) it rarely occurs in older adults.
C) the classic symptoms may not be present in older adults.
D) there are no recognizable symptoms; it is a "silent killer."
Q2) You are assisting your elderly client with chronic obstructive pulmonary disease (COPD)in self-care activities.Which direction provided by you will best help her achieve the goal of being able to perform self-care activities?
A) Bathe and eat slowly,allowing rest periods.
B) Attempt to walk short distances without oxygen.
C) Perform all activities of daily living at one time,and then rest.
D) Bathe right after eating,and then rest.
Q3) An older adult with pneumonia often:
A) presents with an elevated temperature.
B) is not treated with antibiotics.
C) presents with a change in functional status and mental status.
D) presents with a markedly elevated white blood cell (WBC)count.
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Page 12
Chapter 11: Pain and Comfort
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12 Flashcards
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Sample Questions
Q1) The safest narcotic choice for your elderly client experiencing severe acute pain is:
A) Demerol (meperidine).
B) Talwin (pentazocine).
C) morphine sulfate.
D) none; there are no safe narcotics for elderly clients.Nonsteroidal antiinflammatory drugs (NSAIDs)should always be used instead.
Q2) An 81-year-old female patient was recently admitted to the subacute setting after having a knee replacement.She is very anxious and refuses to get out of bed,stating that it is too painful.What is the best action for the nurse?
A) Tell the patient that she must get out of bed and that she will get used to the pain.
B) Use the Hoyer lift to get her out of bed so that she does not have to move her knee.
C) Offer pain medication,administer the medication,and wait 20 minutes before getting her out of bed.
D) Let her rest in bed.
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Chapter 12: Geropharmacology
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) 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?"
Q2) Which pharmacokinetic/pharmacodynamic parameter is least affected by the aging process?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Q3) What is an important contributing factor to polypharmacy in older adults?
A) Inadequate communication among medical care providers
B) Implementation of Medicare Part D prescription drug benefit
C) Use of generic medications
D) Increasing popularity of dietary and herbal supplements
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14
Chapter 13: The Use of Herbs and Supplements in Late Life
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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) An 88-year-old woman is being seen for the first time at the outpatient geriatric clinic.When the nurse completes her nursing admission history,she asks the patient about her medication list.She inquires about the use of herbs and other supplements as well as prescription medications.The reason for this inquiry is that herbs and supplements:
A) may interact with prescription medications.
B) are hazardous when used by older adults.
C) replace the need for prescription medications.
D) cause excessive sedation in older adults
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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Page 15
Chapter 14: Sensory Function
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Sample Questions
Q1) 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.
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 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.
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Chapter 15: Mobility
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Sample Questions
Q1) A nurse in the geriatric outpatient clinic frequently receives questions from clients about exercise.The nurse answers their questions based on the knowledge that regular exercise:
A) performed in excess as a young adult will lead to osteoporosis.
B) prevents muscle atrophy and improves mobility,thus reducing the risk of falls.
C) must be avoided by older adults with rheumatoid arthritis because it strains the joints.
D) is likely to lead to increased falls and possibly fractures.
Q2) An elderly patient is being discharged from the hospital after an acute exacerbation of gout.The nurse reviews instructions for allopurinol (Zyloprim)with him.The nurse knows that this medication:
A) blocks the excretion of uric acid.
B) neutralizes uric acid.
C) lowers the formation of uric acid.
D) increases the excretion of uric acid.
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17
Chapter 16: Environmental Safety and Security
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Sample Questions
Q1) You notice that a newly admitted resident to the long-term care facility insists on maintaining a large collection of personal items on her bedside table,including several photographs of her deceased husband.As you are walking by the door to her room,you overhear an argument between the resident and a nursing assistant who is encouraging her to store the personal items in her dresser drawer.You intervene,realizing that:
A) this is an attempt by the resident to maintain a sense of personal space.
B) the resident is not coping well with the loss of her spouse and is using the photographs in an attempt to live in the past
C) the resident is exhibiting combative behavior,which may be an early warning sign of dementia.
D) the resident is exhibiting controlling,manipulative behavior and needs to learn the rules of the institution.
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18
Chapter 17: Economic,Residential,and Legal Issues
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Sample Questions
Q1) One significant difference in the two levels of care in a nursing home-subacute (skilled)care and chronic care-is that subacute care:
A) provides 24-hour personal assistance to the resident.
B) focuses on rehabilitation or management of complex medical needs.
C) is provided in for-profit facilities only.
D) is not covered by Medicare.
Q2) When an older adult is considering long-term care insurance (LTCI),what is an important consideration?
A) The older one is when applying,the lower the rates will be.
B) It is financially better to avoid purchasing LTCI through a group policy.
C) It is wise to scrutinize all exclusions before enrolling.
D) All policies cover care at home as well as in a long-term care facility.
Q3) The original intent of Social Security was to:
A) provide a hospital insurance plan.
B) minimize the dependency of older members on younger members of society.
C) provide the blind,elderly,or disabled with adequate financial support.
D) penalize women financially for numerous zero wage years while raising children.
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Page 19
Chapter 18: Frailty,Vulnerability,and Elder Mistreatment
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Sample Questions
Q1) A 90-year-old client tells her home care nurse that she must buy her neighbor's groceries or the neighbor will not take her to the store.This is an example of which type of elder mistreatment?
A) Abandonment
B) Abuse
C) Neglect
D) Exploitation
Q2) What is a true statement about mandatory reporting of elder mistreatment?
A) Nurses are mandatory reporters of elder mistreatment in all states and territories in the United States.
B) The nurse must have documented proof of elder abuse before reporting an incident. C) Elder mistreatment reports require that the reporter identify herself in the report.
D) The standard for reporting is one of reasonable belief that a vulnerable person has been or is likely to be abused.
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Chapter 19: Intimacy and Sexuality in Late Life
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Sample Questions
Q1) The following have been identified as benefits of therapeutic touch except:
A) provision of sensory stimulation.
B) relief of physical and psychosocial pain.
C) reduction of anxiety.
D) improved skin integrity.
Q2) You are a preceptor to a new nurse on the geriatric unit of the hospital.You observe the nurse admit a new patient to the nursing unit and you are reviewing her documentation of the assessment.You note that she has left the section on the assessment form related to "sexuality" blank,and you question her about it.She states that it is "not applicable" and that the patient is 79 years old,then she draws a line through the section.What action do you take?
A) There is no action needed.The patient is 79 years old and this is not an area of concern.
B) There is no action needed.The patient would have shared information if there was anything of concern,so there is no need to ask.
C) Speak to the new nurse,because the role of the nurse is to offer an opportunity for discussion.
D) Speak to the new nurse,because this is an area for the physician to complete.
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21
Chapter 20: Relationships,Roles,and Transitions
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Sample Questions
Q1) An 89-year-old Chinese patient had a cerebrovascular accident that left him totally dependent in activities of daily living.He subsequently had a percutaneous enteral gastrostomy (PEG)tube placed for feeding.He is ready to be discharged from the acute care setting,and the family is expressing that they want to take him home and care for him.The following are important for the nurse to assess when evaluating the family support system except:
A) number of family members who are accessible.
B) economic status of each of the family members.
C) recent stresses of each of the family members.
D) ethnic background of each of the family members.
Q2) 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.
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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) Which is true about health care disparities among older adults?
A) Older adults of color have equal risk factors for vulnerability as all older adults.
B) Older adults of color have equal risk factors for vulnerability as young adults of the same ethnic group.
C) Older females of color have increased risk factors for vulnerability than do older males of the same ethnic group.
D) Health care disparities are only seen in older adults of color who receive care in public hospitals and clinics.
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Chapter 22: Nursing and Aging in Rural and Frontier Settings
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Q1) A 76-year-old patient is hospitalized after falling and fracturing her hip while visiting her daughter in a large city.She lives in a small farming community about 3 hours away from the nearest urban area.She is found to have hypertension.When questioned about her preventive health care practices,she reports that she does not have a primary care physician,that the nearest physician is a 3-hour drive,and that she takes garlic for her hypertension.In analyzing her health care maintenance practices,the nurse knows that:
A) the patient is typical of rural older adults in that primary care in rural areas is scarce and rural older adults tend to use self-care strategies.
B) the patient is typical of rural older adults in that most rural older adults have hypertension due to the large amount of physical activity.
C) the patient is atypical of rural-dwelling older adults in that most do seek out primary care,but not specialty care.
D) the patient is atypical of rural-dwelling older adults in that most do not use alternative medicine or "home remedies."
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Page 24
Chapter 23: Cognition and Caring for Persons with Cognitive Impairment
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Sample Questions
Q1) In evaluating the plan of care for an older adult with the nursing diagnosis Risk for Injury related to delirium,which evaluative statement would best suggest that the problem is resolving?
A) Client attempted to climb over the side rails.
B) Client manipulated intravenous pump,stating "I can't get this transformer to work."
C) Client correctly stated year and month but not date.
D) Client stated,"If we don't hurry,I'll miss the bus."
Q2) 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.
Q3) The Mini-Mental State Exam (MMSE)is a tool used to:
A) diagnose Alzheimer's disease.
B) provide a baseline mental status measurement and track changes.
C) diagnose delirium in hospitalized older adults.
D) predict the progression of cognitive changes.
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Chapter 24: Stress,Crises,and Health in Aging
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Sample Questions
Q1) What is a true statement regarding crises and stress?
A) Stress always precipitates a crisis.
B) Crises always create stress.
C) Personal perception of an event is less significant than the event's magnitude.
D) Stress is time limited.
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."
Q3) What is a true statement about coping strategies in older adults?
A) Older adults are often less able to cope with stress due to decreased adaptive capacity.
B) Older adults are less able to cope with stress due to cognitive declines.
C) Coping strategies used in earlier life are ineffective in later life.
D) Older adults use coping strategies directed at avoiding the problem.
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26
Chapter 25: Emotional Health in Late Life
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Sample Questions
Q1) You are assigned to the care of an 80-year-old schizophrenic client who has been admitted to your acute care facility.As you develop a plan of care for this client,you are taking into consideration what reality about being an older adult with schizophrenia?
A) The majority of mental health care for older adults is provided in long-term psychiatric facilities.
B) Mental health services for older adults are readily reimbursed by Medicare.
C) Popular managed care programs usually include in-depth assessment involving specialized expertise in mental health.
D) The mental health needs of older adults are not easily recognized or accurately reported.
Q2) One goal of reminiscence is to:
A) provide cognitive stimulation.
B) divert the individual's attention from the problem.
C) eliminate painful memories.
D) educate the individual on proper communication strategies.
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Chapter 26: Loss,Death,and Dying in Late Life
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Q1) The family of a 78-year-old patient who is dying of colon cancer with metastases to the liver is concerned because he refuses to eat or drink.He is alert and oriented,and states that he has no desire to eat.What should the nurse do?
A) Comply with the patient's wishes.
B) Force fluids.
C) Contact the physician for an order for enteral feeding.
D) Contact the dietitian for feeding supplements.
Q2) A woman died after a lengthy illness.Her brother failed to attend the funeral and family gatherings because he was on a drinking binge.He has always been the "black sheep" of the family due,in part,to his history of alcohol abuse.What best describes the brother's behavior?
A) Pathological grief
B) Anticipatory grief
C) Acute grief
D) Disenfranchised grief
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Chapter
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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) A 90-year-old resident of an assisted living facility states,"I want to donate my brain to science." This is an example of a:
A) living legacy.
B) last will and testament. C) postmortem obligation.
D) postmortem legacy.
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