Health Assessment in Older Adults
Practice Questions
Course Introduction
This course focuses on the principles and techniques of comprehensive health assessment in older adults, emphasizing the unique physiological, psychological, and social changes associated with aging. Students will learn to conduct thorough health histories and physical examinations using evidence-based tools, with attention to common geriatric syndromes, functional status, cognitive and sensory impairments, and cultural considerations. The course prepares students to identify age-related health risks, promote wellness, and develop tailored care plans for older adult populations in a variety of healthcare settings.
Recommended Textbook
Ebersole and Hess Gerontological Nursing and Healthy Aging Edition 1st Canadian Edition by Theris
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26 Chapters
306 Verified Questions
306 Flashcards
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Page 2
Chapter 1: Introduction to Healthy Aging
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Sample Questions
Q1) Mr. Levesque, 65 years old, has been living in homeless shelters for the last three years after having lost his job as a maintenance attendant at a local store. He suffers from alcoholism and appears malnourished upon arrival at the hospital, after falling on the sidewalk and injuring his left shoulder. When implementing a primary health care approach, what is the main principle the nurse should consider with this older adult?
A) Health promotion
B) Accessibility
C) Primary care
D) Public participation
Answer: A
Q2) Which statement describes aging in developing countries?
A) Aged dependence is likely to improve from 1:4 to 1:2.
B) The biggest problem for older adults will be lack of food.
C) Most of the world's older adults are likely to reside in developing countries.
D) Like fertility, life expectancy is increasing, although at a different rate.
Answer: C
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Chapter 2: Gerontological Nursing History, Education, and Roles
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Sample Questions
Q1) The gerontological nurse collaborates with the wound care team about an older adult who has an ulcer. How is this nurse demonstrating leadership in the care of an older person?
A) The nurse is screening and assessing older persons effectively.
B) The nurse is facilitating access to older person care programs.
C) The nurse is coordinating members of the health care team.
D) The nurse is empowering older persons to manage chronic illness.
Answer: C
Q2) A male older adult is transferred to a hospice facility with end-stage disease. Which of the following is a suitable nursing intervention for this older adult and his family, according to the Canadian Gerontological Nursing Association's Standards of Practice?
A) Decrease the analgesic dose to prevent sedation.
B) Provide a basin and towels for morning self-care.
C) Inform family members about strict visiting hours.
D) Facilitate family rituals related to death and dying.
Answer: D
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4
Chapter 3: Communicating With Older Adults
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Sample Questions
Q1) Which type of question should the nurse avoid when communicating with an older person who has aphasia?
A) The nurse should avoid questions that validate understanding.
B) The nurse should avoid questions that have open-ended answers.
C) The nurse should avoid questions that require a yes or no answer.
D) The nurse should avoid asking several questions in a series.
Answer: B
Q2) The nurse needs to obtain information from an older person who has dysarthria. If the nurse experiences difficulty in understanding the older person, which one of the following actions would be the nurse's best response?
A) Allow for several brief conversations.
B) Repeat a part that is not understood.
C) Ask questions using very simple terms.
D) Provide a questionnaire with large type.
Answer: B
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Chapter 4: Culture, Ethnicity, and Aging
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Sample Questions
Q1) A resident in a nursing home insists that a priest hear his confession. The resident is very anxious, and the nursing home does not have a Roman Catholic chaplain. Which one of the following interventions should the nurse implement?
A) A rabbi is coming to visit the home this evening. Arrange an appointment for the resident.
B) Report the resident's change in behaviour in detail so that the attending physician can prescribe medication appropriately.
C) Refer the resident to the staff psychologist to address the underlying cause of the patient's anxiety.
D) Contact a Roman Catholic church, and request that the priest visit the resident.
Q2) The nurse plans care for an older adult who follows the beliefs of the personalistic or magicoreligious system. Which of the following should the nurse consider when planning care?
A) The older adult may attribute his illness to voodoo or a hex.
B) Invite the hospital chaplain to speak with the older adult.
C) Maintain blood pressure below 120/70 mm Hg.
D) Review principles of the magicoreligious system.
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Page 6
Chapter 5: Nursing Documentation for Optimal Care
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Sample Questions
Q1) The same nursing documentation record is used in every unit of a hospital. Why does a hospital use a standardized form for nursing documentation?
A) Standardized documentation helps to provide continuity of care.
B) Standardized documentation assists in maintaining confidentiality.
C) Standardized documentation reduces the number of medication errors.
D) Standardized documentation guarantees excellence of care between units.
Q2) Mrs. Smadu, who is 80 years of age, was recently admitted to a long-term care setting. Over the past month, Mrs. Smadu appears to be deteriorating. She does not wish to eat, sleeps all the time, and is not able to participate in any of her activities of daily living. Which of the following assessment tools will help inform and guide comprehensive care and planning for this older adult?
A) Clinical Assessment Protocols (CAPs)
B) Continuing Care Reporting System (CCRS)
C) Resident Assessment Instrument (RAI)
D) Utilization Guide (UG)
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Chapter 6: Biological Theories of Aging and Physical
Changes of Aging
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Sample Questions
Q1) The nurse cares for an older adult who appears to be malnourished and short of breath and has an infection in a large wound on his coccyx. Which intervention is the nurse's priority?
A) Monitor temperature and leukocytes.
B) Provide assistance with meal planning.
C) Provide high-quality protein in the diet.
D) Maintain oxygen saturation above 95%.
Q2) An older adult male who spray-paints houses for a living has had a myocardial infarction (MI). Which intervention should the nurse implement to prevent adverse health effects from his occupational history?
A) Provide low-cholesterol diet meals.
B) Avoid substances that are hepatotoxic.
C) Promote coughing and deep breathing.
D) Analyze the electrocardiogram's rhythm.
Q3) Which age-related change contributes to anorexia and weight loss in the older adult?
A) Excessive saliva
B) Fewer taste buds
C) Wearing dentures
D) Softened tooth enamel
Page 8
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Chapter 7: Social, Psychological, Spiritual, and Cognitive Aspects of Aging
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Sample Questions
Q1) The nurse at a nursing home wants to help decrease the risk of Alzheimer's disease among the residents. Which of the following should the nurse do to implement this goal?
A) Keep the curtains open in the residents' rooms.
B) Offer beads for the residents to string on yarn.
C) Show movies that the residents choose.
D) Assist residents with ambulation to meals.
Q2) An older male adult with severe knee pain tells the nurse how he lost his job and his home after starting a new business when he was 48 years old. Now he lives alone and relies on welfare. Using Jung's theory, what in this individual's life is the most pivotal in his personality development?
A) Living alone
B) Meagre income
C) Severe knee pain
D) Job loss and home loss
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Chapter 8: Nutritional Needs
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Sample Questions
Q1) An older female adult with alterations in her cognitive status has an increased temperature, poor appetite, and almost fell beside her bed. What should the nurse consider when caring for this older adult?
A) The older adult may be experiencing loneliness.
B) The older adult may be demonstrating signs of constipation.
C) The older adult may be hungry and feeling weak.
D) The older adult has a fever and is delirious.
Q2) Bowel function in the older adult can be a source of concern, and potentially serious problems may develop. What mechanical factors may contribute to constipation in the older adult?
A) Inadequate toileting
B) Abscess or ulcer of the anal sphincter
C) Altered cognitive status
D) Irregular defecation habits
Q3) Which of the following is a true statement about dental health in older adults?
A) Most people can expect to lose most of their teeth by old age.
B) Excessive saliva production is a common problem among older adults.
C) Functional and cognitive limitations may contribute to poor oral hygiene.
D) A little blood on the toothbrush is normal.
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Page 10
Chapter 9: Hydration and Continence
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Sample Questions
Q1) Which one of the following increases the risk for chronic dehydration in older adults?
A) Overuse of diuretics
B) Poor cognitive function
C) Dry mucous membranes
D) Fluid loss from vomiting
Q2) An older adult who is on bedrest has tachycardia and dry mucous membranes, and decreased urinary output after surgery. Which of the following situations is the nurse's priority for preventive care because of the patient's fluid volume status?
A) Bowel obstruction
B) Delirious behaviour
C) Thromboembolic events
D) Delayed wound healing
Q3) Which type of incontinence is characterized by a large residual urine volume?
A) Urge incontinence
B) Stress incontinence
C) Overflow incontinence
D) Functional incontinence
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Chapter 10: Rest, Sleep, and Activity
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Sample Questions
Q1) An older female adult maintains an active lifestyle, playing various games with friends. She reports to the nurse that she experiences wakefulness during the night and an inability to fall asleep after waking up at night. Which intervention should the nurse implement to improve the quality of this woman's sleep?
A) Recommend preparation for sleep.
B) Suggest trying a cup of warm milk at bedtime.
C) Inquire about her nightly sleep habits.
D) Propose volunteer work at a thrift shop.
Q2) Which factor contributes to sleep problems in older adults?
A) Excessive napping
B) Daily exercise
C) Lethargy
D) Rapid eye movement (REM)
Q3) Which of the following statements is true about sleep in older adults?
A) The time spent in bed increases, but the time spent asleep decreases.
B) The amount of leg movement during sleep remains steady throughout life.
C) Rapid-eye-movement (REM) sleep increases with age.
D) The amount of stage III sleep increases steadily throughout life.
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12
Chapter 11: Promoting Healthy Skin and Feet
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Sample Questions
Q1) The nurse plans care to protect the skin covering an older adult's greater trochanter. What is the nurse's priority intervention when the older adult is positioned on the side?
A) Turn the patient at least once every hour.
B) Place a cushion between the patient's knees.
C) Keep the patient's skin clean and dry.
D) Use the Sims' position.
Q2) The nurse cares for an older male adult who has a malignant melanoma. Which intervention should the nurse implement for this man, to prevent a recurrence or advancement of this condition in the future?
A) Place posters about sunscreen in the halls of his apartment building.
B) Promote application of sunscreen at his neighbourhood health fair.
C) Tell him to schedule all outdoor activities after 4 P.M. daily.
D) Instruct him to wear sun-protective clothing and a hat at all times.
Q3) Which of the following topical agents is safe to apply?
A) Corn starch, to absorb moisture in the groin area
B) Betadine, to disinfect a healing pressure ulcer
C) An over-the-counter preparation, to dissolve a corn
D) Zinc oxide ointment to an area of excoriation
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Chapter 12: Maintaining Mobility and Environmental Safety
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Sample Questions
Q1) An older female adult who receives intravenous (IV) fluids is making wide gesticulations with her arms and insulting the nursing staff loudly. Which intervention should the nurse implement to maintain safe, effective nursing care initially?
A) Apply bilateral upper extremity restraints.
B) Administer haloperidol (Haldol) for agitation.
C) Close the door to her room to reduce the noise.
D) Use a temporary air splint to prevent elbow and wrist flexion.
Q2) The nurse can place an older adult into one of four patient rooms. Which one of the following is a suitable room for an older adult?
A) A brightly lit, blue room with cozy throw rugs.
B) A room with orange carpeting and soft lighting.
C) A brightly lit, blue room with waxed vinyl floors.
D) A room for television and crafts.
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Chapter 13: Assessment Tools in Gerontological Nursing
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Sample Questions
Q1) The FANCAPES model represents Fluids, Aeration, Nutrition, Communication, Activity, Pain, Elimination, and Socialization. When would this tool be used to assess an older adult?
A) To determine functional performance
B) To determine mental status
C) To determine physical assistance
D) To determine caregiver burden
Q2) Which of the following does the nurse do when preparing to perform a skilled and detailed assessment of an older adult that is not usually required when assessing a younger individual?
A) Provide for adequate privacy.
B) Allow more time for assessing.
C) Gather all needed supplies.
D) Complete the evaluation in one sitting.
Q3) Which assessment tool is the most comprehensive exam of an older adult's functional status?
A) Katz Index
B) Fulmer SPICES
C) The Functional APGAR Evaluation Tool
D) The Older Americans Resources and Services (OARS) instrument
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Chapter 14: Safe Medication Use for Older Adults
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Sample Questions
Q1) The relationship of biological rhythms to variations in the body's response to drugs is known as chronopharmacology. When caring for an older adult with asthma, what information would help guide the nurse in planning the time to administer medication to the patient?
A) The asthma is most distressing before bedtime.
B) The asthma is most distressing at mid-day.
C) The asthma is most distressing between four and five A.M.
D) The asthma is most distressing after performing activities of daily living.
Q2) An older adult who has an albumin level of 25 g/L takes aspirin and phenytoin (Dilantin) by mouth daily. Which adverse effect of these medications does the nurse expect because of the older adult's nutritional status?
A) Depressed mood
B) Clay-coloured stools
C) Increased heart rate
D) Gingival hyperplasia
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Chapter 15: Living With Chronic Illness
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Sample Questions
Q1) Which one of the following describes the nurse's role for an older patient with a chronic illness?
A) Implement an individualized therapeutic regimen that brings about a cure.
B) Provide caring to help the patient live at the optimal level of health and wellness.
C) Suggest that the patient accept eventual death to reduce burdens on the patient's family.
D) Encourage the patient to minimize the utilization of services to control costs.
Q2) An older female adult has diabetes mellitus. Which of the following validates the nurse's conclusion that this patient's illness is in the foreground perspective of the Shifting Perspectives Model of Chronic Illness?
A) The older adult has an amputation of two toes.
B) The older adult lives at home with her husband.
C) The older adult self-checks blood sugar frequently.
D) The older adult changes the battery in her glucometer.
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Chapter 16: Pain and Comfort
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Sample Questions
Q1) Which statement is true about analgesic medications for older adults?
A) Opioids are less effective in older patients than in younger patients.
B) Stool softeners and laxatives should be used with opioids.
C) Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are generally harmless.
D) The dose limit for acetaminophen is difficult to reach for older adults.
Q2) The nurse uses comfort measures to enhance an older adult's pharmacological pain management. Which should the nurse use to identify relationships between comfort measures, pharmacotherapy, and the older adult's pain level?
A) Older adult's self-report
B) Older adult's pain diary
C) Visual Analogue Scale
D) Pain medication frequency
Q3) Which one of the following interventions would provide comfort, reduce anxiety and distress, and alleviate pain?
A) Acupuncture treatments
B) Adjuvant therapy
C) Transcutaneous electrical nerve stimulation
D) Touch
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Page 18
Chapter 17: Diabetes Mellitus
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Sample Questions
Q1) Which one of the following is the most important goal when planning nursing care for an older patient with diabetes mellitus?
A) Stabilize the serum glucose.
B) Prevent disease progression.
C) Set walking distance goals.
D) Plan for consistent exercise.
Q2) Which of the following laboratory results is a goal for reducing a person's risk for diabetes and heart disease?
A) Triglycerides over 1.69 mmol/L (150 mg/dL)
B) Cholesterol over 5.18 mmol/L (200 mg/dL)
C) High-density lipoprotein under 1.03 mmol/L (40 mg/dL)
D) Fasting blood glucose under 6.11 mmol/L (110 mg/dL)
Q3) Which of the following is a true statement about diabetes mellitus?
A) Type 2 diabetes results from a failure of the pancreas to produce insulin.
B) Diabetes is diagnosed after two fasting plasma glucose readings over 5.6-6.9 mmol/L (125 mg/dL).
C) Non-insulin dependent diabetes mellitus is another name for type 1 diabetes.
D) The incidence of diabetes mellitus does not increase with age.
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19
Chapter 18: Bone and Joint Health
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Sample Questions
Q1) An older female adult with osteoarthritis is seen by the nurse. She has a low-grade fever, and she tells the nurse that her pain is changing: it is worse at night and in her shoulder muscles. What should the nurse do to determine if the older adult is now experiencing polymyalgia rheumatica (PMR) rather than an exacerbation of her osteoarthritis?
A) Assess the patient's joints for swelling and redness.
B) Obtain blood specimens for blood cultures.
C) Direct the patient to report temporal or scalp pain.
D) Tell the patient to apply moist heat for 20 minutes.
Q2) Which of the following represents characteristics of rheumatoid arthritis (RA) that are unlike osteoarthritis (OA)?
A) RA involves myalgia and stiffness.
B) RA involves joint pain, and it is curable.
C) RA involves crepitus and instability.
D) RA is systemic and symmetrical.
Q3) Which of the following statements about osteoporosis is true?
A) Osteoporosis is indicative of an underlying health problem.
B) The most common site for osteoporosis fractures is in the long bones.
C) Women who are of African descent have the highest risk for osteoporosis.
D) A high risk of death follows an osteoporosis-related hip fracture.
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Chapter 19: Visual and Auditory Changes
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Sample Questions
Q1) Glaucoma is a major public health problem. It is estimated that 250,000 Canadians were living with glaucoma in 2009. Mr. Gonzalez, 70 years of age, has told the nurse that he is experiencing frequent headaches, poor vision in dimly lit areas, increased sensitivity to glare, "tired eyes," and some impaired peripheral vision, especially when he is driving. Which type of glaucoma is Mr. Gonzalez experiencing?
A) Primary open-angle glaucoma
B) Acute angle-closure glaucoma
C) Low tension glaucoma
D) Normal tension glaucoma
Q2) The children of an older male adult feel that he is too old to drive a car. Which assessment information about the older adult warrants further investigation by the nurse to determine his fitness to drive a car safely?
A) This older adult has recently experienced an increased rate of tripping.
B) This older adult prefers reading in a dimly lit room.
C) This older adult socializes with a partners bridge group.
D) This older adult cooks gourmet meals for entertainment.
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Chapter 20: Cardiovascular and Respiratory Disorders
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Q1) The nurse notices that an older female nursing home resident is not eating and that her heart rate is faster than usual at 110-120 beats per minute. What should the nurse do to eliminate pneumonia as a potential cause of the change in this resident's status?
A) Obtain a specimen for aerobic blood cultures.
B) Send the resident for a chest X-ray exam promptly.
C) Analyze sputum for colour, texture, and volume.
D) Compare tympanic temperature to the baseline.
Q2) The Public Health Agency of Canada and the Canadian Lung Association recommend that every older adult who will be entering a long-term care (LTC) facility as a resident will become part of communal living and must therefore undergo annual testing for tuberculosis (TB).Which of the following statements about TB in older adults is true?
A) The principal threat from TB is its highly contagious nature.
B) The tuberculin purified protein derivative (PPD) test is a conclusive test for TB.
C) Antimicrobial drugs have made TB a thing of the past.
D) Older persons who contracted TB in their youth may suffer reactivation of TB.
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Chapter 21: Cognitive Impairment
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Q1) Pharmacological interventions should not replace thoughtful and careful evaluation and management of the underlying causes of delirium. Which medication administered for delirium in a controlled environment can reduce the duration and severity of delirium for high-risk patients?
A) Haloperidol (Haldol)
B) Thioridazine (Mellaril)
C) Fluphenazine (Prolixin)
D) Chlorpromazine (Thorazine)
Q2) An older female adult has a wound infection five days after having undergone a below-the-knee amputation brought about by diabetes mellitus. What is the nurse's priority intervention to prevent cognitive dysfunction and postoperative complications in this older adult?
A) Remove invasive devices as soon as possible.
B) Minimize administration of opioid analgesics.
C) Allow for self-care and independent activities.
D) Administer short-acting benzodiazepines as needed (PRN).
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Chapter 22: Economic and Legal Issues
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Q1) Mrs. Bilyea is an 80-year-old widow who lives in a very expensive neighbourhood with her 55-year-old son. She requires minor assistance with her activities of daily living. She has recently been admitted to hospital with chest pain. The nurse examines the older adult and discovers that she has bruises on both of her upper arms. The son states that she was in the shower and fell, and while he was lifting her up, he grabbed both of her arms very tightly because she was wet and he did not want her to fall again. The nurse discusses her observations with other members of the health care team. Which statement by a member of the health care team indicates that more education is required?
A) "This could not possibly be older adult abuse. Mrs. Bilyea is white and wealthy; abuse does not happen to ladies like her."
B) "Abuse increases proportionately to the increased time needed to provide care."
C) "We are not sure what has happened so we should report our suspicions."
D) "Most abusers are either adult children or spouses."
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Chapter 23: Relationships, Roles, and Transitions
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Q1) As the wife of a university president, an older female adult met exciting people and travelled extensively until her husband died. The nurse identifies that, besides grieving an intimate partner, this woman is most likely to grieve for the loss of which area of her life?
A) Self-confidence
B) Economic security
C) Status in community
D) Intellectual stimulation
Q2) Which of the following statements about older adult relationships is true?
A) After 50 years of marriage, a couple can face new and severe challenges to their relationship.
B) Older adults are usually alienated from their family members and their care is abandoned to institutions.
C) Older adults find rewarding relationships by becoming a member of a church.
D) For older adults, friends can never take the place of family.
Q3) Which statement is true about the relationships of older adults?
A) Loneliness is evidence of self-centredness and unwillingness to love.
B) A person may be lonely even when surrounded by other people.
C) Hostile behaviour indicates that a person prefers to be left alone.
D) A pet cannot substitute for human attention.
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Page 25
Chapter 24: Mental Health and Wellness in Later Life
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Q1) An older adult female resident lowers her voice and tells the nurse that another female resident is looking at her behind her back and is going to make her move tonight with a male staff member. Which of the following ideas should the nurse include in a response to this individual?
A) Tell her that the staff receives training in ethics and will not act against another resident's interests.
B) Validate her impression and add additional information about the other resident.
C) Advise her to avoid suspicious, paranoid thinking because the staff and residents are trustworthy individuals.
D) Tell her that the nurse will look in on her and to use the call bell if she becomes frightened.
Q2) Which of the following statements about suicide among older adults is true?
A) Older adults and young adults manifest suicidal intent in similar ways.
B) Older female adults have the highest risk of suicide.
C) Ethics require that the nurse respect a person's intent to terminate his or her own life.
D) Depression and other mental health problems contribute to the risk of suicide.
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Chapter 25: Loss, Grief, Dying, and Death in Later Life
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Q1) Nurses have had strong opinions both for and against assisted passive euthanasia. Considerable confusion exists regarding terminology and interpretation of what effects the nurse's role may have in end-of-life care or palliative care. Which one of the following might constitute an example of active euthanasia?
A) Relieving patient suffering and improving the person's quality of living until death
B) Discontinuing tube feeds, but continuing with intravenous fluids
C) The physician providing the patient with sleeping pills and instructions about a lethal dose
D) A patient voluntarily requesting to be helped to die and receiving a lethal injection of pain-relieving medication
Q2) The primary difference between the Loss Response Model (LRM) and the Worden model of grief is which of the following?
A) In the Worden model, those grieving pass through stages in order.
B) The LRM uses a systems approach that acts to uphold stability.
C) In the Worden model, the system helps to maintain the equilibrium.
D) In the LRM model, those grieving transition through several stages.
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Chapter 26: Care Across the Continuum
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Q1) As the nurse admits an older female adult to a long-term care facility from her home of 50 years, the woman mistakes the nurse for her daughter. Which of the following diagnoses should the nurse consider carefully when planning care for this woman?
A) Hypoxia due to chronic disease
B) Relocation stress syndrome
C) Alzheimer's disease (AD)
D) Attention-seeking behaviour
Q2) Nurses are concerned with assessing the impact of relocation on older adults, and determining methods to mitigate any negative reactions. Which characteristic of relocation stress syndrome in a resident being transferred from acute care to a long-term care facility should the nurse be aware of?
A) Agitation
B) Feelings of loss of control
C) Presence of a caring family
D) Hallucinations
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