Health Assessment of Older Adults
Practice Questions
Course Introduction
This course provides an in-depth exploration of health assessment techniques and strategies tailored specifically for older adults. Students will learn to conduct comprehensive physical, psychological, and functional assessments, taking into consideration normal aging processes, common geriatric syndromes, and the unique health challenges faced by this population. Emphasis is placed on developing critical thinking and clinical reasoning skills to accurately interpret assessment findings, identify risk factors, and design age-appropriate care plans. The course also examines the impact of culture, communication, and social determinants of health on the assessment and well-being of older adults, preparing students to deliver holistic and person-centered care in diverse settings.
Recommended Textbook
Basic Geriatric Nursing 6th Edition by Williams
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Chapter 1: Trends and Issues
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Q1) Which of the following is true of ageism?
A) It is discrimination against persons solely on the basis of age.
B) It causes a person to fear aging.
C) It involves the use of cultural sensitivity to address concerns of aging.
D) It focuses on resources for the older adult.
Answer: A
Q2) The nurse reminds a patient who was born in 1965 that eligibility for full Social Security benefits for persons of this age is now the age of __________.
Answer: 67
Q3) Which type of elder abuse is demonstrated by the nonprovision of medical care?
A) Physical abuse
B) Neglect
C) Emotional abuse
D) Self-neglect
Answer: B
Q4) The nurse clarifies that the term that refers to the promotion of high-level functioning and supportive care to older adults is __________.
Answer: gerontics
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Chapter 2: Theories of Aging
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Q1) Which of the following would be considered positive outcomes of Erikson's "life review"? (Select all that apply.)
A) Wisdom and integrated self-image
B) Comparing self with others
C) Understanding self and relationships
D) Seeking another's opinion of his or her achievement
E) Acceptance of self
Answer: A,C,E
Q2) The theory that identifies an unstable molecule as the causative factor in aging is the _____ theory.
A) free radical
B) molecular
C) neuroendocrine
D) crosslink
Answer: A
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4
Chapter 3: Physiologic Changes
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Sample Questions
Q1) What are Heberden nodes?
A) Yellow longitudinal lines in the nails
B) Thickened discolored fingernails
C) Darkened areas under the fingernail
D) Bony enlargements of distal joints of the fingers
Answer: D
Q2) 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
Q3) 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
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Page 5
Chapter 4: Health Promotion, Health Maintenance, and
Home Health
Considerations
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Q1) Which of the following tasks could not be performed by an unlicensed home health aide?
A) Transfer the patient into a bathtub.
B) Measure or dispense medication.
C) Contact family members independently.
D) Accompany the patient outside the home.
Q2) The 65-year-old overweight, hypertensive male farmer tells the home health nurse that he eats two fried eggs, four pieces of bacon, and biscuits with gravy every morning for breakfast because he believes that a robust breakfast keeps him healthy. What would be the most appropriate response by the nurse?
A) "That sort of food is not on your low-sodium diet."
B) "You won't be healthy long with a diet like that."
C) "One egg and whole wheat toast would be even healthier."
D) "You should eat whole-grain cereal with fruit instead of all that fat and sodium."
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
Page 6
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Chapter 5: Communicating with Older Adults
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Q1) In what respect do Baby Boombers differ from young adults? (Select all that apply.)
A) Experience with technology
B) Attitude about lifestyles
C) Value of money
D) Methods of communication
E) Perceptions of gender roles
Q2) What percent of communication is transmitted by verbal methods?
A) 7
B) 18
C) 22
D) 36
Q3) When asked about the severity of pain, the 93-year-old patient does not answer right away. What is the best response by the nurse?
A) Ask rapid questions: "Is it better? Is it worse than yesterday? Is it worse than this morning?"
B) Repeat the question in a louder voice.
C) Say, "You must be feeling better because you're not complaining."
D) Keep eye contact and wait for the answer.
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Chapter 6: Maintaining Fluid Balance and Meeting
Nutritional Needs
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Q1) What are contained in complex carbohydrates that make them important in the diet? (Select all that apply.)
A) Minerals
B) Fats
C) Vitamins
D) Soluble fiber
E) Polysaccharides
Q2) An older adult who is a resident in an extended-care facility would be at risk for which of the following nutritional deficits? (Select all that apply.)
A) Repetitive nature of meals
B) Lack of culturally significant food
C) Environmental odors
D) Reaction to being fed by others
E) Non-nutritious food choices
Q3) What makes up high-density lipoproteins (HDL)?
A) Mainly proteins
B) Mostly triglycerides
C) Mainly cholesterol
D) A variety of minerals
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Chapter 7: Medications and Older Adults
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Q1) Arrange the steps for preparing crushed medications to be given by feeding tube in order of priority.
A) Flush the tube to clear feeding.
B) Thoroughly crush the medication.
C) Administer each medication separately.
D) Dissolve each crushed medication in a medicine cup.
E) Flush the tube to clear the medication from the tube.
F) Reconnect the feeding tube.
Q2) The patient complains that her medications stick in her throat. What would be an appropriate response of the nurse?
A) Suggesting that she take all the pills at one time with a mouthful of water.
B) Offering the patient one pill at a time.
C) Crushing all the pills and mixing them in the patient's breakfast cereal.
D) Offering a sip of water before and after each pill.
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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Chapter 8: Health Assessment for Older Adults
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Q1) By what means can a health screening be conducted? (Select all that apply.)
A) A health professional
B) Telephone interview
C) Telecomputer
D) Pen and paper surveys
E) Lay persons
Q2) What is the correct term for the difference between the apical pulse and the radial pulse?
A) Pulse pressure
B) Pulse deficit
C) Pulse ratio
D) Pulse quality
Q3) When conducting a health assessment, which finding would be recorded as crackles?
A) High-pitched sounds in the lung bases on inspiration
B) Continuous low-pitched snoring sounds over major bronchi
C) Squeaky musical sounds on expiration
D) Coarse grating sounds on inspiration and expiration
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Chapter 9: Meeting Safety Needs of Older Adults
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Q1) The nurse is volunteering at a homeless shelter. What intervention should be taken for a patient admitted with severe hypothermia?
A) Give the person hot coffee or soup.
B) Place the person in a warm bath.
C) Briskly rub the person's hands.
D) Wrap the person in blankets.
Q2) What is a common reason that an older adult may deny that he has fallen?
A) Fear that he will fall again
B) Fear of being hospitalized for treatment
C) Afraid of being seen as frail and dependent
D) Fear of being considered clumsy
Q3) The home health nurse conducts a safety assessment in a patient's home. Which of the following would be identified as a fire hazard?
A) Baking soda near the stovetop
B) A smoke detector in the kitchen
C) Multiple appliances plugged into one outlet
D) A metal container for cigarettes
Q4) The nurse takes into consideration that the most common injuries to the older adult are the result of __________.
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Chapter 10: Cognition and Perception
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Q1) Antipsychotic medication can be prescribed to control which of the following?
A) Disruptive verbal behavior
B) Constant yelling and hitting others
C) Hallucinations
D) Disorientation
Q2) How should the nurse approach a patient who has profound hearing loss?
A) Knock on the door before entering.
B) Touch the patient on the hand to gain attention.
C) Give the patient a list of interventions that the nurse plans to perform.
D) Speak in a higher tone of voice.
Q3) The nurse instructs a hearing-impaired patient on some methods to improve communication, which include __________. (Select all that apply.)
A) informing others of the hearing deficit
B) focusing on the speaker
C) facing the speaker
D) requesting the speaker to shout if necessary
E) asking the speaker to repeat what is not clear
Q4) The nurse explains that the term that describes the ability to make judgments quickly on the basis of unfamiliar stimuli is __________ __________.
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Chapter 11: Self Perception and Self-Concept
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Q1) 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
Q2) What symptom could be an indicator of depression in an 80-year-old man?
A) Repetitive routines
B) Agitation and irritability
C) Constant talking
D) Seeking the company of family members
Q3) What can the long-term care nurse do to best relieve anxiety in a female resident?
A) Stimulate her with group activity.
B) Sedate her to allow her to sleep.
C) Provide her with coffee for relaxation.
D) Offer her a diversion of a quiet activity.
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Chapter 12: Roles and Relationships
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Q1) What is grief a normal response to? (Select all that apply.)
A) Loss of loved ones
B) Loss of professional roles
C) Loss of dependence
D) Loss of health
E) Loss of relationships
Q2) What is the status of any role based upon?
A) Age
B) Responsibility
C) Society
D) Health
Q3) Which stage of grief usually resolves after approximately 2 weeks?
A) Disorientation
B) Shock and numbness
C) Reorganization
D) Searching and yearning
Q4) The nurse uses a diagram to depict __________, which is a term for interaction between different roles.
Q5) A society that has numerous subcultures with different or conflicting expectations is said to be a(n) __________ society.
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Chapter 13: Coping and Stress
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Q1) When are stress-related physical, behavioral, and cognitive changes more likely to occur?
A) When the stress has a sudden onset
B) When stress is low level but constant
C) When stress is varied and cumulative
D) When stress is suppressed or denied
Q2) What does a person experience as stress increases? (Select all that apply.)
A) Widened focus
B) Decreased problem-solving ability
C) Indecisiveness
D) Irrational behavior
E) Attention to detail
Q3) Why is depression a common symptom in older adults who have been admitted to a long-term care facility? (Select all that apply.)
A) Their usual coping skills have been overwhelmed.
B) They think that they have no family support.
C) They have self-knowledge that will enable them to cope with new situations.
D) They find support of self-worth through activities and making new friends.
E) They actively seek assistance to reduce depression.
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Page 15
Chapter 14: Values and Beliefs
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Q1) An 80-year-old Orthodox Jewish patient dies in the hospital. What should be the first action by the nurse?
A) Notify the rabbi to send a member of the synagogue to stay with the body.
B) Inform the mortuary about the desire of the patient to be cremated.
C) Prepare the body for the ritual bath by temple members before embalming.
D) Facilitate removal of the body because the burial must take place 48 hours after death.
Q2) What is included in the spiritual beliefs of Native Americans?
A) There is no life after death.
B) All things in the world have a spirit.
C) After death, the spirit stays as part of the tribe.
D) The spirit world is the protector of health.
Q3) A terminally ill Roman Catholic patient asks the nurse to place spiritual objects near her bed. What would the nurse place at the bedside?
A) Koran and prayer mat
B) Rosary and vial of holy water
C) Torah and prayer shawl
D) Bible and whole kernels of corn
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Chapter 15: End-of-Life Care
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Q1) What are a person's perceptions regarding end-of-life care dependent upon?
(Select all that apply.)
A) Age
B) Gender
C) Cultural background
D) Caregivers
E) Life experiences
Q2) Why should an 86-year-old man with a terminal illness be encouraged to file an advance directive?
A) To demonstrate understanding of his imminent death
B) To comply with most hospital policies
C) To clarify treatment protocols
D) To spare his family the burden of making end-of-life decisions
Q3) A dying patient is receiving 2 mg of morphine sulfate every hour. The patient's daughter is worried about oversedation. What does the nurse explain that this small dose of morphine controls?
A) Dyspnea
B) Pain
C) Hallucinations
D) Fatigue
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Chapter 16: Sexuality and Aging
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Q1) The home health nurse takes into consideration the concerns of aging gay and lesbian couples, which include __________. (Select all that apply.)
A) health care providers being willing to discuss a homosexual union
B) the health care system's focus on heterosexuality as the norm
C) difficulty finding senior housing as a homosexual couple
D) fear of discrimination based on sexual orientation, resulting in substandard health care
E) delay of entry to a long-term care facility because of the possibility of not being able to share a room
Q2) The nurse is counseling a 70-year-old patient regarding vaginal dryness. Which statement by the patient would indicate a need for further teaching?
A) "Vaseline was good enough for my mother. It's good enough for me."
B) "I use a water-soluble lubricant to aid intercourse."
C) "I'm trying an estrogen cream to see if it works."
D) "I'll let you know how wild yams work for vaginal dryness."
Q3) The nurse explains that a decrease in estrogen and __________ are responsible for the changes in the female reproductive system.
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Page 18
Chapter 17: Care of Aging Skin and Mucous Membranes
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Q1) A dark-complexioned African American has a suspected skin breakdown over the trochanter. What would be appropriate measures for the nurse to implement during the assessment? (Select all that apply.)
A) Use a halogen light to examine the area.
B) Palpate for local edema in the area.
C) Touch the area to feel for changes in tissue temperature.
D) Assess for localized pain.
E) Press the area to test for blanching.
Q2) 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
Q3) When the patient complains of dry mouth, what should the nurse assess for?
A) Difficulty in chewing and swallowing
B) Mouth ulcerations
C) Adequate intake of vitamin B
D) Inflammation of the tongue
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Page 19
Chapter 18: Elimination
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Q1) 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
Q2) What are causes of bowel and bladder elimination problems in the older adult?
(Select all that apply.)
A) Daily use of laxatives for defecation
B) Inability to get to adequate water
C) Fear of pain with defecation
D) Total privacy during elimination
E) Use of a bedpan for elimination
Q3) What influences regular bowel patterns? (Select all that apply.)
A) Level of activity
B) Diet
C) Medication
D) Fluid intake
E) Lifestyle
Q4) The nurse is aware that the urge to defecate is increased peristalsis stimulated by the defecation reflex and the __________ reflex.
20
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Chapter 19: Activity and Exercise
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Q1) What are the effects of decreased speed impulses in the older adult?
A) A "scrambled" message in the brain
B) Longer time required to complete an activity
C) Increased confusion
D) Forget how to complete an activity
Q2) To increase safe mobility for a patient recovering from a fractured left hip, the nurse would instruct the patient to place the cane on the __________ side.
Q3) On what day should an outing to the park for a group of older adults be canceled?
A) 75-degree sunny day in Texas
B) 70-degree cloudy day in Oregon
C) 80-degree sunny day in Florida
D) 75-degree ozone alert day in California
Q4) What would be included in a plan of care that is custodial in its focus?
A) Attention to high-level wellness
B) Plans for physiologic and safety concerns
C) Aggressive rehabilitation goals
D) Patient participation in his or her own care
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Chapter 20: Sleep and Rest
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Q1) In what stage of sleep is sleepwalking most likely to occur?
A) Stage 1 NREM
B) Stage 2 NREM
C) Stage 4 NREM
D) REM sleep
Q2) What can alter an older adult's diurnal patterns? (Select all that apply.)
A) Shift work
B) Time zone changes
C) Altered nutrition
D) Illness
E) Medications
Q3) What factors can contribute to sleep apnea? (Select all that apply.)
A) Obesity
B) Diabetes
C) Hypotension
D) African American heritage
E) Use of alcohol
Q4) The nurse clarifies that the individual's pattern of wakefulness and sleeping is referred to as the __________ rhythm.
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