Long-Term Care Nursing Final Exam
Course Introduction
Long-Term Care Nursing focuses on the specialized care provided to individuals with chronic illnesses, disabilities, or age-related conditions who require extended nursing support. This course explores the roles and responsibilities of nurses in various long-term care settings, such as nursing homes, assisted living facilities, and home health care. It examines best practices in patient assessment, individualized care planning, and interdisciplinary collaboration, emphasizing the promotion of quality of life, dignity, and autonomy for residents. Ethical and legal considerations, communication strategies, and evidence-based interventions for common geriatric syndromes and chronic diseases are also covered, preparing students to deliver compassionate, holistic care in long-term care environments.
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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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 nurse is completing discharge instructions for an 88-year-old patient who is being discharged from the hospital following a myocardial infarction.She provides him with written literature on heart healthy diets,exercise,and smoking cessation.His daughter states,"I don't know why you are bothering,what difference is it going to make? He has been smoking and eating poorly for years; he isn't going to change now." This statement reflects the concept of:
A) reality orientation.
B) character assessment.
C) negative stereotyping.
D) senescence.
Answer: C
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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Sample Questions
Q1) You are caring for a 90-year-old resident of an assisted living facility.He seems sad and depressed and frequently talks about how his health has declined during the past few years.He talks about all of the things he planned to do once he retired,but was not able to due to a recent stroke.You respond to him by helping him understand that changes in health are often a challenge that older adults must cope with and adapt to in order to age successfully.This response is based on what type of aging theory?
A) Biological
B) Psychological
C) Social
D) Spiritual
Answer: B
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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Sample Questions
Q1) Select the statement about wellness that best applies to your client,who is terminally ill with end-stage prostate cancer.
A) Wellness is possible even if he refuses to assist in management of his medical care.
B) Wellness is unfortunately not a realistic option for him.
C) Wellness is the same thing as faith healing,and if he would be more receptive,he could be back at active gardening in a few weeks.
D) Your nursing interventions can help empower him to achieve a higher level of wellness.
Answer: D
Q2) 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
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Chapter 4: Physiological Changes with Aging
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Sample Questions
Q1) In implementing care for an elderly bedridden client,which nursing intervention reflects appropriate action to compensate for normal changes of aging to her immunological system?
A) Turning her every 2 hours to maintain intact skin integrity
B) Administering prophylactic antibiotics
C) Inserting multiple intravenous lines in case fluid resuscitation becomes necessary rapidly
D) Drawing daily laboratory values for complete blood count with differential to analyze for "shift to the left"
Q2) You have four rooms to choose from for your elderly client to be admitted this afternoon.Which room would you choose?
A) A brightly lit,blue room with cozy throw rugs
B) An orange carpeted room with soft lighting
C) A brightly lit,blue room with an EZ-Glide wax floor
D) A combination television/children's playroom with cute pastel wall hangings.
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Chapter 5: Laboratory Values and Diagnostics
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Sample Questions
Q1) A 69-year-old patient in the geriatric clinic has his annual physical examination,and a complete blood count and serum electrolytes are drawn.His laboratory results show an elevated blood urea nitrogen (BUN).What is the next action of the nurse?
A) Assume that the laboratory result was a false-positive because the patient did not exhibit any symptoms of renal failure.
B) Look at his medication list because an elevated BUN may be the result of specific medications.
C) Instruct him on collecting a 24-hour urine specimen for protein analysis.
D) Tell him that an elevated BUN is normal in older adults.
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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Sample Questions
Q1) When comparing the Older American's Resources and Services (OARS)with the Katz index of ADLs,what is true?
A) The Katz index and the OARS both measure only ADL performance.
B) The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz index measures only ADL performance.
C) The OARS is used only for older adults in the long-term care setting; the Katz index is used in all settings.
D) The OARS is not valid for use in older adults who are cognitively impaired,whereas the Katz index is.
Q2) A 78-year-old man is being evaluated in the geriatric clinic.His daughter reports that he has been very forgetful lately,and she is concerned that he might be "senile." The advanced practice nurse administers the clock drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape.Based on his performance,the nurse concludes that the patient:
A) probably has Alzheimer's disease.
B) needs further evaluation.
C) probably has delirium.
D) needs a functional status assessment.
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Chapter 7: Managing Basic Physiological Needs
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Sample Questions
Q1) 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)
Q2) An older adult has Alzheimer's disease.His wife says he gets up at night and wanders around the house.What suggestion given by the nurse would be most appropriate?
A) "Ask your physician to prescribe strong sedatives."
B) "Increase his daily activity by taking him on frequent walks."
C) "Try using a restraint jacket at night."
D) "He needs his rest,so make sure he takes a nap during the day."
Q3) 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.
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Page 9
Chapter 8: Biological Maintenance Needs
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Sample Questions
Q1) Your 70-year-old client has been coming to the clinic for 5 years for medical follow-up of her osteoporosis.Lately she has been complaining of dry skin,and she asks for your advice.What would be the best suggestion you could offer her?
A) Use extra soap to moisturize the skin.
B) Keep bath water at a moderate temperature-90 to 105 degrees F.
C) Move to a climate with lower humidity.
D) Dry vigorously with a rough towel after bathing.
Q2) 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
Q3) A basal cell carcinoma is characterized by:
A) a persistent red lesion with a poorly defined base and an adherent yellow-white scale.
B) a slightly raised discolored patch that may be tan,blue,red,black,or white.
C) an open sore that bleeds,oozes,or crusts and remains for 3 weeks or more.
D) rough,scaly,sandpaper-like patches.
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Chapter 9: Nutritional Needs
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Sample Questions
Q1) An 80-year-old patient has gout.Diet teaching should include the avoidance of alcohol and:
A) foods high in purine.
B) foods high in calcium.
C) foods high in phosphorous.
D) foods high in magnesium.
Q2) 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.
Q3) Factors that make older adults more susceptible to dehydration than younger adults include the following except:
A) decreased percentage of body fat.
B) decreased percentage of body water.
C) decreased concentrating ability of kidneys.
D) decreased thirst sensation.
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11
Chapter 10: Chronic Disease in Late Life
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Sample Questions
Q1) Treatment of a cerebrovascular accident (CVA)with thrombolytic therapy:
A) is used for both thrombotic and hemorrhagic CVAs.
B) is indicated if the first symptoms of the CVA have occurred within 6 hours or less.
C) is given to dissolve the clot and reestablish circulation to the affected part of the brain.
D) is not associated with serious complications.
Q2) 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.
Q3) 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.
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Chapter 11: Pain and Comfort
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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) A 77-year-old female patient is admitted to the hospital for pneumonia.She has a history of lung cancer with metastases to bone.She is ordered a long-acting opioid administered around-the-clock.Her daughter asks you why the pain medication is ordered in that manner.You base your answer knowing that:
A) administering opioids around-the-clock prevents the development of an addiction.
B) administering opioids around-the-clock provides more stable therapeutic plasma levels of the drug.
C) administering opioids around-the-clock prevents the many side effects of opioids.
D) administering opioids around-the-clock requires the use of less opioid.
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13
Chapter 12: Geropharmacology
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14 Flashcards
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Sample Questions
Q1) The Beers list is a list of medications that should not be used in older adults.The reason that the medications should not be used is that:
A) they are not covered by Medicare Part D prescription drug benefit.
B) they have a higher than usual risk for older adults.
C) they are likely to be abused by older adults.
D) they cause allergic reactions in older adults.
Q2) 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?"
Q3) Tardive dyskinesia is defined as an irreversible movement disorder characterized by:
A) a compulsion to be in motion.
B) facial movements and involuntary twisting of the limbs,trunk,neck,and face.
C) an inability to move.
D) a bilateral tremor and rigidity.
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Page 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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Sample Questions
Q1) In altered perceptual organization,disorientation usually occurs first in which domain?
A) Time
B) Person
C) Place
D) Situation
Q2) A 69-year-old patient reports that she is having difficulty hearing.Which interventions would the nurse perform? (Select all that apply.)
A) Perform a Rinne test.
B) Eliminate extraneous noise in the environment.
C) Speak in an extra loud tone of voice.
D) Review prescribed medications.
Q3) An 86-year-old nursing home resident is being evaluated for a hearing disorder.What is the most common and easily corrected of all interferences in the hearing of older adults?
A) Otosclerosis
B) Tinnitus
C) Cerumen impaction
D) Ototoxic drug therapy
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Page 16
Chapter 15: Mobility
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Sample Questions
Q1) A nurse is making a visit to the home of an 88-year-old client.The nurse reviews safety measures with the client and screens the home environment for potential hazards that could precipitate a fall.The nurse urges the client to eliminate:
A) night lights.
B) railings on the stairway.
C) throw rugs.
D) the use of a cane.
Q2) An 88-year-old woman is admitted to the hospital with a diagnosis of pneumonia.She has a history of hypertension and congestive heart failure and is on a total of five different medications for these chronic conditions.The nurse caring for the woman develops a care plan that includes the diagnosis Risk for falls.A priority nursing intervention for this client is to:
A) perform a fall assessment.
B) keep all of the side rails up on the client's bed at nighttime.
C) place the client on bedrest so that she does not fall.
D) assess the client's dietary intake for calcium adequacy.
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Chapter 16: Environmental Safety and Security
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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 cost of nursing home care is significant.The primary payer for nursing home care is:
A) Medicare.
B) Medicaid and private pay.
C) long-term care insurance.
D) Medi-Gap insurance.
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) 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.
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19
Chapter 18: Frailty,Vulnerability,and Elder Mistreatment
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Sample Questions
Q1) A visitor to a nursing home witnesses an attendant scolding a client with dementia about being incontinent.The visitor reports the incident to the charge nurse.This is an example of:
A) caregiver burnout.
B) exploitation.
C) psychological abuse.
D) neglect.
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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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) 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.
Q3) What is true regarding aging and sexuality?
A) Sexuality is important as long as one is not institutionalized.
B) One's sexuality can give meaning to life and bolster security,belonging,and esteem.
C) The sexual emphasis in later life is on procreation.
D) One cannot possess sexual health if widowed.
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Chapter 20: Relationships,Roles,and Transitions
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Sample Questions
Q1) An 82-year-old widow with Alzheimer's disease is being cared for at home by her daughter.Twice a week,the widow goes to an adult day care program.This is an example of:
A) long-term care.
B) a PACE program.
C) transitional care.
D) respite care.
Q2) Lesbian,gay,bisexual,and transgender older adult couples face additional challenges as they age.All are challenges frequently encountered except:
A) ability to access social security and health care benefits of partner.
B) health care systems geared to special needs of lesbian,gay,bisexual,and transgender older adults.
C) same-gender marriages not recognized in all states in the United States.
D) family members not recognized as relatives in the traditional sense.
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22
Chapter 21: Culture,Gender,and Aging
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Sample Questions
Q1) 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.
Q2) 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.
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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) An 87-year-old client is being discharged from the subacute facility to home with a sterile dressing on her right leg.You are her nurse and are responsible to teach her how to change the dressing.The following are important concepts to consider except:
A) assessing client readiness to learn.
B) teaching a family member because older adults are usually not able to learn new tasks.
C) providing enough time to respond because older adults' reaction times are often slower than younger adults.
D) using audio,visual,and tactile clues to reinforce learning.
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25
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) 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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Chapter 25: Emotional Health in Late Life
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Sample Questions
Q1) Your elderly client has just suffered a myocardial infarction.Upon discharge,he says to you,"I watched all those heart videos and stuff,but I still insist it was just indigestion." In formulating a response,you recognize that he is showing signs of:
A) denial.
B) projection.
C) altruism.
D) deficient knowledge.
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 is discussing hospice care with the wife of an 88-year-old patient who has end-stage liver cancer.The wife is worried that Medicare will stop paying for hospice at home if her husband lives longer than 6 months.What can the nurse tell the wife in order to allay her anxiety?
A) Medicare does not limit the hospice benefit.
B) The doctor should explain the hospice benefit.
C) The finance department should answer questions about hospice benefits.
D) Most patients with liver cancer do not live longer than 6 months.
Q2) An 82-year-old patient has end-stage congestive heart failure.Her primary care physician requests a consult from the palliative care service to assist in developing a discharge plan of care.Her son asks the nurse,"What is palliative care? Does it mean Mom is going to die in the next few days?" The nurse's best response is:
A) "Palliative care is only available to persons in the last 6 months of life."
B) "Palliative care focuses on care rather than cure."
C) "Palliative care is only offered to patients whose deaths are imminent."
D) "Palliative care means that your mother will not be resuscitated in the event of a cardiac or respiratory arrest."
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Chapter 27: Self-Actualization,Spirituality,and Transcendence
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Sample Questions
Q1) You are the nurse manager of the geriatric unit in a large teaching hospital.You partner with the nurse manager of the pediatric unit to arrange an intergenerational holiday party.Your rationale for doing this includes the following except:
A) intergenerational activities can help older adults establish new relationships. B) intergenerational activities are required by state and local regulatory agencies. C) intergenerational activities can increase self-esteem of the younger people. D) intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpose.
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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