Long-Term Care Nursing Solved Exam Questions
Course Introduction
Long-Term Care Nursing focuses on the specialized knowledge and skills required to care for individuals with chronic illnesses, disabilities, or those who require prolonged assistance due to aging. The course covers the principles of person-centered care, interdisciplinary team collaboration, ethical and legal considerations, management of complex health conditions, and communication with patients, families, and other healthcare professionals. Emphasis is placed on promoting quality of life, functional independence, and emotional well-being for residents in long-term care settings such as nursing homes, assisted living facilities, and home care environments.
Recommended Textbook Ebersole and Hess Gerontological Nursing Healthy Aging 4th Edition by Theris A. Touhy
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25 Chapters
426 Verified Questions
426 Flashcards
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Chapter 1: Introduction to Healthy Aging
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) The nurse develops a community program to promote exercise for older adults.Which should the nurse include in the exercise program?
A) Reinforce the ease of exercising every day.
B) Use exercise to relax any dietary restrictions.
C) Describe ways to resume exercise after lapses.
D) Participate because exercise achieves wellness.
Answer: C
Q2) An older woman has left-sided paralysis from a thrombus formation in the cerebral vasculature.Rank the nursing goals of this woman's plan of care in order of importance,starting with the most important goal.
A)Instruct her to call for help before moving.
B)Maintain her blood pressure below 120/80 mm Hg.
C)Reinforce occupational therapy for feeding.
D)Use range-of-motion exercises to prevent contractures.
E)none of the above
Answer: B,A,D,C
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3
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 patient who has an ulcer.How is this nurse demonstrating leadership in the care of older people?
A) Assessing older adults effectively
B) Facilitating access to elder care programs
C) Coordinating members of the health care team
D) Empowering older adults to manage chronic illness
Answer: C
Q2) Which was the first formal action the ANA took in relation to gerontological nursing?
A) Established a national geriatric nursing group
B) Defined educational standards for gerontology
C) Created the ANA Division of Geriatric Nursing
D) Formed the Council of Long Term Care Nurses
Answer: A
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4
Chapter 3: Care Across the Continuum
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Sample Questions
Q1) A resident of a long-term care facility has been asking to have the drain in the bathroom sink repaired for 2 months.The nurse responds by saying that when they move to the new building,the sinks will work very well.Which right of a resident of a long-term care facility has the nurse violated?
A) Right to be free of all forms of abuse
B) Right to be transferred for appropriate reasons
C) Right to voice grievances and have them remedied
D) Right to information about conditions and treatments
Answer: C
Q2) Which home modification interventions are designed to enhance the ability of older adults to remain in their homes?
A) A 36-inch-wide doorway
B) Entryways with less than two steps
C) Electrical outlets at chest level
D) A bathroom on the first floor
Answer: A,D
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Chapter 4: Culture and Aging
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Sample Questions
Q1) The nurse prepares an older woman,who is Polish,for discharge through an interpreter and notes that she becomes tense during the instructions about elimination.Which intervention should the nurse implement?
A) Move onto the discussion about medication.
B) Ask the older woman how she feels about this topic.
C) Instruct the interpreter to repeat the instructions.
D) Have the older woman repeat the instructions for clarity.
Q2) Which action should the nurse take when addressing older adults?
A) Speak in an exaggerated pitch.
B) Use a lower quality of speech.
C) Use endearing terms such as "Honey."
D) Speak clearly.
Q3) A nurse caring for older adults must be aware of which consequences of ageism in language?
A) Reduced sense of self
B) Poor nutritional intake
C) Lowered self-esteem
D) Decreased memory performance
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Chapter 5: Theories of Aging and Physical Changes
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Sample Questions
Q1) The latest trends in medicine encourage health care providers to prescribe nutrient-dense foods and exercise to prevent or delay the shortening of telomeres.On which biological theory of aging are these practices based?
A) Genetic research
B) Caloric restriction
C) Pacemaker theory
D) Cross-link theory
Q2) Which factor(s)associated with aging contribute(s)to the high incidence of type 2 diabetes mellitus in older adults?
A) Fewer T-lymphocytes
B) Less lean muscle mass
C) Decreased thyroid function
D) Decreased physical activity
E) Left ventricular hypertrophy
F)Decreased insulin sensitivity
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Chapter 6: Social, Psychological, Spiritual, and Cognitive Aspects of Aging
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Sample Questions
Q1) The nurse provides opportunities for nursing home residents to read aloud to others.Which cognitive skill is this nursing intervention most likely to improve?
A) Verbal fluency
B) Logical analysis
C) Object naming
D) Visuospatial skills
Q2) Which of the following is a true statement about the theories of aging?
A) Research data support the disengagement theory, activity theory, and continuity theory.
B) Everyone should be able to achieve the three tasks of Peck's model of integrity.
C) The exercise of rights is not a task of aging in Kelly's model.
D) A person may choose to avoid pursuing inner discovery in older age.
Q3) Which statements are true about aging and the brain?
A) Most areas of the brain do not lose brain cells.
B) Memory decline is inevitable as people age.
C) Basic intelligence remains unchanged with age.
D) The brain does not continue to make new brain cells.
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Page 8
Chapter 7: Assessment and Documentation for Optimal Care
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Sample Questions
Q1) The nurse scans an older man's identification band in preparation for medication administration.Which step should the nurse implement next?
A) Ask the patient to state his name.
B) Check for allergies to the medication.
C) Document the medication as given.
D) Administer the patient's medication.
Q2) Which of the following is a true statement about documentation?
A) Nurses should keep records of patients' wishes.
B) Patients do not have access to their own medical records.
C) The Outcomes and Assessment Information Set (OASIS) is a complete record of the health status of a patient.
D) The nurse is responsible for completing all of the Minimum Data Set (MDS).
Q3) Which of the following does the nurse use to categorize the desired end result of nursing care delivered to a patient when using problem-oriented nurses' notes?
A) North American Nursing Diagnosis Association (NANDA) nursing diagnosis
B) Nursing Goals Classification
C) Nursing Outcomes Classification (NOC)
D) Nursing Interventions Classification (NIC)
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Chapter 8: Safe Medication Use
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Sample Questions
Q1) Which interaction between each prescription and food or nutritional supplement is favorable?
A) Warfarin (Coumadin) and ginkgo biloba
B) Terazosin (Hytrin) and increased fluids
C) Lithium (Eskalith) and low-sodium diet
D) Warfarin (Coumadin) and leafy, green vegetables
Q2) An older woman who takes escitalopram (Lexapro)10 mg by mouth daily states she does not feel better after 1 week of treatment.Rank the interventions in order,starting with the first intervention the nurse should implement to facilitate patient compliance with therapy.
A) Tell her that the beneficial effects can take 4 to 6 weeks to appear.
B) Instruct her to take the medication as prescribed without stopping.
C) Suggest hard candy, ice chips, and sips of water for a dry mouth.
D) Collaborate with the health care provider to provide an increased dose.
E) None of the above
Q3) Which process is increased in the early morning?
A) Fibrinolytic activity
B) Blood plasma
C) Asthma symptoms
D) Rheumatoid arthritis pain
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Chapter 9: Nutrition and Hydration
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Sample Questions
Q1) Which of the following is a true statement about fluid intake for older adults?
A) Daily total volume should be 1500 ml to 2000 ml.
B) Coffee is a suitable beverage for maintaining hydration.
C) Caffeinated beverages are sometimes preferable to water.
D) Total daily fluid intake should be approximately 10 ml per kg of body weight.
Q2) The following nursing interventions represent each of the four steps of a nutritional assessment.Rank them in order,beginning with the first step.
A)Measure the midpoint of the upper arm.
B)Obtain blood for serum transferrin level.
C)Examine the lips,gums,and oral cavity.
D)Ask for an up-to-date list of medications.
E)None of the above
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) Dentures should be cleaned once a day by brushing and soaking in a cleaning solution.
D) A little blood on the toothbrush is normal.
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11
Chapter 10: Elimination
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Sample Questions
Q1) A large residual urine volume characterizes what type of incontinence?
A) Urge
B) Stress
C) Overflow
D) Functional
Q2) The nurse evaluates the urinalysis (UA)of a female patient with an indwelling urinary catheter.The UA report shows gross contamination of the urine.Rank the nursing interventions in order,beginning with the first intervention the nurse should implement.
A)Provide perineal hygiene.
B)Provide urinary catheter care.
C)Check the duration of catheterization.
D)Obtain a urine specimen from a sterile port.
E) None of the above
Q3) The nurse understands that stress incontinence occurs:
A) With a urinary tract infection (UTI)
B) Because of emotional strain
C) As a result of increased intraabdominal pressure
D) With a specific amount of urine in the bladder
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Page 12
Chapter 11: Rest, Sleep, and Activity
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Sample Questions
Q1) An older man has Alzheimer disease,and his wife says he is up and wandering around the house at night.Which intervention should the nurse implement to increase the man's duration of sleep?
A) Instruct the wife to increase his daily physical activity.
B) Collaborate with the health care provider to administer a hypnotic medication.
C) Teach the wife how to apply a vest restraint during sleep.
D) Help the wife plan daily periods for napping and activity.
Q2) An older woman 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 rituals.
D) Propose volunteer work at a thrift shop.
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Chapter 12: Promoting Healthy Skin and Feet
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19 Verified Questions
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Sample Questions
Q1) Which topical agent is safe to apply?
A) Cornstarch 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) Light mineral oil to moisten skin after bathing
Q2) The nurse identifies which of the following intervention(s)in the treatment of fungal infections?
A) Eliminate the conditions that created the problem.
B) Lubricate affected area daily with moisturizing lotion.
C) Thoroughly clean and dry skin daily.
D) Use an antibacterial cleanser daily.
E) Apply miconazole (Micatin)as directed.
Q3) The nurse is conducting an admission assessment on an older adult and notes a small lesion with a multicolor appearance.Which assessment approach should the nurse use?
A) Braden Scale
B) Wound staging
C) ABCD (asymmetry, border, color, diameter) rule
D) Pressure ulcer scale for healing (PUSH) tool
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Page 14
Chapter 13: Promoting Safety
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Sample Questions
Q1) Which of the following statements is true about a safe,effective care environment for older adults?
A) Cold beer with steak and potatoes is a good meal for an older adult on a hot day.
B) Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers.
C) Barrier-free buses and low fares make public transit a safe transportation option.
D) A nurse's perception of temperature is a useful guide for patient thermal needs.
Q2) An older man was oriented and responded appropriately in the hospital,but he is now disoriented and confused in his home after discharge.Which of the following issues is the first that the home nurse should examine to determine whether an environmental issue is contributing to the patient's condition at home?
A) Complaints of shivering
B) Temperature of household
C) Types of food preparation
D) Presence of radon
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15
Chapter 14: Living With Chronic Illness
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Sample Questions
Q1) Which of the following is a true statement about Medicare for older adults?
A) Eighty percent of Medicare's annual expenditures are for individuals with chronic illnesses.
B) Medicare enrollees spend under $1500 annually for out-of-pocket expenses related to chronic illnesses.
C) Complementary and alternative medicines (CAM) are not covered by Medicare.
D) Medicare covers care for those who have trouble with activities of daily living.
Q2) Which factor(s)is(are)modifiable health risk behaviors for chronic illness?
A) Physical activity
B) Prescription medication use
C) Poor nutrition
D) Tobacco use
Q3) Over 50% of the population,aged 65 years and older,suffers from which one of the following chronic health conditions?
A) Hypertension
B) Renal failure
C) Multiple sclerosis
D) Cancer
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16
Chapter 15: Pain and Comfort
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Sample Questions
Q1) An older adult admitted for back surgery asks for opioid pain medication.The nurse knows the patient asks for pain medication 15 minutes before it is due.Which recommendation should the nurse implement?
A) Validate the pain with other assessment data.
B) Administer the pain medication as requested by the patient.
C) Tell the patient that it is too soon for pain medication.
D) Teach the patient alternative comfort measures.
Q2) The safest opioid analgesic choice for an older patient who has severe acute pain is which of the following?
A) Meperidine (Demerol)
B) Pentazocine (Talwin)
C) Morphine sulfate (Morphine)
D) Safe opioids do not exist.
Q3) Which of the following statement(s)is(are)true about pain in older adults?
A) Pain is not a normal aging process.
B) Pain sensitivity decreases with age.
C) If patients do not complain, they do not have pain.
D) Opioid analgesics are often the best treatment for persistent pain.
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Chapter 16: Diseases Affecting Vision and Hearing
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15 Verified Questions
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Sample Questions
Q1) Which of the following is used to treat the most common cause of impairment to an older person's hearing?
A) Hearing aids
B) Cochlear implants
C) Ear canal irrigation
D) Sign language
Q2) The nurse is teaching older adults about maintaining health and wellness.Which recommendation should the nurse include in the teaching to maintain optimal vision?
A) Take 50,000 units of vitamin A daily.
B) Wear sunglasses that block sun rays.
C) Read in good light to avoid eye strain.
D) Visit the ophthalmologist every 5 years.
Q3) The nurse recognized which of the following as symptoms of wet age-related macular degeneration (AMD)?
A) Rarely causes severe visual impairment
B) Yellow deposits under the retina
C) Decrease in central vision
D) Visual distortion
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18
Chapter 17: Metabolic Disorders
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Sample Questions
Q1) The nurse assists an older man who has type 2 diabetes mellitus to improve his glucose control.Which of the following instructions does the nurse give to this individual when he plans to walk more than usual in one day?
A) Omit antidiabetic medication.
B) Wear sturdy open-toed shoes.
C) Supplement caloric intake.
D) Prepare to administer insulin.
Q2) Which co-morbidity commonly associated with type 2 diabetes mellitus enhances the development of the microvascular complications of diabetes mellitus?
A) Hyperlipidemia
B) Hypothyroidism
C) Venous insufficiency
D) Chronic constipation
Q3) Which is the best 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.
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Page 19
Chapter 18: Bone and Joint Problems
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Sample Questions
Q1) Which of the following characteristics of RA are unlike those of OA?
A) Myalgia and stiffness
B) Joint pain that is curable
C) Crepitus and instability
D) Systemic and symmetrical
Q2) An older adult who has OA receives a prescription for alendronate (Fosamax).Which instruction should the nurse include in patient teaching?
A) Use with a bisphosphonate medication.
B) Is available for oral use.
C) Take this medication for up to 2 years.
D) Consume up to 600 mg of calcium daily.
Q3) Which assessment is typical for a patient with OA?
A) Narrow joint spaces with crepitus
B) Effects in symmetrical joints
C) Morning stiffness for at least an hour
D) Swelling from excess synovial fluid
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20
Chapter 19: Cardiovascular and Respiratory Disorders
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Sample Questions
Q1) Which of the following is a true statement about tuberculosis (TB)in older adults?
A) The principal threat from TB is its highly contagious nature.
B) The tuberculin purified protein derivative (PPD) is a conclusive test for TB.
C) Antimicrobial drugs have made TB an infection of the past.
D) Older persons, particularly those in nursing homes, are at risk for TB.
Q2) An African-American 58-year-old man in good health has a blood pressure at 120/73 mm Hg at his annual physical examination.Which of the following is the best goal for the nurse to use to assist him in maintaining his health and wellness into older age?
A) Alter modifiable risk factors.
B) Prevent cardiovascular disease.
C) Recognize disease in early stage.
D) Maintain tight glycemic control.
Q3) The nurse should instruct a patient on which of the following modifiable risk factor(s)for essential hypertension?
A) Tobacco use
B) Alcohol
C) Stress management
D) Adequate rest
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21
Chapter 20: Neurological Disorders
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Sample Questions
Q1) Which of the following are common side effects of PD and the medications used to treat it?
A) Skin irritation
B) Dyskinesias
C) Dystonia
D) Nausea
Q2) _____________ _____________ is the result of a lesion in the part of the brain adjacent to the primary auditory cortex (Wernicke area).
Q3) Which of the following statements is true about dysarthria?
A) Does not affect intelligence.
B) Stems from severe rheumatoid arthritis.
C) Physical therapy can be beneficial.
D) Can affect the balance.
Q4) Which of the following statements is true about Parkinson disease (PD)?
A) Drinking large amounts of alcohol can relieve symptoms of essential tremor.
B) Motor tremors and slow movement accompany severe cognitive impairment.
C) Lewy body dementia (LBD) is the most common form of dementia.
D) Older adults taking rasagiline (Azilect) must avoid eating foods containing tyramine.
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Page 22
Chapter 21: Cognitive Impairment
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Sample Questions
Q1) Which of the following statements is true about cognitive impairments in older adults?
A) Loss or interruption of sleep can lead to delirium.
B) Confusion is a normal and unavoidable consequence of aging.
C) Older patients who are agitated often have a lower cognitive status than those who are quietly sitting.
D) The Mini-Mental State Examination-2nd edition (MMSE-2) should be administered on admission to detect delirium.
Q2) A definitive diagnosis of Alzheimer disease (AD)can be made by detecting or using which one of the following methods?
A) Clinical observation of dementia
B) Inability to speak with relevance
C) Development of neurofibrillary tangles
D) Computed axial tomographic (CAT) scan
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Chapter 22: Mental Health
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Sample Questions
Q1) An older man,who has activity intolerance as a result pulmonary fibrosis,barks orders and commands at the nursing staff when he cannot help himself.Which of the following is the nurse's first priority patient outcome for planning care to resolve this problem?
A) Verbalizes requests in a calm, respectful, and appreciative manner.
B) Identifies potential triggers of anger, and positively redirects energy.
C) Expresses an understanding of the need to balance rest and exercise.
D) Resolves the pulmonary fibrosis to restore baseline activity tolerance.
Q2) Although the older man who was forced to retire from law enforcement has multiple physical complaints,the primary care health care provider finds nothing abnormal.After the man tells the nurse that his girlfriend just left him,which of the following is the priority nursing intervention to complete before the older adult leaves?
A) Ask him how he plans to cope with his loss.
B) Use direct questions about access to firearms.
C) Collaborate with his provider for antidepressants.
D) Allow him to express himself by intently listening.
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24
Chapter 23: Economic and Legal Issues
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Q1) The nurse understands which of the following indicator(s)describe(s)the profile of an elder abuser?
A) Does not have a history of abuse.
B) Has mental health problems.
C) Has substance abuse problems.
D) Is stressed with the caregiving role.
Q2) Which of the following statements is true about case management and care management for older adults?
A) A case manager works for a health care system to save time and money.
B) Care managers are usually paid from public agencies such as the Area Agency on Aging (AAA).
C) One nurse can only perform care management.
D) The Outcomes-Based Quality Improvement system is designed to evaluate the expected benefit of a procedure.
Q3) Which is the fundamental difference between Medicare Part A and Medicare Part B?
A) Hospice care
B) Health care setting
C) Home care services
D) Invasive procedures
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Chapter 24: Relationships, Roles, and Transitions
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Q1) Which population(s)is(are)most at risk for developing HIV?
A) Those over the age of 50 years
B) Women
C) Those who are cognitively impaired
D) Those who are sexually active
Q2) Which of the following statements is true about the role of grandparents?
A) The usefulness of grandparents declined with the advent of the industrial age.
B) Today, many grandparents are the primary caregivers of their grandchildren.
C) The value of grandparents is to provide gifts to younger family members.
D) Traditionally, parents are subordinate to the grandparents in caregiving.
Q3) Which one of the following older adults is most likely to need preretirement counseling to avoid significant concerns in retirement?
A) African-American woman who is a certified public accountant
B) Mexican-American woman who receives cash for cleaning services
C) Middle-aged man who has a history of type 1 diabetes mellitus
D) Older male clerk who works for the Department of Homeland Security
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Chapter 25: Loss, Death, and Palliative Care
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Q1) Which of the following is a true statement about loss,dying,and death for older adults?
A) Men and women tend to respond similarly to the loss of a spouse.
B) Visions on the part of a person who has lost a spouse are not normal grief reactions and should be regarded as signs of underlying defects.
C) The grieving process is not rigidly structured.
D) Bereaved persons regain their normal capability approximately 6 months after loss, and regressive behavior after that time should be discouraged.
Q2) The son of an older adult couple ends his life suddenly and violently.The husband proceeds with living as usual.After 1 year,the wife remains in seclusion and is hospitalized for dehydration.Which steps should the nurse implement to help improve the wife's mental health and wellness?
A) Encourage additional fluids and social activity.
B) Instruct the husband to display empathy for her.
C) Establish a trusting, caring relationship with her.
D) Ask social services for a survivor's support group.
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