Exam Review

A health care provider asks the nurse about an older adult client's durable power of attorney (POA) because consent is needed for a medically necessary invasive procedure. The client has end-stage disease, is intubated, and is on mechanical ventilation. Which steps should the nurse implement?
A)
Assist with obtaining informed consent from the client.
B)
Refer to the client's advance directive for a name.
C)
Determine the client's inability to make reasonable decisions.
D)
Use the oral trail-making test to measure cognitive function.
Which of the following is a true statement about nutrition for older adults?
A)
Transportation can be a critical factor in nutritional insufficiency in older adults.
B)
Soul food is a concern primarily for the African-American culture.
C)
No government programs promote congregate dining among older adults.
D)
The older person should be encouraged to practice strict controls on cholesterol intake to ensure protection against heart disease
Which of the following statements is true about conservators?
A)
Because a conservatorship is the least restrictive alternative, a court hearing is not required
B)
The most legally restricting way individuals and property can be handled are through conservatorships and guardianships.
C)
A conservatorship entails control over property, whereas a guardianship entails control over the person.
D)
Conservators cannot be members of the conservative's (client's) family
Components to a cognitive assessment include which of the following? (Select all that apply.)
(SATA)
A)
Comprehensive assessment
B)
Assessing for atypical presentation of Illness
C)
Complete blood count
D)
Differentiating delirium, dementia, and depression

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Exam Review

As a nurse caring for a cognitively impaired older adult client, you need to observe for which of the following? (Select all that apply.)
(SATA)
A)
Pointing to a grimacing face or crying
B)
Staring off into space
C)
Aggression
D)
Agitation
E)
Increased confusion
F)
Decreased passivity
An older client's daughter asks a nurse the following: "I have heard about Pace programs and think that it might be a good option for my parent Can you tell me more about what the qualifications to be part of a Pace program are?" The nurse includes which of the following in her response to the family member? (Select all that apply.)
(SATA)
A)
Participants in Pace programs must be able to perform their own ADLs Independently.
B)
Participants in Pace programs must have been residents in a nursing home prior to enrollment in the Pace program.
C)
Participants in Pace programs must be eligible for either Medicare or Medicaid.
D)
Pace programs only provide service to individuals who are age 55 and over.
E)
Pace programs provide services to individuals who meet the criteria for nursing home admission
What are the benefits associated with telehealth technology? (Select all that apply.)
(SATA)
A)
Facilitates remote physical assessment and monitoring of chronic conditions
B)
Decreases costs by replacing the role of the nurse with technology
C)
Reimbursed by all health care insurances
D)
Promotes self management of illness in rural and underserved areas
E)
Decreases costs by reducing hospital readmissions
Which of the following statements are true about Medicare-part 8 supplemental insurance? (Select all that apply.)
(SATA)
A)
It covers the costs of outpatient services.
B)
It must be purchased and is a subsidized medical policy
C)
It covers the costs of speech therapy.
D)
It covers medication costs

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Exam Review

The nurse is trying to improve the nutritional status of residents in the nursing home. Which recommendations should the nurse implement?
(SATA)
A)
Develop a seating chart for the main dining room based on the unit to facilitate a more organized and efficient meal delivery
B)
Provide nutritious food according to the residents' expressed food preferences.
C)
Replace the fluorescent lighting with candles at every table to create a cozy, restaurant-like atmosphere.
D)
Distribute "med-pass nutritional supplements.
An older client is being discharged from the hospital to a sub-acute unit. The client says to a nurse, "I am not sure I understand the difference between a sub-acute unit and a nursing home. Can you help me understand?" The nurse considers which of the following in formulating a response:
A)
Sub-acute care is more intensive than traditional nursing home care
B)
Sub-acute care and nursing home care are identical
C)
Sub-acute care is reimbursed by either Medicaid on private pay
D)
Professional nursing staff levels are the same as those in traditional nursing home settings
An older adult client who is cognitively intact and has decision-making capacity makes a decision to stop chemotherapy for breast cancer after being told of further spread of the cancer. The client's daughter is upset at her parent's decision an approaches the nurse and states: "I don't agree with the decision to stop treatments, I am my parent's health care proxy, I want to override that decision." What is the best response by the nurse?
A)
"As the health care proxy, you are the one who makes the decisions. Let's call your mones doctor.
B)
"I understand why you are so upset. I don't think she is doing the right thing either. Let us think together how we can change her mind
C)
You will need to go to court and be declared a guardian"
D)
"Health care proxies only come into play when the individual can no longer make their own decisions. Your mother is able to make her own decisions. I suggest you talk with her."
Which of the following assessments should be included in a post fall prevention assessment of an older adult? (Select all that apply.)
A)
Functional status
B)
Medical history
C)
Financial status
D)
Occupational history
E)
Physical status
F)
Environment

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Exam Review

A nurse conducts a comprehensive assessment of an older adult client. The nurse utilizes the Mini-Cog, a valid and reliable assessment tool to assess the individual's mental status. The nurse understands that the benefit of utilizing a standard assessment tool is what?
A)
A standard assessment tool will increase likelihood of obtaining accurate data.
B)
A standard assessment tool is required by Medicare and Medicaid,
C)
A standard assessment tool will increase reimbursement by Medicare and Medicaid.
D)
A standard assessment tool will increase the client's confidence in the nurse.
What components are included in a person-centered community? (Select all that apply.)
A)
Optimize physical health
B)
Provide financial assistance
C)
Provide social engagement
D)
Maximize independence
E)
Address basic needs
A home health nurse is making a home visit to an older adult client. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. The nurse recommends that the client eliminate which of the following? (Select all that apply.)
A)
Night lights
B)
Excess clutter
C)
Loose carpeting on the floors
D)
Railings on the stairway
E)
The use of a cane
Which of the following is a true statement about elimination in older adults?
A)
Defecation less than once each day is not necessarily constipation.
B)
Leaking liquid feces should be treated as diarrhea.
C)
Mineral oil is recommended as a laxative for the older adult
D)
Excessive sleep can be a symptom of constipation

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Exam Review

When assessing your client who has a history of falls, you should pay particular attention to which of the following? (Select all that apply.)
A)
Hearing
B)
Vision
C)
Cognitive disorders
D)
Preprandial hypotension
E)
Orthostatic hypotension
To prevent malnutrition in older clients with dementia, which of the following would benefit your client? (Select all that apply.)
A)
Making refreshment stations readily available
B)
Caloric supplements with the meals
C)
Providing feeding assistance
D)
Optimal social supports
Which recommendations for daily food intake is correct for older adults according to the MyPlate for Older Adults? (Select all that apply.)
A)
Two servings of deep-colored fruit
B)
Six or more servings of fortified, enriched, or whole grain foods
C)
Three or more servings of low-fat or nonfat dairy products
D)
Three 8 ounce glasses of water
E)
Four or more servings of high quality protein
F)
One or two servings of brightly colored vegetables
A nurse admitting and orienting an older adult to the hospital unit discusses fall prevention and demonstrates the use of the call bell to the patient. The patient's daughter asks: "Why don't you just put up all the side rails to prevent my mother from getting out of bed by herself and falling. That should work, right?" What is the nurse's best response?
A)
"Side rails do not decrease falls, but they do decrease fall related injuries."
B)
"There is no evidence that side rail use decreases falls, and in fact, there is a greater risk of injury."
C)
"Side rails are only effective when used with patients who have dementia"
D)
Side rails have only proven to be effective in decreasing falls in patients who have already fallen."

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Exam Review

A 79-year-old client resides independently in the community. The visiting home health nurse finds that despite it being 90°F outside, the windows are closed and the client is wearing a sweater. The nurse initially recognizes that this behavior may be related to what?
A)
Age-related motor deficiencies that result in self-neglect
B)
Age-related neurosensory changes that diminish awareness of temperature changes
C)
Delirium-related to an acute illness that is affecting body heat production
D)
Cognitive changes that diminish the individual's awareness of temperature changes
A nurse counseling an 85-year-old person regarding modifying driving habits would include
A)
driving in heavy traffic is fine as long as it is not raining.
B)
if you have a passenger, you may drive at any time of the day.
C)
limit driving to familiar places close to home.
D)
playing music will help keep you alert.
The overall temperature in the gerontological unit is 62°F during the evening shift. In documenting this concern to the administration, which factor is the most important for the health and well-being of older adults?
A)
Some of the residents are wearing blankets around their shoulders to keep warm.
B)
It feels much warmer in the administration wing than out in the client care areas
C)
An ambient temperature of 62°F is unsuitable for older people because they have impaired thermoregulation
D)
It is not fair for older adults to have to deal with an uncomfortable environment
Which patient assessment data does the nurse recognize could contribute to an older adult's risk of hyperthermia?
A)
Keeps room temperature at 72°F
B)
Has a history of osteoarthritis
C)
Takes furosemide 40 mg daily
D)
Bathes daily with a hot shower

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