Nursing For Wellness in Older Adults 6th Edition by CarolMiller -Test Bank

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Nursing For Wellness in Older Adults 6th Edition by CarolMiller -Test Bank



Nursing For Wellness in Older Adults 6th Edition by CarolMiller -Test Bank

Chapter 2- Addressing Diversity of Older Adults



1. The nurse is attempting to justify the need for education in cultural competence in the health care venue. Which of the following statements accurately reflects the need for nurses to be culturally competent?
  A) Life expectancies among minorities are expected to increase while those among nonminorities are expected to decrease.
  B) Government and health care organizations have ignored the need for culturally appropriate care.
  C) The proportion of health care consumers who are minorities will increase significantly in the future.
  D) Nurses have a moral obligation to achieve cultural competency with all cultural groups.



2. The nurse is beginning a new job in an area with a large African American population. Which of the following statements recognized by the nurse best captures a characteristic of African Americans?
  A) Older African Americans are more likely than other Americans to live alone.
  B) Female-headed households are common among African Americans.
  C) African Americans have a more positive subjective self-perception of health than do other Americans.
  D) Lifestyle and risk factors account for the differences in health between African Americans and other Americans.



3. The nurse has observed an increasing number of Asian patients in the hospital. Which of the following statements is true of older Asian Americans?
  A) Chinese and Japanese Americans are likely to be recent immigrants to the United States.
  B) Health is often viewed as a state of physical and spiritual harmony.
  C) Older Asian Americans are more likely than other Americans to live alone.
  D) Care of elders is commonly provided in institutional environments such as nursing homes.



4. The nurses colleague states, Older people who live in the country are a lot healthier than city folk. How can the nurse respond most accurately to this statement?
  A) The differences arent large, but rural adults do have better health outcomes than do city dwellers.
  B) But chronic conditions are more common among rural adults.
  C) Overall, yes. Higher levels of family support translate into longer average life spans for rural adults.
  D) Unfortunately, no. And this is mostly attributable to the problem of homelessness.



5. The nurse realizes the need to educate a colleague when the colleague states the following:
  A) I know that the consequences of racism are still present and theyre linked to health disparities.
  B) Im sure the percentage of patient-care hours that we spend working with minority patients is bound to increase.
  C) Theres a huge amount of diversity within the group thats labeled Asians and Pacific Islanders.
  D) Its inaccurate to link the prevalence of particular diseases with particular minority groups.



6. A nurse has recently begun to provide care to older adults in a large, urban hospital. Having lived until recently in an ethnically homogenous region, the nurse has begun to recognize the significant differences in priorities and perspectives of patients from other cultural groups and has taken action to learn about these groups. What stage of cultural self-assessment is this nurse demonstrating?
  A) Unconscious incompetence
  B) Conscious incompetence
  C) Conscious competence
  D) Unconscious competence



7. A nurses colleague has recommended that the nurse read up on some of the more common cultural groups in the area. How should the nurse interpret information that is available about cultural groups in the United States?
  A) Cultural generalizations can be useful and accurate, but they do not replace individualized assessment and care.
  B) It is simplistic and problematic to make generalized claims about members of a particular cultural group.
  C) Characteristics of cultural groups are normally consistent between every member of that group.
  D) It is unjust to categorize individual patients as being members of a specific cultural group.



8. Following knee replacement surgery 10 days earlier, a 79-year-old woman has been diagnosed with an infection in the knee. A sample of synovial fluid has been cultured in order to determine the causative microorganism and to select an appropriate antibiotic. This course of events characterizes what major health belief system?
  A) Magico-religious paradigm
  B) Holistic paradigm
  C) Scientific (biomedical) paradigm
  D) Analytical paradigm



9. A nurse has identified several practice improvements that will promote culturally competent care. Performing a thorough and reflective cultural self-assessment will result in which of the following outcomes for the nurse?
  A) Identification of the flaws and weaknesses of the nurses own culture
  B) An accurate ranking of different cultures according to their specific merits
  C) The ability to assess patients according to their cultural affiliation rather than individual characteristics
  D) A progression from judgmental views of other cultures to a recognition of positive attributes



10. The nurse at a long-term care facility has completed the admission assessment of a 79-year-old male resident. The resident has identified himself as gay and has expressed sadness at having to leave his partner of several decades in order to move to the facility. The nurse should recognize that this resident is likely to have a history of
  A) homelessness.
  B) stigmatization.
  C) nominal employment or unemployment.
  D) infectious diseases.




Answer Key


1. C
2. B
3. B
4. B
5. D
6. B
7. A
8. C
9. D
10. B



Chapter 14- Impaired Cognitive Function- Delirium

1. Which of the following is a priority nursing intervention for the management of delirium?
  A) Giving the patient low-dose oxygenation and maintaining his or her fluid and electrolyte balance
  B) Reducing noise and placing familiar objects in the patients environment
  C) Giving the patient a clock, a watch, and calendars to provide the patient with temporal orientation.
  D) Providing psychological support through cognitive and social stimulation



2. A nurse is conducting a class at a senior citizens center on factors that protect against dementia. Which of the following statements by an older adult in the class indicates a need for further teaching by the nurse?
  A) Engaging in exercise will not help prevent symptoms of dementia.
  B) Taking vitamin C, vitamin E, and fish oil will help preserve my thinking processes.
  C) Engaging in social activities that have meaning to me will help prevent dementia.
  D) Ive heard there are studies that now say the statin drugs help prevent dementia.



3. Which of the following statements about cholinesterase inhibitors is true?
  A) Exelon (Rivastigmine) is more likely to interact with other drugs and may be poorly tolerated.
  B) Nausea, vomiting, diarrhea, and loss of appetite can be prevented or reduced by starting with a low dose.
  C) Galantamine (Reminyl) is effective only for behavioral symptoms with Alzheimers and vascular dementia.
  D) Older adults should have a drug holiday with the cholinesterase inhibitors to improve their functioning.



4. Which of the following are examples of appropriate communication techniques for dealing effectively with people with dementia?
  A) Ask open-ended questions so the person feels he or she can make choices.
  B) For people in the later stages of Alzheimers disease, talk as you would to a child.
  C) Maintain good eye contact and use a relaxed and smiling approach.
  D) When the person forgets something, remind him or her not to forget next time.



5. Which of the following interventions specifically facilitates performance of independent activities of daily living in an older adult with dementia?
  A) Using simple pictures, written cues, or color codes to identify items in the environment
  B) Offering finger foods and nutritional snacks if the person will not sit at the dining table to eat
  C) Placing nonglossy, glare-free pictures of familiar people in very visible places in the older adults environment
  D) Keeping the older persons environment free of clutter, and keeping medications and poisons in an inaccessible area



6. An 80-year-old man was referred to a neurologist after several months of worsening cognitive deficits and has subsequently been diagnosed with Alzheimer disease. Which statement by the nurse to the mans family demonstrates appropriate use of terminology?
  A) Its very difficult and stressful when a loved one becomes senile.
  B) Even though your father is demented, we will do all we can to promote his quality of life.
  C) This form of organic brain syndrome is a common health problem in the ninth decade of life.
  D) We always try our best to foster wellness in persons who have dementia.



7. Mr. Holdom was diagnosed 3 years ago with a cognitive impairment, a condition that worsened over the next several months and which culminated in his recent death. An autopsy revealed numerous infracted brain regions resulting from vessel occlusions. Mr. Holdom most likely suffered from which type of dementia?
  A) Alzheimers disease
  B) Vascular dementia
  C) Lewy body dementia
  D) Frontotemporal dementia.



8. A long-time resident of an assisted living facility has just been diagnosed with Alzheimers disease. A nurse who provides care at the facility has remarked to a colleague, Its a real shame, but at least shell never know whats happening to her. What fact should underlie the colleagues response?
  A) Older adults with Alzheimers disease and other dementias rarely have insight into their cognitive deficits.
  B) Many persons with dementia are acutely aware of the fact that they are experiencing a cognitive deficit.
  C) Certain types of dementia are occasionally marked by older adults awareness of their disease.
  D) An awareness of dementia is an indication that the condition is either latent or resolving.



9. A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. What goal should the nurse prioritize when conducting ongoing assessment of this client?
  A) Identifying strategies that can be used to cure the clients dementia
  B) Identifying genetic or lifestyle factors that may have contributed to the clients dementia
  C) Determining whether the client has Alzheimers disease, Lewy body dementia, frontotemporal lobe dementia, or vascular dementia
  D) Identifying factors affecting the clients functioning and quality of life



10. A nursing home is in the planning stages of building a new wing that will be specifically designed for the needs of older adults who have dementia. What design characteristic should be included in this new facility?
  A) Monochromatic walls and floors that are a neutral color
  B) Pictures, signs, and color codes for identifying places
  C) Bright, glossy floors that can provide sensory stimulation
  D) Bright lighting during the day and total darkness at night




Answer Key


1. A
2. A
3. B
4. C
5. B
6. D
7. B
8. B
9. D
10. B



Chapter 28- Caring for Older Adults Experiencing Pain

1. The nurse is teaching new nursing students about the differences between acute and persistent pain among older adults. Which of the following descriptors more accurately applies to persistent pain than to acute pain?
  A) Its a normal physiologic response to adverse stimuli.
  B) It may or may not be associated with a recognizable disease process.
  C) Postoperative pain is a common example for many older adults.
  D) It will normally respond to anti-inflammatory drugs and opioid analgesics.



2. The nurse is working with an older adult who is experiencing ongoing problems with pain control. Which of the following statements could the nurse best use as a principle to guide nursing practice?
  A) Increasing pain is a normal age-related change.
  B) Older adults tend to be more vocal than younger adults about making their pain issues known to care providers.
  C) Older adults experience a modest decrease in pain perception as they age.
  D) The increased prevalence of chronic conditions in older adults predisposes older adults to pain.



3. The nurse is assessing an older adult who has been experiencing pain recently. Which of the following observations should the nurse prioritize as a part of a pain assessment?
  A) The patients vital signs are within expected norms.
  B) The patient is asleep and not likely to be experiencing pain at this time.
  C) The patient has not recently reported pain to the nurse.
  D) The patient has talked recently to the nurse about the cause of the pain.



4. The nurse is working with an older adult patient with diagnoses of hyponatremia and anemia who is complaining of pain. Which of the following pieces of data should the nurse prioritize as a guide for choosing interventions?
  A) The patients medical diagnoses are normally not associated with pain.
  B) The patient is confused and complains frequently about numerous aspects of his care.
  C) The patient is complaining of intense pain that he rates at 8 out of 10.
  D) The patient does not manifest any of the common outward signs of pain.



5. The nurse is teaching an older adult about some of the risks associated with using opioid analgesics.  Which of the individuals following statements best demonstrates a sound knowledge base?
  A) I know that if I become dependent on the drug, my doctor and I will come up with a plan to discontinue it.
  B) Ill need to be careful that I dont become addicted to the drug over time.
  C) If I do develop a tolerance to the drug, I can expect some withdrawal symptoms.
  D) It sounds like I might have my dosages increased over time because of tolerance.



6. A nurse who works in a geriatric setting occasionally encounters myths and erroneous beliefs about pain in older adults. Which of the following statements by the nurses colleagues most clearly warrants further teaching?
  A) We have to treat older adults pain a lot more conservatively than younger patients.
  B) All considered, older adults tend to have more health problems than younger people and this puts them at risk of experiencing pain.
  C) The dividing lines between acute and persistent pain are sometimes not as clear as we would like them to be.
  D) Its simply not true that older adults have a blunted sensation of pain.



7. A 79-year-old woman is postoperative day 1 following total knee replacement and she has rung her call light complaining of pain. What consideration should the nurse prioritize when choosing an appropriate intervention?
  A) The fact that the woman has a documented history of persistent pain that precedes her surgery
  B) The need to ensure that the woman does not develop addiction to opioid analgesics during her course of treatment
  C) The fact that the character of the womans pain experience is determined by age-related changes
  D) The need to provide prompt, adequate relief of the womans pain



8. A 74-year-old man with a history of osteoarthritis is being treated in the hospital for pneumonia. The nurse administered 650 mg of acetaminophen 90 minutes ago and the patient is now requesting another dose. The nurse should understand that
  A) the patient is exhibiting early signs of addiction.
  B) excessive quantities of acetaminophen are hepatotoxic.
  C) the patient should have been provided with a patient-controlled analgesic (PCA) pump.
  D) the patient is experiencing nociceptive pain.



9. A nurse who provides care in a large, inner-city hospital comes in contact with patients from a wide variety of cultural groups. How is culture most likely to influence the assessment and management of pain?
  A) Cultural differences affect the intensity of pain.
  B) Culture can dictate the appropriate expression of pain.
  C) Culture should determine the choice of analgesia when treating pain.
  D) Culture is unrelated to pain because pain is a physiological, rather than psychosocial, phenomenon.



10. A nurse who oversees the care at a hospice implements a wellness approach to the pain management of older adult clients. This approach encompasses
  A) extensive teaching about the physiology of pain and pharmacodynamics of pain treatment.
  B) a clear dichotomy between the management of acute pain and the management of persistent pain.
  C) proactive pain management and the incorporation of the patients preferences.
  D) a rejection of nonopioid analgesics in favor of more effective, opioid medications.




Answer Key


1. B
2. D
3. D
4. C
5. D
6. A
7. D
8. B
9. B
10. C



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