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

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




Nursing For Wellness in Older Adults 6th edition by CarolMiller

1. The nurse is discussing an older adults recent diagnosis of rheumatoid arthritis with a colleague. Which of the nurses statements reflects an accurate view of the relationship between aging and wellness?
  A) Its important that the individual knows this is an expected part of growing older.
  B) We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis.
  C) We need to make sure our teaching is not too detailed for someone of his age.
  D) We need to ensure his expectations of continuing to live alone are realistic.



2. The nurse is teaching an older person about the concept of successful aging. Which of the nurses questions addresses an important contributor to successful aging?
  A) Are you largely free of acute or chronic illnesses?
  B) Do you feel financially secure?
  C) Do you feel like you actively engage with life?
  D) Do you have a reliable support network?



3. An older adult has recently begun to display unprecedented lapses in short-term memory. The nurse overhears a colleague reassuring the person by saying, Try not to worry; its just a part of growing older. The nurse recognizes that this is an example of what phenomenon?
  A) Multiple jeopardy
  B) Gerontophobia
  C) Age attribution
  D) Implicit ageism



4. The nurse hears a colleague make the statement, Most older adults have nothing to worry about financially. Which of the following statements reflects an accurate response to this?
  A) You have to remember that theres a huge economic disparity among older adults.
  B) Actually, the number of older people living below the poverty line has been increasing, not decreasing.
  C) This isnt really true now, but it is true that the gaps that disadvantaged groups live with are expected to shrink.
  D) This is true for some groups, but not for minorities who are less likely to be living with their relatives.



5. The nurse is conducting a study on the needs and living situations of older adults in the community. Which of the following statements should the nurse take into account?
  A) A majority of older Americans will live in a nursing home at some point.
  B) More older men live alone than older women.
  C) Assisted-living arrangements have become increasingly common.
  D) Most older Americans reside in some form of institutional arrangement.



6. A nurse who provides care to many older adults recognizes the importance of implementing a wellness approach to care. What principle underlies this approach to the health care of older adults?
  A) Older adults have decreasing expectations for wellness as they move through the aging process.
  B) Health problems are a Western cultural construct that has no objective, physiological basis.
  C) Older adults must come to accept a decline in wellness as they age.
  D) A holistic approach to caring for older adults can foster their well-being at every stage of life.



7. A diabetes nurse is providing care for a 73-year-old man who is a regular client of the hospitals outpatient diabetes clinic. What assessment question most clearly addresses this clients potential for optimal function?
  A) What are some goals that you have for maximizing your level of wellness?
  B) How can we help you to take ownership of your own health?
  C) Is there anything that youre doing that might be exacerbating your diabetes?
  D) How long do you think that youll be able to live independently?



8. Mr. Say is an 81-year-old man whose current hospital admission has been prompted by an exacerbation of his chronic renal failure. The nurse who is caring for Mr. Say is aware of the importance of fostering his wellness, a goal that can be achieved by emphasizing which of the following?
  A) Comparing Mr. Says health to other patients who are more ill
  B) Exploring Mr. Says abilities and strengths
  C) Advocating that Mr. Says code status be changed to do not resuscitate
  D) Teaching Mr. Say that his health problems do not have to affect his daily routines



9. A nurse administrator is involved in strategic planning for a large long-term care facility that has locations in numerous regions of the country. The nurse should anticipate what trend when planning for the future care of older adults?
  A) A gradual decline in overall life expectancy
  B) A decrease in the proportion of older adults who are members of minority groups
  C) Average longevity of males exceeding that of females
  D) Increased use of assisted living facilities by older adults



10. A notable demographic trend that is expected to become more pronounced involves the sandwich generation. Which of the following individuals exemplifies the demands and challenges experienced by the sandwich generation?
  A) A 50-year-old woman who balances the care of her 82-year-old father and her 20-year-old son
  B) A 58-year-old man whose elderly parents have been forced to live in separate care facilities
  C) An 83-year-old man who is the sole caregiver for his 79-year-old wife.
  D) A 70-year-old woman who must accommodate her own health problems with the care of her grandson




Answer Key


1. B
2. C
3. C
4. A
5. C
6. D
7. A
8. B
9. D
10. A
1. The nurse is using the Functional Consequences Theory as a lens for planning patient care in a health care facility.  The nurse recognizes that which of the following is an element of this nursing theory?
  A) Most problems affecting older adults may be attributed to age-related changes.
  B) Most functional consequences cannot be addressed through nursing interventions.
  C) Wellness is a concept that is broader than just physiologic functioning.
  D) The Functional Consequences Theory is a more comprehensive alternative to holistic nursing care.



2. The nurse is working with a 79-year-old female patient with a diagnosis of osteoporosis.  Which of the following interactions best exemplifies the nurses understanding of the relationship between age-related changes and risk factors?
  A) The nurse performs strength and mobility training appropriate to the patients age and diagnosis.
  B) The nurse teaches the patient about bone density in older women and the role of vitamin D and calcium intake.
  C) The nurse plans interventions in light of the body-mind-spirit interconnectedness of the patient.
  D) The nurse teaches the patient about how her risk factors are a consequence of age.



3. The nurse is teaching a colleague about the difference between age-related changes and risk factors. Which of the following examples best demonstrates an age-related change?
  A) An older adult with a diagnosis of diabetes mellitus
  B) An older adult who is obese
  C) An older adult with obstructive lung disease
  D) An older adult with decreased bowel motility



4. The nurse is differentiating between an 81-year-old patients age-related changes and his risk factors for disease.  Which of the following characteristics of the patient would the nurse consider as a risk factor?
  A) Chronic bronchitis
  B) Loss of bone density
  C) Decreased vital lung capacity
  D) Delayed gastric emptying



5. The nurse is identifying positive functional consequences as part of the development of an older patients care plan. Which of the following statements best captures the concept of positive functional consequences?
  A) They are synonymous with functional assessment.
  B) They are the result of conscious intent.
  C) They are not outcomes of age-related changes.
  D) They result from automatic actions or purposeful interventions.



6. The Functional Consequences Theory accounts for the important role that each of the domains of nursing play in the wellness of older adults. Which of the following situations best demonstrates the effect of environment on the older adult?
  A) A resident of a care facility experiences a fall because there are not grab bars outside his bathtub.
  B) A hospital patient develops Clostridium difficile-related diarrhea because a care provider did not perform adequate hand-washing.
  C) A man cannot afford a wheeled walker and suffers a fall while trying to mobilize using his cane.
  D) A woman develops emphysema as a result of her 70 pack-year history of cigarette smoking.



7. The Functional Consequences Theory can be applied to promote wellness in older adults in diverse settings. Which of the following examples demonstrates this application?
  A) Organizing an interdisciplinary meeting to discuss the available treatment options for an older adult with an acute illness
  B) Facilitating early mobilization to prevent muscle wasting and loss of function in an older hospital patient
  C) Deferring the final decision regarding an older mans choice of assisted living facility to the mans son and daughter
  D) Placing a 76-year-old woman on the waitlist for a kidney transplant



8. A nurse is aware that addressing issues related to connectedness and quality of life is central to the Functional Consequences Theory. Which of the following actions is most likely to enhance the older adults connectedness?
  A) Teaching a patient who has had a below-the-knee amputation how to care for his stump
  B) Organizing a clients intravenous antibiotic therapy on an outpatient basis
  C) Performing a focused respiratory assessment on a client who has a diagnosis of lung cancer
  D) Changing a policy so that a husband and wife can remain in the same room of a care facility



9. A nurse who provides care for older adults in a long-term care setting is aware of the importance of maintaining residents connectedness to society. How can this aspect of quality of life be best achieved?
  A) Ensuring that there are multiple television sets available to residents of the facility
  B) Arranging regular visits by school children to the facility
  C) Conducting reminiscence therapy
  D) Allowing residents to have input into the meal planning at the facility



10. A 79-year-old man is dismayed that his drivers license will not be renewed, an action that his primary care provider states is a result of his loss of visual acuity and increased reaction time. This man is experiencing the consequences of
  A) risk factors.
  B) age-related changes.
  C) positive functional consequences.
  D) wellness outcomes.



1. The nurse is explaining to a new colleague the similarities and differences between gerontology and geriatrics.  Which of the following situations would most likely be addressed by a geriatrician rather than a gerontologist?
  A) Teaching older adults techniques to identify and deal with age-related changes
  B) Organizing and leading exercise classes to facilitate mobility
  C) Identifying and treating a patients vascular dementia
  D) Rearranging an older adults apartment to minimize the risk of falls



2. The nurse works with a program that performs interviews, blood work, and digital rectal exams aimed at identifying older men with benign prostatic hyperplasia (BPH).  The program also facilitates bathroom alterations in older adults homes to ensure men with BPH have easy access to a toilet.  Which of the following components of health promotion has yet to be implemented in the program?
  A) Screening
  B) Risk assessment
  C) Environmental modification
  D) Risk reduction interventions



3. The nurse is teaching nursing students about the importance of health promotion among older adults.  Which of the following statements by the students indicates a need for further teaching?
  A) Teaching older adults how to live with diabetes would be a useful health promotion initiative.
  B) I can see why we would want to promote timely discharge back to the community following hospitalization.
  C) I think that attending to spiritual growth could likely be a part of health promotion.
  D) If we could promote healthy, simple diets, then some diseases could likely be prevented.



4. Which of the following interventions most closely aligns with the practices of health promotion?
  A) Leading a flexibility and mobility class among older adults
  B) Providing presurgical teaching to an older adult prior to hip replacement
  C) Administering an anti-inflammatory and analgesics to an older adult with osteoarthritis
  D) Teaching an older adult how to administer her inhaled bronchodilators independently



5. Which of the following circumstances would be most likely to render a screening program unnecessary?
  A) Treatment of the disease is available at low cost.
  B) The disease follows a predictable course.
  C) The disease is more common among older adults than among younger and middle-aged adults.
  D) The symptoms of the disease appear at the same time that it is detectable by screening.



6. A nurse who works with older adults is teaching a colleague about the similarities and differences between gerontology and geriatrics. Which of the following questions best conveys the focus of gerontology?
  A) How can we secure more funding for research and development of drugs specifically for older adults?
  B) How can we teach older adults about the relationship between their lifestyle and their health?
  C) How can we help older adults maintain wellness as they age?
  D) How can we reduce the incidence of falls among older adults who live in care facilities?



7. Despite the fact that older adults are proportionately the highest users of health care services, many nurses harbor misconceptions and deficits in practice related to gerontological nursing. What is the most likely solution to this problem?
  A) A shift from the treatment of older adults in institutional settings to home care
  B) Increased nursing education and clinical experience specific to working with older adults
  C) A focus on early discharge planning for older adults in hospital settings
  D) Increased use of aggressive pharmacological interventions in the treatment of acute illnesses in older adults



8. Mr. Dey is a 69-year-old man who has been a cigarette smoker since his late teens. In recent weeks, he has asked the nurse who helps manage his diabetes numerous questions about the potential benefits of quitting smoking, a subject that he has normally avoided in past interactions. The nurse has now explicitly asked Mr. Dey if he would like to quit smoking, to which he has replied that he will give it some serious thought. Mr. Dey is demonstrating what stage of the transtheoretical model (TTM)?
  A) Precontemplation
  B) Preparation
  C) Contemplation
  D) Action



9. A gerontological nurse who works in a public health setting has limited funding for initiatives. Which of the following prevention and health promotion initiatives is most likely to result in significant benefits for the older adults who participate?
  A) A awareness program that promotes screening sigmoidoscopy
  B) Teaching older adults about falls prevention in the home
  C) A program of bone density screening for older adults
  D) An exercise program for older adults who live in the community



10. A group of community health nurses is using the transtheoretical model (TTM) as the foundation of a new health promotion campaign for older adults. What goal for the participants are the nurses likely to promote when working with older adults in the program?
  A) A recognition of the importance of screening for common health problems
  B) Increased participation in exercise programs and an awareness of the relationship between exercise and wellness
  C) The replacement of participants unhealthy behaviors with healthy behaviors
  D) An awareness of the differences between life expectancy and active life expectancy



1. The nurse is responsible for assessing an older adult in an acute care setting. Which of the following statements most accurately captures the complexity involved in assessing the older adult?
  A) Older adults manifest fewer symptoms of illness than do younger patients.
  B) Signs and symptoms of illness are often obscure and less predictable among older adults.
  C) Care must be taken to avoid assessing normal, age-related changes.
  D) Older adults experience fewer acute health problems but more chronic illnesses than do younger patients.



2. An 82-year-old man is getting advice from a family member on how to drive safely. What piece of advice should the older adult follow?
  A) Avoid modifying your vehicle with devices that were not supplied by the manufacturer.
  B) Realize that normal, age-related changes should not affect your ability to drive safely.
  C) You can consider timing your medications to avoid their interfering with safe driving.
  D) You should transition from driving to using public transportation as soon as possible.



3. The nurse is conducting a functional assessment of a resident who has recently moved to the assisted-living facility. Which of the following statements best describes functional assessment?
  A) It excludes information on the residents medical diagnoses and health problems.
  B) It is a rehabilitative approach focused on the residents ability to perform self-care tasks.
  C) It is an alternative to assessing the residents activities of daily living (ADLs).
  D) It prioritizes the residents ability to perform roles in relationships and in society.



4. As part of a functional assessment, the nurse is assessing an older adults activities of daily living (ADLs) and instrumental activities of daily living (IADLs).  What piece of assessment data would most likely be considered an IADL rather than an ADL?
  A) The older adult is able to ambulate to and from the bathroom at home.
  B) The older adult can feed herself independently.
  C) The older adult can dress in the morning without assistance.
  D) The older adult is able to clean and maintain her own apartment.



5. The nurse is employed in a Medicare- and Medicaid-funded nursing home. Which of these statements is true of the functional assessments the nurse is likely to perform?
  A) The nurse will address core activities of daily living (ADLs) but not more complex instrumental activities of daily living (IADLs).
  B) The nurse will identify changes in the older adults function over time.
  C) The nurse will utilize various functional assessment models.
  D) The main goal of functional assessments will be to ensure older adult safety.



6. A nurse who provides care in a nursing home has completed the admission assessment of an 84-year-old man who has just moved from an assisted living facility. The nurse would document a deficit in the residents activities of daily living (ADLs) in light of what assessment finding?
  A) The man experiences chronic pain as a result of rheumatoid arthritis.
  B) The man is able to ambulate with a wheeled walker for 60 ft but then requires a rest break.
  C) The man is able to wash himself but requires assistance entering and leaving the bathtub.
  D) The man is unable to explain the rationale for each of the medications that he receives.



7. A 79-year-old woman has been admitted to a nursing home primarily because her diagnosis of Alzheimer disease has progressed from the mild stage to the moderate stage. How should the nurse proceed with functional assessment in light of the womans cognitive deficits?
  A) Obtain assessment data from the womans family members and friends.
  B) Utilize an assessment tool that is specifically designed for use with cognitively impaired clients.
  C) Perform assessment passively by observing and recording the womans behavior and actions over the next several days.
  D) Document the fact that it is not possible to accurately gauge the womans activities of daily living.



8. A nurse who works in an acute care for elders (ACE) unit has observed that a female patient on the unit frequently stumbles when she ambulates with her walker. How should the nurse best follow up this observation?
  A) Provide a wheelchair for the patient to use for the duration of her hospital stay.
  B) Ask the patient to remain in her bed or in a chair as much as possible and teach her about falls risks.
  C) Place a chair in the hallway so the patient can take a rest break when she feels unsteady on her feet.
  D) Liaise with an occupational therapist to ensure that the womans mobility is thoroughly assessed and an appropriate assistive device is provided.



9. Staff members at a nursing home have been reminded by management of their responsibility to utilize the Minimum Data Set (MDS) for Resident Assessment and Care Screening. When should the MDS be used?
  A) Upon resident admission and every 3 months after that
  B) Once per week for the first month after admission and once per month after that
  C) Whenever a registered nurse or physician documents a significant change in a residents level of function
  D) Daily, as part of routine assessment in the facility



10. Assessment of an older adults activities of daily living (ADLs) addresses parameters such as mobility, dressing, and elimination. In addition to such functional parameters, assessment of ADLs should also address
  A) pain and range of motion.
  B) mental status.
  C) previous medical history.
  D) integumentary assessment.



1. A nurse is leading a word-quiz game with a group of nursing home residents because the nurse knows this activity will assist the residents in maintaining
  A) Fluid intelligence
  B) Adaptive thinking
  C) Crystallized intelligence
  D) Psychomotor memory



2. A 69-year-old woman has recently been diagnosed with mild cognitive impairment and has asked the nurse to help her remember things better. Which of the following nursing diagnoses is appropriate for this older adult?
  A) Knowledge deficit
  B) Altered thought processes
  C) Health-seeking behaviors
  D) Altered health maintenance



3. A 70-year-old man tells his nurse that he is worried that Im losing his mind. He reports that he has difficulty remembering names as well as he used to, and adds that he has missed two health care appointments in the past month because he forgot about them. The nurse initiates a memory training program for him, although the nurse has been unable to identify any risk factors that might affect the older adults cognitive abilities. Which of the following questions is the best approach to evaluating the effectiveness of the memory training program?
  A) Have you seen an improvement in your memory?
  B) Are you less worried about your memory now?
  C) How have the memory training techniques helped you?
  D) Are you using the memory training techniques now?



4. Which of the following teaching methods is most appropriate for a 1-hour group health education program on nutrition for older adults?
  A) Limiting background noise and using a brightly colored Food Guide Pyramid
  B) Establishing a learning environment that is challenging and stimulating
  C) Giving the participants a handout and allowing them to take notes
  D) Using an overhead projector to list nutritional requirements for older adults



5. Which of the following points should the nurse emphasize when educating older adults about memory and cognition?
  A) Long-term memory loss is normal.
  B) Using calendars, notes, and imagery can help enhance memory.
  C) Drinking caffeinated beverages for mental stimulation is a good idea.
  D) Having a diminished capacity for learning is an inevitable part of growing older.



6. A 54-year-old woman has brought her father to an appointment at a community clinic because of his increasingly frequent lapses in memory. What assessment question is most likely to identify his potential risk factors for impaired cognitive functioning?
  A) What did your mother and father die of?
  B) What line of work were you in?
  C) What medications are you currently taking?
  D) Where are you currently living?



7. A 74-year-old man is distraught at the fact that he recently forgot an important appointment as well as lost his wallet. The man has always prided himself in being intelligent, alert, and informed, so even minor lapses in cognition are a source of stress. How should the mans nurse best interpret these recent deficits in memory?
  A) The man is likely experiencing the early stages of Alzheimer disease.
  B) The man is likely experiencing a temporary state of delirium that will self-resolve.
  C) The man may be experiencing age-related changes in personality.
  D) The man may be experiencing benign senescent forgetfulness.



8. A nurse leads a reminiscence session each Monday afternoon at a long-term care facility. Why does storytelling hold the potential for a positive impact on the cognition of older adults?
  A) Storytelling is a therapeutic distracter from daily stressors that negatively impact cognition.
  B) Creative activities can positively benefit the structure, and thus function, of the brain.
  C) Creative arts and storytelling provide accurate assessment data on which appropriate care can be based.
  D) Reminiscence therapy promotes social interaction and relieves symptoms of dementia and delirium.



9. A nurse who provides care in a long-term care setting is aware that the cognitive function of older adults does not necessarily decline on an inevitable trajectory. What action has the greatest potential to enhance the cognitive function of residents and prevent cognitive declines?
  A) Encourage older adults to openly express their emotions and opinions.
  B) Provide residents with four or five low-fat, high-protein meals during the day.
  C) Encourage older adults to participate in mentally stimulating activities.
  D) Present older adults with numerous opportunities to make autonomous decisions.



10. Mrs. Terence, age 82, lives with a number of health problems, including type 2 diabetes and chronic venous ulcers. Despite these challenges, she has confided in the nurse that she feels more satisfied with her life now than when she was a younger woman. Mrs. Terence is exemplifying what phenomenon?
  A) Metamemory
  B) The paradox of well-being
  C) Crystallized intelligence
  D) Neuroplasticity



1. A 62-year-old man who works in a factory on an assembly line takes indomethacin (Indocin) for arthritis. He recently read in a magazine that older individuals should take baby aspirin to decrease the incidence of heart disease. He takes an adult dose of aspirin instead of baby aspirin, because he didnt think it would make a difference. Soon after, he starts to have problems with his hearing and with ringing in his ears. Which of the following problems should the nurse suspect?
  A) Tinnitus
  B) Vertigo
  C) Ototoxicity
  D) Noise-induced hearing loss



2. A new nursing assistant asks the nurse how best to approach a hearing-impaired older adult. Which of the following approaches should the nurse recommend?
  A) Raise the volume of your voice
  B) Leave the radio on to calm the older adult
  C) Lower the tone of your voice
  D) Use exaggerated lip movements



3. A nurse is teaching a group of hearing-impaired nursing home residents about hearing aids. Which of the following points should be stressed?
  A) It is not necessary to use the hearing aid for one-on-one conversations.
  B) The hearing aid should be used in the dining room or social area.
  C) While inserting the hearing aid, make sure the volume is turned off.
  D) If whistling is heard, the volume of the hearing aid may need to be increased.



4. When the nurse finds that an older adults ear canal is impacted with cerumen, what is the priority nursing intervention?
  A) Refer the person to an otolaryngologist.
  B) Check for contraindications to ear canal irrigation.
  C) Allow the cerumen to drain naturally.
  D) Begin irrigating the affected ear canal.



5. An 85-year-old woman who lives alone says to the nurse, There is nothing I can do about my hearing. I am 85 years old, and I am not really interested in listening to television programs anymore. Which of the following would be the nurses best response?
  A) You are lucky you still live alone at 85, and I understand why you dont care about the programs on television.
  B) Have you talked with your health care provider about a hearing evaluation? This would determine the problem and possible solutions to it.
  C) I know a hearing aid dealer who offers free testing. Have you thought about trying a hearing aid?
  D) Did you know that there are closed-caption television sets that would allow you to enjoy some shows?



6. A 76-year-old man is upset that he is experiencing hearing loss despite a lifetime of being conscientious about avoiding known causes of hearing damage. The nurse would recognize which of the following age-related changes that may result in hearing loss?
  A) Changes in the structure and function of the inner ear
  B) Decreased viscosity and quantity of cerumen
  C) Plaque formation and occlusion of the Eustachian tubes
  D) Atrophy of the external ear structures



7. A nurse who performs regular visits to an adult daycare center has noted evidence of a hearing deficit in a man who has no documented history of hearing loss. Which of the following factors should the nurse consider when attempting to ascertain the etiology of the mans hearing loss? (Select all that apply)
  A) Genetic factors
  B) Environmental threats
  C) Fluid and electrolyte imbalances
  D) Ototoxic medications
  E) Atherosclerosis or thrombotic events



8. The incidence of hearing loss in a long-term care facility is high, especially among White males. What strategy should care providers adopt when communicating with older adults who have hearing loss?
  A) Use less complex concepts when communicating with hearing-impaired older adults
  B) Use a high, consistent tone and pitch when speaking to adults with hearing loss
  C) Speak at a high volume directly into the less affected ear when talking to an older adult with a hearing deficit
  D) Make eye contact before and during a conversation with hearing-impaired adults



9. As part of a comprehensive physical assessment of an older adult client, a nurse is performing an otoscopic examination. Which of the following assessment findings most clearly warrants further assessment and possible intervention?
  A) There is a small amount of cerumen visible in the ear canal.
  B) The epithelial lining is bright red.
  C) The tympanic membrane is intact
  D) The tympanic membrane is a pearl-gray color



10. The nurse has been providing care for an 83-year-old male resident of a nursing home for 2 years and has developed a high level of familiarity and trust with the resident. Which of the following recent changes in the residents behavior may signal the possibility of hearing loss?
  A) The residents statements occasionally suggest that he is not oriented to time.
  B) The resident had a recent episode where he became visibly angry at a nursing assistant.
  C) The residents attention span seems shorter than it has been in the past.
  D) The resident has become increasingly disagreeable and terse in his demeanor.



1. Which of the following meals would assist an individual in lowering cholesterol levels?
  A) Baked chicken, carrots, and angel food cake
  B) Green salad, applesauce, and an oatmeal cookie
  C) Vegetable beef soup, crackers, and JellO
  D) Baked pork chop, green beans, and sherbet



2. A nurse knows additional teaching is needed when an older adult says the following:
  A) Alcohol intake will interfere with absorption of B-complex vitamins and vitamin C.
  B) Certain fluid pills can decrease the potassium level in my blood.
  C) Anticholinergic medications can cause my intestines to work slower.
  D) My over-the-counter beta-carotene pill is appropriate for long-term use.



3. A 70-year-old man is admitted to your unit with sepsis. He has elevated sodium, blood urea nitrogen, and creatinine, and albumin. Which of the following nursing diagnoses is appropriate for this patient?
  A) Imbalanced Nutrition: Less than Body Requirements
  B) Fluid Volume Excess
  C) Impaired Tissues Perfusion
  D) Fluid Volume Deficit



4. Which of these nursing interventions would be most successful to encourage optimal nutrition in older adults with congestive heart failure?
  A) Encourage calorie supplements
  B) Teach older adults to sit upright for 2 hours after a meal
  C) Use moderate to large amounts of flavor enhancers
  D) Provide 55% of calories from complex carbohydrates



5. Which of the following points should a nurse stress in a health education class for older adults about constipation?
  A) Older adults who do not have a daily bowel movement should use a laxative.
  B) Older adults should limit their intake of high-fiber foods because of a risk of lactose intolerance.
  C) If older adults need a medication to promote bowel regularity, a laxative or enema should be given.
  D) If older adults need a medication to promote bowel regularity, a bulk-forming agent is needed daily.



6. Despite the lack of a history of strokes or transient ischemic attacks, an 81-year-old woman states that she occasionally has difficulty in swallowing. The womans primary care provider attributes this problem to presbyphagia, or age-related changes in swallowing ability. This fact should prompt the womans nurse to assess for which of the following problems?
  A) Aspiration
  B) Fluid volume deficit
  C) Dyspepsia
  D) Cholelithiasis (gallstones)



7. A gerontological nurse is aware that older adults have different nutritional requirements than younger adults. Which of the following teaching points reflects these changes in nutritional requirements?
  A) If possible, try to eliminate animal fats from your diet.
  B) You should try to eat less meat and proteins than you did when you were younger.
  C) Overall, you dont need to take in as many calories as you used to.
  D) As an older adult, you dont need to eat as many starches and complex carbohydrates.



8. The incidence and prevalence of nutritional deficits is worryingly high among the population of a large nursing home. What measure can care providers institute to address the risk factors for malnutrition?
  A) Provide incentives for residents to eat all the food on their trays
  B) Encourage residents to eat in their rooms to minimize distractions
  C) Offer four to five small meals a day rather than three larger meals
  D) Prioritize thorough oral care for residents



9. Mr. Reynolds experienced an ischemic stroke 3 weeks ago that had significant effects on his motor and sensory function. Which of the following assessment findings should signal the nurse to the possibility that Mr. Reynolds is experiencing dysphagia?
  A) Mr. Reynolds complains of being excessively hungry in the mid-afternoon and evening.
  B) When providing oral care, the nurse finds food pocketed in Mr. Reynolds cheeks.
  C) Mr. Reynolds drinks large amounts of water before, during, and after his meals.
  D) Mr. Reynolds prefers to sit in a high Fowlers position after he ea

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