"7 SWUINursing

E3Npso0dpe

| SCHOOL OF HEALTH AND ALLIED HEALTH SCIENCES

, NUR 151 P1 EXAMINATION
GENERAL INSTRUCTIONS:
1. This test questionnaire contains 100 test questions
2. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded
will invalidate your answer.
3. AVOID ERASURES.
4. Student caught with any form of cheating will automatically get a 5.00 or a “fail” mark for
this
examination
5. Read the questions carefully, you have 1 hour and 30 minutes to complete the examination.
6. Good Luck and God Bless!

= Situation 1: You are working as a Gerontologic Nurse and it is important to know the different
principles concerning care of the older adult population,
1. Which of the following improves attitudes toward aging and older adults?
a. Staying away from older adults
Education about older adults
= c. Travelling to older communities
\/: d. Watching the portrayals of older adults in movies and on TV
g 2. What best describes nurses as a care provider?
\ _3. Determine client's need
b. Provide direct nursing care
¢. Help client recognize and cope with stressful psychological situation
d. Works in combined effort with all those involved in patient’s care
Nurse Angelee told Mr. Dela Cruz about ways to decrease the risk of heart disease.
What
role of a gerontologic nurse did Nurse Beth portray? =
a. Manager c ]Teacher
- b Advocate d. Provider of Care
. What role involves gerontological nurses being aware of current research
literature,
continuing to read and put into practice the results of reliable and valid studies?
-2
Research Consumer c. Teacher
b. Advocate d. Provider of Care
5. As a nurse manager, Nurse Mira knows that she needs to develop the following
skills
except;
a. Time management c. Staff insubordination
b. Assertiveness d: Communication
Situation 2: As a Gerontologic Nurse, you should know the scope and the
roles of one's function
in the field.
6. As a student nurse, you understand that it is important to study
Gerontological Nursing
because:
a. it is fixed and unchanging.
b. it provides a way to understand the aging process and provide
quality care to older
adults
¢. it can help predict the responses that the body can do
in during aging.
d. it gives positive outlook to older adults.
7. Nurse Justin explains medical and nursing procedures to
Mr. Rommel’ 's family members.
What role did Nurse Justin play in this situation?
a. Manager ¢, Teacher
_b. Advocate d. Provider of Care
8. ADr. Michelle indicate that a consent form needs
1o be signed. Since Nurse Heather was
not present when the doctor discussed the procedure, which
statement best illustrates the
nurse fulfill ed the client advocate role?
a. “The doctor has asked that you sign this consent form.”
b. “Do you have any questions about the procedure?
”
i‘Whai were you told about the procedure you
are going to have?”
d. *Remember that you can change your mind and
cancel the procedure.”

L T TR RSSO SRR
 rch findings into nursing
i i y corporatSes ré: seal
earcl h articles and in
s e following roles
Uenicas EaCl00 e
T & gr';r;iece would demonstrate which of the
ronts, (het e e
f e;f nursing interest e
that
. Primary Investigator = Consf"z:i
5 pimary e !
% 'c“alulonomy and self-care, and maintena n
:‘mse Gr:lvynelh
18 vspeoializ Fobedie e
es in disease prevention, increasing
'

= of function for older adults is o, developmental psychology.

‘ ic health )
: _E ::]:g:,rz::.::
Situation gy
As a éemn'olog ic Nurse assigned in the clinical field, y:h:lJa must know the differenti
i i pml’gc

AN i I?rii?i:l::
p""?f . eg?:r'ul';eil ospitaliza
nglds of nursing that deals with tl?a propelr _carelvaensdu:de;: tion bof
swnding
|
R : aged or geriatric patients. This specialized field is Intncat‘e asit lnv::hce
)\ aging process and the tremendous changes every Indlvgua{la:ng:mmo'.o ey iy
' 2 a, Gerontological i
i Nursing C. oc| [t
LA -b‘- Gerontological Rehabilitation d.. Neuropsychology [°]

J 12. NursesOlaf wants to study older people’s mental health and emotions.i He wan ts to ask
first specialists in psychiatry whose knowledge, expertise, and practice are with the older
Ppopulation. Who is he referring to?
!
a. Geriatric nurse C Gerontalogl; nurse
3 / b. Geropsycholo d. Geriatric doctor 4
13Eya hasp gyr;ndpag:;nts Wwho are nearly in their sixties. She wanted
to ask for advice for
they will retire soon from work. She wants to consult about
retirement and health needs.
To whom she can consult these concems?
—&, Social Gerontology c. Environmental Gerontology
b. Financial Gerontology: d. Mental Gerontology
14. The gerontological nurse acts on behalf
of older adults to promote their best interests
strengthen their autonomy and decision-making. and
What is the role of the gerontological
nurse show?
| 2. Provid of er
Care C.
| b. Teacher Manager
& 15. Which best describes what guid
~d._Advocate
es the appropriate nursing care of
E 2. Evidence-based' practice deve an aging adult?
loped with ongoing research into
’1 ~Gutcomes of older adiits the nesds and
b. General nursing care previously practice
s
c. Facility policies and procedures
d. Physician orders for patient comp
laints
Situation 4: As a Gerontologic Nurs
e, you must know the
different scopes of the practice you
to consider prior to be assigned in need
the field.
s

16. The American Nurses Associat

ion's Gerontological Nursing: Scop
Practice emphasizes: e and Standards of
a. that abnormal responses to the
aging process determine the appropri
diagnoses. ate nursing
-b. thatthe health statis data of older adult
. patients be docume
nted in'a retrievable form.
c. the role of the older adult patient as
i the sole decision maker in planning
care, his or her
d. the unchanging natu
re of the goals and plans of care for olde
17. It is a nursing care standard that eval r adult patients.
uates the older adults progress towards
of expected outcomes, attainment
a. Planning
entation ¢. Implem
b. Diagnosis
-d. Evaluation
18. A nursing quality care standard that
contributes to the professional development
colleagues, and others. of peers,
a. Ethics
_¢. Collegiality
b. Collaboration
d. Resource Utilization
S e S [ S s SRS SRR e T
 19.There are differen 1
Psychological, Soci‘alml::nd‘is °'I aging that are influenced by a composite of biological,
Theory which has i, onal,
and spiritual factors, One of the theories s the Stochastic
T erent four different types, Which of the Stochastic Theories
B F errors in DNA and RNA synthesis that occur with aging?
b. o adical theory _c.._ Effortheory
20} P'SYCholig?::af theory d.” Psychologic theory
eae eory of aging has two parts: the Sociological and Psychological Theories.
ey under the sociological theory. Which of the following refers to the function is
ed by ego strength, mobility, health, cognition, sensory perception, and the
environment?
a. SubcAuIture c. Age stratification
b. Continuity . Person-Environment Fit
Snua.lion 5: You are a novice nurse assigned in the hospice care. You are currently reviewing
the different theories and changes affecting the older adult population.
21, According to this theory, aging successfully means remaining physically, psychologically,
and socially engaged in meaningful ways that are individually defined.
a. Nursing Theories of Aging c. Psychological Theories of Aging
-b._ Theory of Successful Aging d. Biological Theories of Aging
22. Which theory suggests that older people who have low levels of social activity have a high
degree of life satisfaction?
i\ 2. Activity c. Disengagement
b. Age stratification d. Exchange
s\gnifmm{y
23. Normal aging is associated with certain physiological changes that can
response. Both pharmacokineti cs and pharmacodyna mics play a role in
influence drug
how a person will respond to a drug. In this regard, what is pharmacokinetics that refers
to the rate of drug movement through the body may decrease with age?
a. Distribution c. Contribution
=h, Absorption d. Collection
24. Which of the following is an age-related physiologic change that may affect the absorption
of drugs?
a. Xerostomia d. Increased gastrointestinal tract
b. Faster stomach emptying motility
g —¢. Altered pH of the stomach
o contents
25. The following are reasons for polypharmacy. Which of the following is not included?
a. Changes in mental health status only.
B. Assumption that, once the medication is started, it should be continued indefinitely and
not changed.
c! Lack of communication among multiple healthcare providers. Changes in daily habits

«f
(smoking, activity, diet/fluid intake).
d. Allof the above
o e. None of the above
Situation 6: As a nurse assigned in the gerontological ward, you must know the different ethical
principles you must uphold at all times.
26. Which of the following is considered to be an intervention that may help the prescriber to
prevent polypharmacy?
-

a. Use of complementary (alternative, folk medicine) therapies and fear of telling health-
care provider.
s

b. Financial limitations (drug substitution).

¢. Changes in mental-emotional status that may affect consumption patterns.
Y

—d. Identifying indications for each medication

27. There are 13 patient bills of rights in the ethical and legal principles. Which of the following
bills corresponds to the rights of every person to have a right to health and medical care
corresponding to his state of health, without any discrimination and within the limits of the
resources, manpower and competence available for health and medical care at the
relevant time?
a. Right to Information
_b._Right to Appropriate Medical Care and Humane Treatment
c. Riaht to Choose Health Care Provider and Facilitv
e ———
—
= d. Right to Medical Records . ‘
competing loyalties and opportuniti ities. Thi is may :
. o “\
28. Conflict of interest situations arise from %
— - include: R s value system an d choices e A
alues between the nurse . the organization, or the
i care team members
T ;::::I::: ?l:e‘i’r families, other health
insurance; company. . -of-Iffe care. .
an.d en:i;f gains create conflict between ;
b. discussions related to resource allocation
finan \
c. occur when incentive systems or other
professional integrity and self-interest.
/ 4. Allof the above
/ of the residents and their family
’ e are asked by your supervisor to take ph otographs
29, You
ion at your long-term care
o members who are attending a holiday dinnel r and celebrat
facility. What should you do? fon &t
a. Take the photographs because these photographs are part of the holiday tradition
this facility i 3
because all of the residents are properly attired and in a
b. Take the photographs
dignified condition
c. Refuse to take the photographs unless you have the consent of all to do so
d." Refuse to take the photographs because this is not part of the nurse's role j
30. Which of the following is most closely aligned with the principles and concepts of informed
consent?
a. Justice . Self determination
b. Fidelity d. Nonmaleficence
Situation 7: As a nurse assigned in the ward specific for older adult population, different levels of
care must be familiarized to ensure safe and quality nursing care is being done at all times.
31. 1t refers to the health, mental health, social, and residential services provided to a
temporarily or chronically disabled person over an extended period of time with the goal
of enabling the person to function as independently as possible.
. Long-term care c. Assisted living
b. Short-term care d. Intermediate care
32. Nurse Olaf provides 24-hour per-day care to his patient. This can be a direct nursing
contact and may be considered to be the entry level into nursing home care.
a. Skilled care c. Intermediate care
b. Alzheimer's care d. Palliative care
33. Complete the statement. Palliative care is not just for when the person is dying or at the
end of their life; it is for any time during a 5
a. terminal illness c. emotional stress
“b. diseases d. physical iliness
34. The following are people and their families with the following conditions may benefit from
palliative care. Which is not included in the list? SELLECT ALL THAT APPLY.
. Progressive dementia -
I People dying as a result of the disease process
[I[8 Advanced heart disease -
IV. Advanced respiratory disease .
V. Cancer Patient
a. landll c. llandV
b. I, Ill; and IV d. 1, IVandV
35. Nurse Jessica visits a 40-year-old Adore who is abreast cancer patient with metastatic
breast cancer who is receiving palliative care. Adore is experiencing pain at a level of 7
(on a 10-point scale). In prioritizing activities for the visit, Nurse Jessica would do which of
the following first?
a. Auscultate for breath sounds.
_b_.’Administer prn pain medication.
C. Check pressure points for skin breakdown.
d. Ask family members about patient's dietary intake.
T e e o e e
 ts oy
"is impO It ant 1 when taking care of older adui
tuation B: Knowing one's cultural backgroul nd eld. 5
"rsing care in |_he i hich refers to breath or wind.
e
= be factor n the implementation 1: " Latin word spifitus: W
i ves from the g
36. The word spirituality derives - (0 a higher being:
Today, spirituality is if and a sense of connection [{
a. Awareness of one's inner sel s illness. ¢
7b. Less important than coping with he PaRrS
U0 e et
c. Patient centered and has no bearing Of s a minor effect oneva in God, nor does he
mal rel igi ous pra cti ce and ha
37. d. Equate
Nurse d to isforcaring for Indy who claims |h§ t he does not bell
Maan
ient
believe in an "ultimate reality." The nurse realize: s that this pat
a. |s devoid of spirituality.
. Is an atheist/agnostic. ;
c. Finds no meaning through relationships with others.
d. Believes that what he does is meaningless. =T ittle
to live.
38. Nurse Jrenzo is caring for Rommel who is terminally ill with vé;'Yh:’:w time left
I'm not so sure.
Rommel states, "I always believed that there was life after death. i
Do you think there is?" The nurse states, 'l believe there is.” " Nurse Jrenzo h: as & ttempted
to
a. Strengthen the patient's religion.
b, Provide hope.
. Support the patient's agnostic beliefs.
d. Support the horizontal dimension of spiritual well-being. . il 5
39. Nurse Frecy is admitting Precia to the hospital. The patient states that he is a very spiritual
person but does not practice any specific religion. The nurse understands that these
statements
.
a. Are contradictory. c. Indicate a lack of faith.
b. Indicate a strong religious d. Are reasonable.
affiliation.
40. Which of the following statement about religion
and spirituality is true?
2. Religion is a unifying theme in people’s lives.
b. Spirituality is unique to the individual.
c. Spirituality encompasses religion.
d. Religion and spirituality are synonymous.
Situation 9: Spirituality is an important aspect in the care
of older adults as spiritual beliefs often
holds a factor in every older aduit.
41. Nurse Naomi creates a referral to pastoral care when he/she
realizes that patient Matthew
is in need of
a. Psychiatric care. c. Spiritual care.
b. Return to religious affiliation. i
_d. Transfer to the psychiatric unit.
42. When caring for a terminally ill, 90 yr old Petrus, Nurse
Kate should focus on the fact that
a. Spiritual care is possibly the least important nursin
g intervention.
b. Spiritual needs often need to be sacrificed for physic
al care priorities.
¢ The nurse's relationship with the patient allows for
an understanding of patient priorities.
d. Members of the church or synagogue play no part
in the patient's plan of care.
43. Nurse Mon is caring for Ara who is in the final
stages of his terminal disease. Ara is very
weak but refuses to use a bedpan, and wants
to get up to use the bedside commode.
What should the nurse do?
a. Explain to the patient that he is too weak and
needs to use the bedpan.
b. Insert a rectal tube so that the patient no longer
needs to actively defecate.
c. Enlist assistance from family members
if possible and assist the patient to get up.
d. Put the patient on a bedpan and stay with him until
he is finished,
44. When evaluating Shahane's risk for spiritual
crises, which of the following are part of the
evaluation process? (Select all that apply.)
|. Review Shahane's self-perception regarding spiritu
al health,
Il. Review Shahane's view of his/her purpose in life.
lll. Discuss with family and associates Shahane's conne
ctedness.
1V. Ask whether Shahane's expectations are being
met.
V. Impress on Shahane that spiritual health is Permanent
once obtained.
 i b1 1V, 4 ang v
C 1 I, IV and v
M:':: Shylove | =, 11, 11l and IV
l o Sleep?va states, ") j been diagnosed with a terminal illness.
(
- Matthew shows g | 3 Partin
a. Not be e ab;u:n|eres( in taking his care. Nurse Shylove should:
s ”\ :’Warfi Suicide
lanore indiyq ual platlenl goals until the current
€ Encourage
Fie th e
crisis is over.
Pal_lem to purchase over-the-counter sleep aids to help him sleep.
y As: B Potential for suicide and make appropriate referrals.
Situation 0. ifferent by-laws have been established in our country to protect the welfare of the
older adults,
46.A hospice nurse, Nurse Michelle is visiting with a dying Kethrel. During the interaction,
Kethrel is silent for some time. What is the best response?
2. Recognize the patient's need for silence. and sit quietly &t the bedside.
. Try distraction with the patient.
€. Change the subject, and try to stimulate conversation.
d. Leave the patient alone for a period. 5 o
47. Which information obtained by the home health nurse, Nurse Clyde when making a visit
to an 88-year-old Stephanie with mild forgetfulness is of \ha‘ mc:st com;erq’?
weekly.
a. The patient's son uses a marked pillbox to set up the patient's medications
LR - e patient has lost 10 pounds (4.5 kg) during the last month.
a son at night.
" c. ;e patient is cared for by a daughter during the day and stays with
d. The patient tells the nurse that a close friend recently died.
e :
48. Which of the following statements accurately reflects data that the nurse should use in
planning care to meet the needs of the older adult?
a. 50% of older adults have two chronic heafth problems.
b. Cancer is the most common cause of death among older adults.
c. Nutritional needs for both younger and older adults are essentially the same.
Adults olderthan 65 years of age are the greatest users of prescription medications.
497 g-term care facility sponsors a discussion group on the administration of medications.
The participants have a number of questions concerning their medications. The nurse
responds most appropriately by saying:
a. "Don't worry about the medication's name if you can identify it by its color and shape."
b. "Unless you have severe side effects, don't worry about the minor changes in the way
you feel."
c.."Feel free to ask your physician why you are receiving the medications that are
prescribed for you."
d. "Remember that the hepatic system is primarily responsible for the
pharmacotherapeutics of your medications."
50. Which of the following statements, made by Dame, the daughter of an older adult client
JAshley, concerning bringing her mother home to live with her family, presents the greatest
concern for the nurse?
a. "If this doesn't work out, she can always go to live with my sister."
b, "I don't think she will react very well to me making decisions for her."
“¢."I'm afraid that mom will be depressed and miss her home."
d. "My children will just have to adjust to having their grandmother with us."
Situation 11: Different settings of care are common nowadays especially when taking care of older
adult patients in our community.
51. An assisted living facility has provided its clients with an educational program on safe
administration of prescribed medications. Which statement made by Selwyn, an older-
adult client, reflects the best understanding of safe self-administration of medications?
a."l don't seem to have problems with side effects, but I'l let my doctor know if something
happens."
b. "I'm lucky since my daughter is really good about keeping up with my medications.”
%_'l‘ll be sure to read the inserts and ask the pharmacist if | don't understand something.”
d. "It shouldn't be too hard to keep it straight since | don't have any really sefious health
issues."
 52.Of the o
owing optio, ns, i
1he
a.
older-aduf glnyy 1O 18 the greatest barrer to providing qually health care to
Poor client com
- Inadequate heafilrfi:c: résulting from generalized diminished capacity
C. Insufficient research lum"“? coverage for the group as a whole
Precon ceived 0 provide a basis for effective geriatric health care
53. Venessah ah assumptions regarding the lifestyles and attitudes of this group
regarding ;his c:::? health aide, is dressing Aaliyah. Which of the following is not true

:‘ gc:‘:;‘:eg:d‘:‘:eflfii':le:lihoc his or. her own clothes

—
sa
ies, if necessary, when undressing and dressing
C. Assist the client to don pants, shirt with sleeves, and socks
d._ Never the force the extremities when undressing and dressing
54. Rica, a home health nurse is assisting Ezra to transfer from the bed to a wheelchair. Which
of the following is not true regarding this process?
% a. Stand in front of the client as he or she stands up to go to the wheelchair
the gait belt from
b. If needed, when the client stands to go to the wheelchair, grasp
i underneath at each side
are fouching the front of the
_ Take large steps to a position so that the client's knee caps
wheelchair
walk to the wheelchair 3
d. On the count of three, assist the client to stand up to
at night time. Which of the
55. Rommel wants to wear a pair of sungk lasses in the facility
following is the appropriate action of Nurse Jrenzo?
A. None of the other options
or her right to do so
B. Allow the client to wear the sunglasses since it is his
will run into something
C. Let the client wear the sunglasses in the hopes that he or she
-:.' due to impaired vision
not allow the
he sunglasses will impair the vision; so, the home health aide should
client to wear the sunglasses
adult
Situation 12: Therapeutic communication techniques are important when dealing with older
j patients as certain changes affects their way of communication with the general public.
o 56. Nurse Mon is setting up an education session with an 85-year-old Methodius who will be
| going home on anticoagulant therapy. Which strategy would reflect consideration of aging
| changes that may exist with this patient?
j 2. Show a colorful video about anticoagulation therapy.
b. Present all the information in one session just before discharge.
k‘j c. Give the patient pamphlets about the medications to read at home.
| d. Develop large-print handouts that reflect the verbal information presented.
577Rurse Jinkx asks a newly admitted client, “What can we do to help you?” What is the
\‘ purpose of this therapeutic communication technique?
a. To reframe the client's thoughts about mental health treatment
b. To put the client at ease
&To explore a subject, idea, experience, or relationship
d"To communicate that the nurse is listening to the conversation
58. Student Nurse Raja is learning about the appropriate use of touch when communicating
with clients diagnosed with psychiatric disorders. Which statement by her clinical
instructor, Nurse Yvie best provides information about this aspect of therapeutic
communication?
a. “Touch carries a different meaning for different individuals.”
b. “Touch is often used when deescalating volatile client situations.”
c. “Touch is used to convey interest and warmth."
d. “Touch is best combined with empathy when dealing with anxious clients.”
59. Which nursing statement is a good example of the therapeutic communication technique
of focusing?
a. “Describe one of the best things that happened to you this week."
b. “I'm having a difficult time understanding what you mean.”
c. “Your counseling session is in 30 minutes. I'll stay with you until then.”
d. “You mentioned your relationship with your father. Let's discuss that further.”
 I 5 T e
Vivienne finds out that the blood
p.m. the previous evening, patient
e
i m 10 stal
swears at7 Nurse Jaida and
o ‘A::‘sr’l:;!m:grer: oancpeled. Vivienne
incompetent!” Which i is the 4
nurse's best respon: se ] e
cwtierl:rell o
a."Do you believe that | was the cause of your blood test !:tslrl\‘gs
s
b, *| see that you are upset, but | feel uncomfortable when yo!
i
3 ou ever thought about ways to express anger ; ;:‘pl!;p
d. “I'l give you some space. Let me know if you need anythin e
Situation 13: In caring with older adult patients, communication is .sn_ Impofla:( l;veY(a :flecflvsly
healthy nurse-patient relationship. Thus, nurses should familiarize on ho!
commun icate an older adult. -
4 iant’ d
61. During a nurse-client interaction, which nursing statement may belittle the client's feeling:
Y I
and concermns?
—a—Don't worry. Everything will be c. 'l notice you have bitten your nails
“lright.” to the quick.” L *
b. “You appear uptight.” d. “You are jumping to conclusions.
62. Patient Petrus states, “You won't believe what my wife said to me during visiting hours.
He has no right treating me that way.” Which nursing response would best assess the
situation that occurred?
2. “Does your wife treat you like this very often?”
b. “What do you think is your role in this relationship?”
. “Why do you think she behaved like that?"
d."Describe what happened during your time with your wife."
63. interviewing Petrus, which nonverbal behavior should Nurse Clyde employ?.
a. Maintaining indirect eye contact with the client
b. Providing space by leaning back away from the client
c.Sitting squarely, facing the client
O Maintaining open posture with arms and legs crossed
64. When working with patient Trinity who is hearing-impaired, the use
of which techniques
| would improve communication? (Select all that apply.)
1 |. Check for needed adaptive equipment.
Il. Exaggerate lip movements to help the patient lip read. k
lli. Give the patient time to respond to questions.
V. Keep communication short and to the. point ke
V. Communicate only through wiitten information.
a.lllandlll t %.l, 1ll, and IV
=~ b.1,1V, and v II, IV, and V.
1 65. Anew nurse, Nurse Shea, complains to her preceptmat she has no time for therapeutic
communication with her patients. Which of the following is the best strategy to help the
nurse find more time for this communication?
| a. Include communication while performing tasks such as changing dressings and checking
ital signs.
| b. Ask the patient if you can talk during the last few minutes of visiting hours.
c. Ask Pastoral care to come back a little later in the day.
d. Remind the nurse to complete all her tasks and then set up remaining time for
communication.
(’ Situation 14: Proper communication process must be upheld at all times to effectively take care
{ of older adult patients in the clinical area.
66. Why is it important for the nurse to be cautious when using medical jargon with an older
adult patient?
a. It could become an opportunity to instruct the patient.
b. It could become an effective abbreviated communication shortcut.
c. It could become an indicator of formal communication.
d. It could become a communication barrier.
67. Nurse Bob is engaging the patient Willow in social conversation. What is the benefit of
soclal conversation in the health care setting? g ’
a1t lets the patient know that he or she is considered to be a person, not just a patient.
b. It encourages sharing of intimate details.
¢. It establishes the nurse's role as a health care provider.
Gye o
d. It blocks more me: a
68, M. Krisjhan, 72 yaq r NE(ul thera
.S myocardiali infarction. i ted o the emergency room with
a diagnosis of acute
7, Which of the following reer . ¢ Alf22amae, “('m scared. | think I'm going to die”
NS 2. “Everything s gor 8 responses by the nurse would be MOST appropriate?
W 80Ing to be fine. We'll take good care of you.”
\ o':!::n. | (houiht 1 was having a heart attack once.”
[ ESTRER You can discuss it with him.”
69% USir‘m:I to feel frightened. We're doing everything we can for you.”
oui Nurl:e aln‘le‘r?reter to speak with an 84-year-old Chinese patient Nica, on what
g 3 ariel focus?
-;;Th&pahenl, not the interpreter
3 f%nt{ouraglng the interpreter to paraphrase
(= lemmng questions from the patient
d. Listening to the words, not emotional tone
70. What are the two parts to communication?
a. There only needs to be one part, when someone says something
by When someone says something, and the other person has understood
c. When someone says something, and the other person has replied
d. When someone says something while using non-verbal communication
N
?
Situation 15: Government programs are established in promoting welfare to the older adulti
proper care to the older adults when in
population. Levels of care are also established to ensure X
the clinical setting. s
out-of-pocket costs for families and involve
71. What is the leading cause of catastrophic and Medica re?
through Medicaid
substantial government spending, primarily
c. Hospice Care
a. Palliative-care
b. Long-term care
d. Home Care ot
ute on the care-giving system
72, Problems that the potential burden on aging society contrib
and public finances are the following except,
a. Challenge of assuring sufficient c. Quality of Long-term care
resources d. More health care workers
b. Effectivity of service system
73. Which of the following is not a solution to add funding for future care services?
a. Efforts to promote private long-term care insurance
b. Medicaid and Medicare expansions
c. Retaining long-term care workers
d. More attention from policymakers
74. The following are the different disability projection scenarios except:

-
P 4 a. High disability scenario c. Middle disability scenario
b. Low disability scenario d. Intermediate disability projection
| 75. This provides the “best guess” of the future size of the frail older population, does not
assume any particular trend in disability rates.
2. High disability scenario ¢. Middle disability scenario
b. Low disability scenario \e’ Intermediate disability projection
1 Situation 16: Integumentary changes are common in the older adult population. Thus, there are
common integumentary considerations prior to implementation of nursing care to promote
safety and welfare of the patients.

76. What is the most appropriate nursing diagnosis for patient Jorlinda who is bedridden
because of progressed Parkinson disease?
3, Risk for impaired skin integrity related toimmaobility
~b. Immobility related to Parkinson disease
¢. Impaired skin integrity related to incontinence
d. Ischemia related to disuse syndrome
77. Patient Bianca who is 79 years old asks why a wound is taking so long to heal. What
explanation should Nurse Laganja provide to this. patient?
“There is less protein in the skin with aging”
_D’The tissue between the skin cells is weaker.”
¢. “The amount of blood flow to the skin is slower with aging.”
 -s
/| d. “The number of immune cells in the skin re duces with aging.”
>, \‘ £ always feeling cold. Which age- relateq
78. Nurse Mon noted that patient Jiad cmjm?'B::: ;atient?
/ \ change to the skin could be causing this in
a8, Fewer protein stores
b. Decreased subcutaneous tissue
TReduced levels of immune cells
d. Slower blood flow to the skin Iavers \Ikely to develop a pressure ulcer on the
79. The primary reason an older adult client is more likely
elbow as compared to a middle-age adult is:
* 2. Areduced skin elasticity is common in the older adult
) b. The attachment between the epidermis and dermis is weaker
¢ The older client has less subcutaneous padding on the elbows
“FOlder adults have a poor diet that increases risk for presswelulcerfs. pae
80. While bathing an elderly client Shaira who has limited
abilities for sel & 'coccyx
Auddrey notices several patches of dry skin on the client's heels, elbovw's, and Th.a'
Nurse Auddrey cleans and dries all the areas well and applies a maistur:znn;
lotion.
most appropriate immediate follow-up by Nurse Auddrey to ensure appropriate
nursing
care for this client’s skin is to:
i o
Revise the client's care plan to show the need for the
application of moisturizing lom?n
3 -E.Tssume personal responsibility to apply the moisturizing lotion
daily
to the cliem"s skin
¢. Encourage the client to tell whomever bathes her
to apply the moisturizing lotion to
her areas of dry skin
\ d. Inform the staff that the client's skin is showing signs
) of breakdown and moisturizing
lotion needs to be applied daily

3. “Go on, you can do it.”

b. “Give yourself time to rest
1 between exercise routine.”
T ou need to finish the exercise
routines to facilitate lung expans
d. “You are not allowed to exer ion.”
| cise with your condition.”
82. In performing a physical asse
| ssment: for Jiemson, Nurse Mon
the following normal physiologica anticipates finding which of
2 l changes of aging?
+2-Increased perspiration
¢. Increased salivary secretions
ncreased airway resistance
e 83. ja fent Akio, who is assigned d. Increased pitch discriminati
to Nurse Ayanna has pneumonia on
| lated changed involved with the . She is reviewing the age-
| older adult. Select all age-rela
respiratory system that apply. ted changes of the
1. Decreased in residual lung
volume
2. Decreased gas exchange
| 3. Decreased cough efficiency
| 4. Increased gas exchange
2land2 % P
.2and3 c.3and4
84. What is the most significant cha d.1and 4
nge in vital organs in the agin
3. No change in organ tissue g client?
is noted
b. The outer appearance of
an organ changes, but the
cha nge functional component does not
¢. Organs show signs of decrease
in function during the aging proces
_Jhe aging process speeds s
up the functional capacity
85. Factors that may further decrea of maj or org ans
se lung function besides aging incl
a. Smoking ude all but:
c. Immobility
b. Obesity
’EL Exercise
Situation 18: Cardlovascular change
s are expected In the older adult populatio
must have several considerations before glvi n. Thus, nurses
ng any Implementations to their planned nurs
interventions, ing
 a. Hypertension
c. Diabetes
b. Dyslipidemia t, Sexual orlentatlon
87. What is the single most cost-eff
ective discovery made In the past 30
influenced the prevention and trea years that has
tment of cardiovascular events?
a. The development of oral hypogl
ycemic drugs
. Recognizing the need to lower bloo
d pressure i 6lder adults
c. Ant ismoking campaigns
d. Zero tolerance for drug and alcohol abus
e in older adults
88. Nurse Simonee is examining a 76-year-
old Nenita with the complaints of fatigue, ankl
swelling, andmild shortness of breath over a three-wee
e
k period. An appropriate nursing
diagnosis might include:
2, Decreased cardiac output related to altered contractilit and
y elasticity of cardiac
muscle
b. Activity tolerances due to compensat
ion of oxygen supply
C. Increased cardiac output related to an aging hear
t muscle
d. Decreased urinary output due to poor kidney perf
usion
89. Patient Clyde is experiencing tachycardia. Nurs
e Rommel’s understanding of the
physiological basis for this symptom is explained by whic
h of the following statements?
a. The demand for oxygen is decreased because of pleu
ral involvement
b. The inflammatory process causes the body to dem
and more oxygen to meet its needs.
c. The heart has to pump faster to meet the demand
for oxygen when there is lowered
“arterial oxygen tension.
d. Respirations are labored.
90. According to the best availabl
e evidence, which one of the followin
interventions for reducing primary hyp g lifestyle
ertension is not likely to be effective?
a. Dietary salt restriction
. Magnesium supplementation
b. Fish oil supplementation
d. Physical activity and Weight loss
Situation 19: Multiple medication administ
ration is fairly common in the older adult com
3 as chronic disorders are frequently dia munity
gnosed at this age. Thus, due to physiolo
\ there must be careful administrati gica l chan ges,
on of medications to avoid accidental
developing toxic manifestatio overdosage or
ns due to drug administrations.

5 91. Which is the best example of polyphar

macy?
% 2. Patient Kethrel is filling her medications
at more than 1 drugs tore.
b. Patient Ezra is taking more than 2 medic
— ations,
C. Patient Jrenzo s taking more than 9
medications.
_j{gan'ent Anika'is taking a potentially
inappropriate combination of medicines.
92. Which is the most effective method
of managing polypharmacy?
a| - Review of medications at each office
Visit, to ensure an accurate med list.
b. Limit your patients” medication list
to no more than 4 medicines,
¢. Regularly assess patient adherence
to the medication regimen.
d Bothaand ¢
% 93. Oral drugs may be absorbed less
quickly in older people because:
a. Of increased number of receptors
in the heart
b. Of increased liver metabolism
c. Of increased kidney function
%Of decreased gastrointestinal
motility
94.%nteric coated tablets are desig
ned to avoid being dissolved in
Instead, they dissolve in the the highly acidic stomach.
intestine. Knowing this and what
gastrointestinal changes associated you know about
with age, what can you conclude abou
tablets and older patients? t enteric coated
2. The tablets will need to be.
given intravenousl
y instead
_bdhese tablets will probably
dissolve more slowly
c. The enteric coated tablets are unaf
fected by changes associated with age
j. These tablets may dissolve more
quickly
 that drugs will b (-5
95. In an older population we can expect more rapidly
a. Absorbed more quickly c. Excreted
. Excreted less readily
b. Metabolized more quickly changes, drug
changes are expecte d in commo n a! dults. Due to these
Situation 20: Physiol ogic
to safeguard the wel |l-being
of the patients.
administration must be tightly monitored that may affect the
of the followi ng is an age-related physiologic chan ge
96. Which
absorption of drugs? stomach
¢, pH imbalance in
a. Xerostomia
'E'._Wpermotile Gl tract
b. Faster stomach emptying all receiving multiple
older adult patients who are
97. Nurse Mon is caring for a group of each patient's
it is essential to individualize
medications. Nurse Mon understands that
practice?
therapy. Which is the best rationale for this
is decreased in older adults.
a. The percentage of drug absorbed often
increased lean mass.
b. Most older adults have decreased body fat and
adults, resulting in decreased drug levels.
¢. Hepatic metabolism tends to increase in older
ased drug excretion.
d. Renal function declines with age, leading to decre
which phase of pharmacokinetics is
98. When assessing for drug effects in the older adult,
the greatest concern?
a, Absorption
c. Metabolism
. Distribution d. Excretion
99. All of the following are impacts of polypharmacy EXCEPT:
_a. Increased communication between care teams
~b. Adverse drug events
c. Increased healthcare costs
d. Medication non-adherence
100. The single most important thing we can do as healthcare providers to prevent
polypharmacy is:
a list of home medications in their wallet
=a. Encourage our patients to carry
b. Tell our patient to appoint a lead doctor
each of their new medications
b¢. Educate our ’ patients on
d. Tell our patients to Google all of their medications