Deck 3: Principles of Geriatrics

Question 1

The nurse is assessing the function of an older adult. Which of the following actions should the nurse take? Select all that apply.
1) Utilize the SPICES tool.
2) Utilize the PULSES tool.
3) Identify the client's strengths.
4) Interview the client's closest family member.
5) Use an interdisciplinary assessment approach.

Answer 1

1, 2, 3, 5

Question 2

The nurse is assessing an older client's health status. Which comments, made by the client, would indicate that the client's health beliefs are based on the perceived importance of taking action to promote health? Select all that apply.
1) "I should get a physical every year so I can stay healthy."
2) "I know that choosing to eat healthy or not will affect my health now and later on."
3) "I know if I go for walks on a regular basis, I am less likely to have a health problem."
4) "I understand if I continue to go to church and spend time with friends, I will feel less lonely."
5) "I understand if I stop drinking alcohol, I will decrease my chance of liver disease and other health issues."

Answer 2

3, 4

Question 3

A nurse has just completed training on the Health Insurance Portability and Accountability Act (HIPAA). Which statement made by the nurse indicates that training has been successful?
1) "Faxing of information is prohibited by HIPAA."
2) "I need to verbally provide the patient with the privacy notice."
3) "I cannot discuss a patient's health history with family members without the patient's permission."
4) "Financial information relating to payment for services is not subject to the HIPAA regulations."

Answer 3

3

Question 4

The family of an older client in a nursing home feels that the client has not been treated fairly and that the client's rights have been violated. Which of the following would be the best action for the family to take?
1) Remove the client from the facility.
2) Call the local ombudsman and report the information.
3) Hire a lawyer to obtain information about the client's care.
4) Request a copy of the client's medical record and determine if appropriate care has been given.

Question 5

Which of the following actions, if observed by the charge nurse, would require the charge nurse to intervene?
1) The nurse looks over the physician's shoulder to see the results of an assigned client's labs.
2) The nurse requires a client to fill out a release of information form when the client requests a copy of his or her medical record.
3) The nurse asks another nurse to quickly look up the results of an x-ray of a client since the other nurse is already signed on the computer.
4) The nurse faxed reports of client tests to a machine that is in the office of the client's primary care physician, and a nurse is expecting the report.

Question 6

The nurse is completing the minimal data set (MDS) for an older patient. What are characteristics of this assessment? Select all that apply.
1) Eliminates listing the patient's prescribed medications
2) Identifies health insurance coverage that is not Medicare or Medicaid
3) Provides a multidimensional view of the patient's functional capacities
4) Used primarily to determine the amount of funding the patient has for long-term care
5) Includes a core set of screening, clinical, and functional measures used in patient assessment

Question 7

Which of the following actions by the nurse would meet the standard of care?
1) The nurse questioned a physician about a prescription where the dose was higher than the recommended dose.
2) The nurse medicated a client who reported severe chest pain with aspirin and then called the physician to get a prescription.
3) The nurse brings a breakfast tray into the client's room and puts in on the counter away from the client who is vomiting and nauseous.
4) A nurse leaving the facility at the end of the shift witnesses a client fall. The nurse calls for help and tells the other nurse that during the next shift he or she will fill out the incident report.

Question 8

Which action should the nurse take to avoid becoming involved in a legal suit with client care?
1) Consistently follow the physician's orders.
2) Document carefully all nursing care provided.
3) Avoid using emails and fax machines to send client information.
4) Always provide friendly and respectful care to the client and families.

Question 9

What actions will the nurse follow when using restraints for an older client in a long-term care facility? Select all that apply.
1) Use restraints for 2 hours or less.
2) Use restraints for emergency situations only.
3) Utilize waist restraints to prevent client falls.
4) Obtain a physician's order before using restraints.
5) Remove the client's eyeglasses when applying restraints.

Question 10

The nurse is talking with an older client who has a history of multiple hospitalizations and a recent decline in mental status. Which of the following interventions should the nurse implement to improve the client's overall health?
1) Have the client evaluated for long-term care.
2) Obtain a referral for a comprehensive evaluation.
3) Collect an accurate and thorough health history.
4) Provide the appropriate amount of help for normal activities.

Question 11

Which of the following situations would be a priority for the nurse to intervene?
1) A client's spouse asks the nurse for the results of an HIV test.
2) Copies of the patient's diagnostic test results are found in the regular trash behind the nurse's station.
3) The charge nurse overhears a physician asking another physician not involved in the client's care to look at a test result.
4) A client's medical record is left unattended on a stretcher outside the radiology department while the client receives an x-ray.

Question 12

An older client recently admitted from a homeless shelter experiences cardiac arrest. The client has no resuscitation orders. Which action should the nurse take?
1) Begin chest compressions.
2) Notify the nursing supervisor.
3) Obtain a prescription for DNR.
4) Attempt to contact the client's next of kin.

Question 13

Which nursing intervention will ensure that the nurse will provide culturally competent healthcare to an older patient?
1) Speak the patient's primary language.
2) Use standardized assessment instruments in health evaluations.
3) Approach patients of a particular ethnic group in the same manner.
4) Know prevalence, incidence, and risk factors for diseases specific to different ethnic groups.

Question 14

An older client is diagnosed with an intestinal obstruction and needs immediate surgery. The client's next of kin is a granddaughter who lives in a neighboring community. Which of the following actions should the nurse take?
1) Obtain consent from the client for the surgery.
2) Perform the surgery since it is emergent, consent is not necessary.
3) Delay the surgery until the client's granddaughter can be contacted.
4) Obtain a consult from mental health to ensure the client's competence.

Question 15

The nurse is preparing to conduct a health history with an older client. Which action should the nurse take to ensure the accuracy and efficiency of the client's health history?
1) Scheduling one-half hour for the medical history interview.
2) Requesting the client use the bathroom before starting the interview.
3) Ensuring the client has their identification and insurance card with them upon arrival.
4) Conducting the history in an environment with comfortable seating and proper lighting.

Question 16

The nurse needs to fax confidential patient information to another office. What actions should the nurse take when faxing this type of information? Select all that apply.
1) Use a cover sheet.
2) Obtain patient permission to fax.
3) Include a confidentiality statement.
4) Verify the fax number before faxing.
5) Print the patient's name on the cover sheet.

Question 17

An older client with confusion has a prescription to receive a blood transfusion. Which of the following actions should the nurse take to obtain consent?
1) Request the client's family member or next of kin sign the consent.
2) Withhold the blood transfusion until the client's mental status improves.
3) Administer the blood transfusion since a signed consent form is not necessary.
4) Explain the transfusion, help the client sign the consent, and administer the transfusion.

Question 18

The nurse is reviewing secondary prevention actions with an older patient. Which interventions should the nurse encourage the patient to complete? Select all that apply.
1) Yearly depression screening
2) Colonoscopy every 10 years
3) Yearly fecal occult blood test
4) Yearly height and weight check
5) Yearly blood pressure screening

Question 19

The gerontological nurse is planning health promotion actions for an older client. Which of the following information should the nurse focus on when planning these actions? Select all that apply.
1) Client has type 2 diabetes mellitus.
2) Client walks for 30 minutes 3 times a week.
3) Client uses BIPAP machine for sleep apnea.
4) Client attends religious services every Sunday morning.
5) Client lives alone and volunteers at the local library most afternoons.

Question 20

Which of the following would violate client's rights according to the Patient's Bill of Rights? Select all that apply.
1) The client signed out and left the facility for the day to go to a casino.
2) The nurse showed the adult daughter of a client the notice posted about the ombudsman.
3) The nurse gave a prescribed prn sedative to a client who continuously yelled out, "Hello!".
4) The nurse refused to allow clients, who are husband and wife, to have private time with the door closed.
5) The nurse told the client, who is a practicing Jew, that the client had to participate in the facilities Christmas party.

Question 21

The charge nurse is reviewing an incident with a staff nurse in which an older client was injured after a fall. Which statement made by the nurse would require immediate intervention by the charge nurse?
1) "The client fell during shift report."
2) "The client fell after getting up from the chair."
3) "The client was instructed to call if they needed help out of bed."
4) "The client was trying to reach for their walker to get to the bathroom."

Question 22

Prior to transferring a client for a scheduled procedure, the client states to the nurse, "I do not know how well I will do after this procedure." Which question should be a priority for the nurse to ask the client?
1) "Are you concerned about your recovery time?"
2) "Do you have any questions about the procedure?"
3) "Do you understand why they are doing this procedure?"
4) "Are you concerned about experiencing pain after the procedure?"

Question 23

An older homeless patient is admitted to the hospital. The patient has no known family, is unresponsive, and his condition is considered guarded. What should be done to ensure appropriate healthcare decisions are made for this patient?
1) The homeless shelter will provide direction.
2) The patient will be represented by the hospital social worker.
3) The hospital will make decisions for the patient's healthcare.
4) The hospital will ask a judge to appoint a guardian for the patient.

Question 24

The nurse is caring for a client with advanced dementia who is refusing to cooperate with the initiation of a blood transfusion. Which action should the nurse take?
1) Consult mental health.
2) Document the treatment as refused.
3) Explain to the client why the blood is necessary.
4) Administer the blood after the client calms down.

Question 25

The nurse is caring for an older client that states, "I am not taking this medication anymore, and I am tired of being here." Which is the best action for the nurse to take?
1) Contact the client's family.
2) Discuss the therapeutic action of the medication.
3) Remind the client about their agreement for treatment.
4) Inform the client of their right to leave the facility AMA.