Deck 4: Gerontologic Assessment

Question 1

The nurse showing the best understanding of how personal attitude affects the interview process during a health assessment of an older adult patient is one who:

A)proceeds with the interview as if the patient were not an older adult.
B)incorporates therapeutic communication into the assessment process.
C)treats all patients with respect regardless of age.
D)has self-reflected on his or her own feelings regarding aging.

Answer 1

has self-reflected on his or her own feelings regarding aging.

Question 2

The nurse most effectively implements guided reminiscence during a patient interview by:

A)reminding the patient to share important memories of the past.
B)scheduling several short interviews rather than one long one.
C)controlling the interview by selecting the memories to be discussed.
D)encouraging the patient to relive his or her memories while maintaining focus.

Answer 2

encouraging the patient to relive his or her memories while maintaining focus.

Question 3

The geriatric nurse recognizes that the body's homeostatic mechanisms may be compromised in the:

A)79-year-old with moderate Alzheimer disease who requires assistance with all activities of daily living (ADLs).
B)73-year-old with a history of chronic bronchitis who lives with family.
C)86-year-old who lost a spouse and is moving into an assisted living facility.
D)69-year-old with peripheral vascular disease who is visited by home health care weekly.

Answer 3

86-year-old who lost a spouse and is moving into an assisted living facility.

Question 4

An older patient is admitted for bacterial pneumonia.The only abnormal assessment values include a heart rate of 102 beats per minute,slight cyanosis of the nail beds,and mild confusion.The patient's daughter questions the possibility of pneumonia stating,"He isn't coughing or having any difficulty breathing." The nurse responds most appropriately by saying:

A)"We are lucky to determine the problem in its early stage."
B)"Respiratory problems develop only after the infection is well established."
C)"People your dad's age often lack the muscular strength to cough."
D)"Older adults frequently lack the typical signs of a respiratory infection."

Question 5

To establish a mutually respectful relationship with an older adult patient being admitted to a skilled nursing unit,the nurse first introduces himself and then asks:

A)how the patient would like to be addressed.
B)if the patient has any specific requests to make of the staff.
C)the patient to share a little about his or her personal likes and dislikes.
D)the patient to read the orientation materials that the facility provides.

Question 6

An older patient is reluctant to report multiple vague signs and symptoms,including lethargy,incontinence,and weight loss that have persisted for 6 weeks.The nurse recognizes that such symptoms place the patient at great risk for:

A)viral infection.
B)disorientation.
C)malnutrition.
D)physical frailty.

Question 7

An older patient is hospitalized after a fall that resulted in a fractured left ankle.By day 4 of the hospitalization,which includes reduction of the fracture and analgesic drug therapy,the patient has become mildly disoriented and is incontinent of urine.The nurse explains to the family that these symptoms reflect the:

A)relationship between aging and both physical and psychosocial responses to trauma.
B)response exhibited by many older adults who are hospitalized.
C)effects of stress-induced perceptual deficits often seen in the hospitalized older adult.
D)results of the pharmacologic pain control therapy.

Question 8

The nurse has administered the Apgar screen tool to assess an older patient's family function status.Upon determining that the family functions at a 4,the nurse:

A)prepares to administer a more detailed tool.
B)prepares to report reasonable suspicion of elder abuse.
C)asks the patient to identify specific family members to include in care planning sessions.
D)notifies social services that the family is not likely to be of much support to the patient.

Question 9

An older patient is being admitted to a long-term care facility.The nurse recognizes that the primary purpose of the initial geriatric health assessment is to:

A)identify the patient's physiologic baselines.
B)ultimately create a plan of care that prevents disability and dependence.
C)initiate the therapeutic nurse-patient relationship.
D)document self-care deficiencies that the patient exhibits.

Question 10

A 76-year-old postsurgical diabetic patient has reported feeling dizzy and clammy.The daily serum glucose level shows the patient's levels to be within normal limits.The geriatric nurse shows an understanding of established health norms for the older adult when stating:

A)"This patient's normal may not be within the typical lab norms."
B)"I'll ask the lab to rerun the test so we can double-check the results."
C)"There must be another reason for the symptoms."
D)"I'll compare the patient's baseline lab work with today's results."

Question 11

The staff members in a long-term care facility have noted a decline in cognitive function in one of the residents;however,each time the resident is given the Short Portable Mental Status Questionnaire (SPMSQ),the score does not change.What action by the nursing manager is best?

A)Provide in-service education on using this tool.
B)Conduct the assessment him- or herself
C)Switch to a different screening tool
D)Determine that no changes have occurred.

Question 12

When unsure about how to address older patients with advanced stage Alzheimer disease,the nurse recognizes that it is best to address the patient by:

A)a pet name,because the patients are not likely to respond to their given names.
B)the first name,to foster a friendly,relaxed atmosphere.
C)the full name,to show respect for the patients as individuals.
D)a childhood nickname,because long-term memory will likely still be intact.

Question 13

A nurse aide working in the geriatric unit's dining room tells the nurse that a patient who was oriented to time and place this morning is now confused about what day it is and why she's "here." The nurse appropriately directs the nurse aide to:

A)take the patient back to her room and put her safely in bed.
B)place a falls risk identification bracelet on the patient and add the status care plan.
C)immediately take the patient's vital signs and report them to her.
D)reorient the patient to time and place frequently and document the patient's response.

Question 14

The geriatric nurse admitting a patient to an assisted living facility recognizes the importance of tools such as the Katz and the Barthel indexes because of the impact they have on:

A)planning the amount of help the patient will need with ADLs.
B)the patient's ability to be realistic about achieving independence.
C)creating an appropriate,patient-specific nursing care plan.
D)appropriate staffing to ensure the safety needs of the patients are met.

Question 15

A nurse is working with an older patient in the gerontology clinic.The patient reports a vague decline in function and says,"I guess I'm just getting older." What action by the nurse is best?

A)Help the patient find ways to cope with the changes.
B)Assess the patient for an undetected illness.
C)Ask if the patient needs any home health services.
D)Find out what the patient thinks of these changes.

Question 16

To best minimize patient anxiety and help ensure a successful history assessment interview,the geriatric nurse first:

A)asks whether the patient has any questions about the interview.
B)makes sure the interview area is comfortable and private.
C)explains the reason for asking the questions.
D)assures the patient that all answers will be kept confidential.

Question 17

A patient is being admitted after a fall that has caused a painful leg injury.In preparing to interview the patient for a health history,the nurse is initially concerned that:

A)the family should be present to help answer questions.
B)a therapeutic nurse-patient relationship should be established.
C)the patient should be free of hearing and vision barriers.
D)the patient's pain should be effectively managed.

Question 18

A nurse assesses a patient using the Barthel Index and scores the patient as a 98.What inference does the nurse draw from this assessment?

A)The patient is nearly dependent in all areas measured.
B)The patient is able to live independently.
C)The patient is close to independent in the areas measured.
D)The patient's cognitive status impaired the assessment.

Question 19

The nurse has used the Yesavage Geriatric Depression Scale (short form)and scored the patient at a 1.What is the nurse's best action?

A)Refer the patient to a mental health practitioner.
B)Assess the patient further for depression.
C)Ask the patient about using antidepressant medications.
D)Document findings in the patient's medical record.

Question 20

The nurse admitting a debilitated patient to a long-term care facility initially assesses the patient using the Katz Index.The student asks why the nurse chose that tool.What answer by the nurse is best?

A)It is quick and simple for a baseline.
B)The Katz Index is mandated by Medicare.
C)It is comprehensive in nature.
D)It shows functioning in 12 areas.

Question 21

A nurse who cares for older adults recognizes which of the following clinical features associated with dementia? (Select all that apply. )

A)Failing to remember his or her room number
B)Becoming increasingly disoriented at night
C)Working on jigsaw puzzles for hours at a time
D)Often referring to a cup as a canyon
E)Misunderstanding when told "it's raining cats and dogs"

Question 22

The nurse using the SPICES model to assess older patients collects data on which topics? (Select all that apply. )

A)Sleep disorders
B)Problems with eating
C)Incontinence
D)Falls
E)Social situations

Question 23

A nurse is conducting an admission interview with an older patient admitted to a long-term care facility.When the nurse asks about the patient's former occupation,the patient states,"What do you care? I am long retired!" What response by the nurse is best?

A)"Your job may have exposed you to some health hazards."
B)"It helps me get to know you and your background better."
C)"We have several clubs here you might be interested in."
D)"No real reason,it's just part of our admission interview."