Gerontological Nursing, 3rd Edition Test Bank

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Chapter 01TabloskiGerontological Nursing, 3/eChapter 01Question 1Type:MCSAThe nurse is preparing discharge instructions for an 84-year-old patient that includes plans forsmoking cessation. The nurse believes that since the patient has been smokingfor years, he isn’tgoing to stop now. Which concept does this nurse’s belief reflect?1.Negative stereotyping2.Character assessment3.Reality orientation4.SenescenceCorrect Answer:1Rationale 1: Often people characterize the elderly in a negative way, believing that after a certainage, things cannot be changed. This is the concept of stereotyping in a negative way.Reference: Page 4Rationale 2: Character assessment is not an identified concept of gerontology but is a process ofidentifying aspects of an individual’s personality and character.Reference: Page 4Rationale 3: Reality orientation is not an identified concept of gerontology but is a strategy to assistindividuals when confused or delusional.Reference: Page 4Rationale 4: Senescence is the process of aging.Reference: Page 4Global Rationale:Cognitive Level:AnalyzingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: PlanningLearning Outcome:3. Identify common myths of aging and their contribution to ageism.Question 2Type:MCMA

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The nurse is planning to conduct a blood pressure screening at a local senior citizen’s high-riseapartment building in the inner-city impoverished location. What are characteristics of the residentsliving in this location?Standard Text:Select all that apply.1.Older women2.Married men and women3.Widowed women4.Less educated women5.Residents living aloneCorrect Answer:1,3,4,5Rationale 1: Women now comprise the majority of the older population and in the United States,women outnumber men.Reference: Page 7Rationale 2: In the United States, women outnumber men and the ratio of men to women over theage of 65 is 49 men to every 100 women.Reference: Page 7Rationale 3: Since the life expectancy of men in the United States is less than that of women, themajority of the residents will most likely be widowed.Reference: Page 7Rationale 4: Older women are more likely to be less educated and have fewer years of laborexperience, making older women more likely to live in poverty.Reference: Page 7Rationale 5: Since older women are more likely to be widowed, they are more likely to live alone.Reference: Page 7Global Rationale:Cognitive Level:AnalyzingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: PlanningLearning Outcome:1. Interpret demographic data according to race, gender, and age.Question 3Type:MCSA

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While completing an admission assessment, the nurse learns that a female adult patient has smokedone pack/day for 20 years and works at a chemical plant. From this information, what is this patientat risk for developing?1.Decreased fertility2.Increased life expectancy because she is female3.No difference in risk because of social and occupational circumstances4.Environmental and occupational hazards that may affect life expectancyCorrect Answer:4Rationale 1: Given the limited information on the chemical exposures, it is inconclusive to considerany effect on fertility.Reference: Page 8Rationale 2: If women begin to approach the rates of tobacco and face the same environmentalhazards as men, the gender gap in life expectancy may narrow.Reference: Page 8Rationale 3: If women begin to approach the rates of tobacco and face the same environmentalhazards as men, the gender gap in life expectancy may narrow.Reference: Page 8Rationale 4: Exposure to environmental and occupational risk factors has been known to affect lifeexpectancy in men and will have the same effect on women given similar circumstances.Reference: Page 8Global Rationale:Cognitive Level:AnalyzingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: DiagnosisLearning Outcome:2. Relate leading causes of morbidity and mortality among older adults.Question 4Type:MCSAAn African American male patient has a blood pressure of 180/104 mm Hg. When asked about theblood pressure, the patient states that he is not on any medication and is unsure if the blood pressurelevel is unsafe. What should the nurse do?1.Nothing since the blood pressure may not be accurate and does not need to be addressed2.Initiate secondary prevention to prevent the progression of illness.

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3.Nothing since this is normal for someone in the hospital4.Reassess the blood pressure with the patient in a standing position.Correct Answer:2Rationale 1: There is no way of knowing if the patient’s blood pressure is inaccurate. Even if it isnot, the blood pressure should be measured again and addressed.Reference: Page 10Rationale 2: One good strategy to control chronic illness and prevent progression and disability is toidentify opportunities to diagnose and treat chronic illnesses. The nurse should initiate secondaryprevention to prevent the progression of illness in the patient.Reference: Page 10Rationale 3: This is not a normal blood pressure even if the patient is in the hospital.Reference: Page 10Rationale 4: This is no evidence to support that thispatient’s blood pressure needs to be reassessedin the standing position.Reference: Page 10Global Rationale:Cognitive Level:AnalyzingClient Need:Physiological IntegrityClient Need Sub:Reduction of Risk PotentialNursing/Integrated Concepts:Nursing Process: AssessmentLearning Outcome:4. Describe the effects of chronic disease.Question 5Type:MCSAAn older patient is worried about the cost of healthcare and supplies now that he has been diagnosedwith type 2 diabetes mellitus. How should the nurse respond to this patient’s concerns?1.“I believe that some parts of Medicare will cover preventative care, such as diabetes monitoring.”2.“You only need to check your blood sugar once a day, so the cost should not be too high.”3.“Don’t worry. I don’t think the total bill will be too much.”4.“I don’t know anything about insurance.”Correct Answer:1Rationale 1: At the current time, Medicare pays for a yearly wellness visit and routine physicalexamination. Medicare also covers diabetes screening and diabetes self-management training.Reference: Pages 10-11

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Rationale 2: The patient may need to check the blood glucose level more than once a day. Thisstatement would be inappropriate for the nurse to respond.Reference: Pages 10-11Rationale 3: The patient is stating concern, so telling him not to worry or assuming that even oneday of costs is affordable is inappropriate.Reference: Pages 10-11Rationale 4: Stating that the nurse does not know anything about insurance is unacceptable. Changesin Medicare coverage occur on an ongoing basis and the nurse should keep track of these changes byvisiting the Medicare website or calling the local Medicare office.Reference: Pages 10-11Global Rationale:Cognitive Level:ApplyingClient Need:Psychosocial IntegrityClient Need Sub:Nursing/Integrated Concepts:Nursing Process: PlanningLearning Outcome:4. Describe the effects of chronic disease.Question 6Type:MCMAThe nurse is assessing an older female patient admitted to the hospital for generalized weakness anda cough. Which assessment findings would be considered normal changes related to aging?Standard Text:Select all that apply.1.Elevated blood pressure2.Needing to urinate every 3 hours3.Needing to wear eye glasses for reading4.Pulse rate 104 beats per minute and thready5.Respiratory rate 22 per minute after walking a short distanceCorrect Answer:2,3,5Rationale 1: Even though the arteries stiffen with age, an elevation in blood pressure needs to beinvestigated and not assumed that it is a normal change related to aging.Reference: Page 17Rationale 2: With aging, bladder capacity declines. Needing to urinate every 3 hours would beevidence of reduced bladder capacity.Reference: Page 17

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Rationale 3: With aging, difficulty focusing up close would necessitate the need for reading glasses.This would be considered a normal change with aging.Reference: Page 17Rationale 4: Even though the heart muscle thickens with age, a pulse rate of 104 and thready needsto be investigated and not assumed that it is a normal change related to aging.Reference: Page 17Rationale 5: Maximum breathing capacity may decline by about 40% between the ages of 40 and 70.A respiratory rate of 22 per minute after walking a short distance can be considered a normal changerelated to aging.Reference: Page 17Global Rationale:Cognitive Level:AnalyzingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: AssessmentLearning Outcome:5. Contrast several major theories of aging.Question 7Type:MCSAThe family of an older male patient asks why the patient needs to be hospitalized for pneumoniawhen the youngest daughter had the same infection a few months ago and was treated at home. Howshould the nurse respond to the family?1.“The patient has chronic illnesses that put him at risk.”2.“I don’t think you can compare your grandfather to yourself.”3.“There are some differences between men and women and illness.”4.“Aging decreases the body’s ability to restore balance to body systems with an infection.”Correct Answer:4Rationale 1: There is not enough information to determine if the patient has chronic illnesses.Reference: Page 17Rationale 2: This response does not address the issue that body systems return to balance slowerafter an illness as a part of aging.Reference: Page 17

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Rationale 3: This response does not address that the patient’s age impacts the body’s ability to fightan infection and return to homeostasis.Reference: Page 17Rationale 4: The loss of organ reserve that can occur with aging can lead to the concept ofhomeostenosis or inability of the body to restore homeostasis after even minor environmentalchallenges, such as trauma or infection. An older person may die from pneumonia, which may haveonly been a minor illness to a younger person.Reference: Page 17Global Rationale:Cognitive Level:ApplyingClient Need:Physiological IntegrityClient Need Sub:Reduction of Risk PotentialNursing/Integrated Concepts:Nursing Process: ImplementationLearning Outcome:5. Contrast several major theories of aging.Question 8Type:MCSAA patient takes herbal supplements in order to “slow down” the aging process. The nurse realizes thatthe patient is following which theory of aging?1.Cross-link2.Wear-and-tear3.Free radical4.Emerging biologicalCorrect Answer:3Rationale 1: The cross-link theory states that cross-linked proteins resulting from binding of glucoseto proteins causes various problems associated with nutrition.Reference: Page 19Rationale 2: The wear-and-tear theory sees the human body as a machine and cellular function slowsdown with time.Reference: Page 19Rationale 3: The free radical theory states that accumulated damage caused by oxygen radicalscauses cells, and eventually organs, to lose function and organ reserve. The use of antioxidants andvitamins is believed to slow this damage.Reference: Page 19

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Rationale 4: The emerging biological theory states that there are specific genes responsible forhuman aging.Reference: Page 19Global Rationale:Cognitive Level:AnalyzingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: EvaluationLearning Outcome:5. Contrast several major theories of aging.Question 9Type:MCMAAn older patient is demonstrating signs of sadness and depression. Upon assessment, the patientexpresses remorse over not accomplishing much in life and is not looking forward to eventual death.Which theories of aging would be applicable for the nurse to use to help this patient?Standard Text:Select all that apply.1.Endocrine theory2.Programmed longevity3.Somatic DNA damage theory4.Jung’s theory of individualism5.Erikson’s developmental theoryCorrect Answer:4,5Rationale 1: The endocrine theory focuses on biological changes with aging. This patient isdemonstrating psychosocial changes with aging.Reference: Page 20Rationale 2: The programmed longevity theory focuses on aging as a result of changes in genefunction which is a biological theory. This patient is demonstrating psychosocial changes with aging.Reference: Page 20Rationale 3: The somatic DNA damage theory focuses on genetic mutations as a cause for aging.This patient is demonstrating psychosocial changes with aging.Reference: Page 20Rationale 4: Jung’s theory of individualism states that with aging the focus is away from the externalworld and moves towards the inner experience. This is a psychosocial theory of aging and would be

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appropriate for the nurse to use to help this patient.Reference: Page 20Rationale 5: Erikson’s developmental theory states that there are developmental stages that a persongoes through in life. This is a psychosocial theory of aging and would be appropriate for the nurse touse to help this patient.Reference: Page 20Global Rationale:Cognitive Level:AnalyzingClient Need:Psychosocial IntegrityClient Need Sub:Nursing/Integrated Concepts:Nursing Process: PlanningLearning Outcome:5. Contrast several major theories of aging.Question 10Type:MCSAA 62-year-old former professional football player is in the hospital for a total knee replacement as aresult of osteoarthritis. Which theory of aging would help explain this patient’s current healthproblem?1.Cross-link2.Free radical3.Wear-and-tear4.Somatic DNA damageCorrect Answer:3Rationale 1: The cross-link theory is related to the accumulation of cross-linked proteins causingdisease. This theory does not explain the damage done to the patient’s joint from playing football.Reference: Page 19Rationale 2: The free radical theory states that cell damage is a result of accumulation of oxygenradicals. This theory does not explain the damage done to the patient’s joint from playing football.Reference: Page 19Rationale 3: Osteoarthritis is characteristic of degeneration that results from joint usage. This diseaseis characteristic of the aspects of the wear-and-tear theory, which states that there is a “master clock”that controls all organs and cellular functions, which becomes less efficient over time. Abusing oneorgan or bodily system through repeated injury that occurs with contact sports may result in

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premature aging and diseases such as osteoarthritis.Reference: Page 19Rationale 4: The somatic DNA damage theory states that genetic mutations occur and accumulatewith increasing age. This theory does not explain the damage done to the patient’s joint from playingfootball.Reference: Page 19Global Rationale:Cognitive Level:AnalyzingClient Need:Psychosocial IntegrityClient Need Sub:Nursing/Integrated Concepts:Nursing Process: AssessmentLearning Outcome:5. Contrast several major theories of aging.Question 11Type:MCSAAn older patient is refusing to receive the influenza and pneumococcal vaccinations because hebelieves he is “too old.” How should the nurse respond to this patient?1.“I understand your feelings.”2.“I will report your concerns to the physician.”3.“You are likely to get sick if you do not take the vaccines.”4.“It is never too late in life to begin health promotion activities.”Correct Answer:4Rationale 1: Telling the patient that the nurse understands the patient’s feelings does not help thepatient understand the importance of health promotion activities.Reference: Pages 9-10Rationale 2: Reporting the concerns to the physician does not help the patient understand theimportance of health promotion activities.Reference: Pages 9-10Rationale 3: While the patient has an increased likelihood of developing an illness if the vaccines arenot taken, stating this does little to meet the patient’s voiced concerns.Reference: Pages 9-10Rationale 4: Receiving vaccinations for communicable diseases is a form of health promotion. Thepatient should be advised that age should not restrict health-saving activities.Reference: Pages 9-10

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Global Rationale:Cognitive Level:ApplyingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: ImplementationLearning Outcome:6. Evaluate the natural history of disease using principles of epidemiology.Question 12Type:MCSAA nursing student is preparing a program to review health concerns for seniors. Which statementshould the student include in the presentation?1.Heart disease is the leading cause of death for senior citizens.2.Decreases have been shown in the rate of Alzheimer’s disease.3.The rate of heart disease death for senior citizens is increasing.4.Cancer is the leading cause of death in the senior citizen population.Correct Answer:1Rationale 1: Heart disease is the leading cause of death in the senior population even though it hasdecreased by 2.4% between 2009 and 2010.Reference: Page 12Rationale 2: The death rate increased significantly for 2009 to 2010 for Alzheimer’s disease.Reference: Page 12Rationale 3: The rate of heart disease in the senior population has decreased by 2.4% between 2009and 2010.Reference: Page 12Rationale 4: Cancer is among the top causes of death but is not the number one cause of death.Reference: Page 12Global Rationale:Cognitive Level:ApplyingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: PlanningLearning Outcome:4. Describe the effects of chronic disease.Question 13Type:MCMA

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The nurse provides care to patients in a long-term care facility that embraces the Continuity Theoryof Aging. Which actions will the nurse plan to promote this theory?Standard Text:Select all that apply.1.Plan rest periods between activities.2.Introduce patients to a wide variety of new activities.3.Encourage family members to visit with the patients.4.Suggest avoiding activities that do not bring satisfaction.5.Remind patients that withdrawing from activities is expectedCorrect Answer:1,3,4Rationale 1: In the Continuity Theory of Aging, the pace of activities may be slowed so rest periodsbetween activities would be appropriate.Reference: Page 20Rationale 2: In the Continuity Theory of Aging, older age is not viewed as a time for major lifereadjustments but rather as a time to continue being the same person. Introducing patients to newactivities does not support this theory.Reference: Page 20Rationale 3: In the Continuity Theory of Aging, successful aging involves maintaining family ties.Encouraging family members to visit with the patients would be appropriate.Reference: Page 20Rationale 4: In the Continuity Theory of Aging, activities pursued in life that did not bringsatisfaction may be dropped. Suggesting that patients avoid activities that do not bring satisfactionwould be appropriate.Reference: Page 20Rationale 5: In the Continuity Theory of Aging successful aging involves maintaining values, habits,and preferences that formed the basic underlying structure of adult life. Reminding patients thatwithdrawing from activities is expected supports the Disengagement Theory.Reference: Page 20Global Rationale:Cognitive Level:ApplyingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: PlanningLearning Outcome:5. Contrast several major theories of aging.

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Question 14Type:MCSAA graduate nurse is nervous about caring for older adult patients because of the personality changesthat occur with aging. How should the nurse’spreceptor respond to this statement?1.“Personality is relatively stable throughout life.”2.“The losses many elderly experience understandably will impact their personality.”3.“The personalities of the elderly do undergo some significant changes afterthe eighth decade oflife.4.“After retirement, feelings of disuse cause many elderly to begin demonstrating personalitychanges.”Correct Answer:1Rationale 1: Personality is stable throughout adult life and rarely do healthy older people show signsof personality change during their final years.Reference: Page 17Rationale 2: Personality usually does not change radically even as a result of major lifestyle changessuch as the death of a loved one.Reference: Page 17Rationale 3: Personality is stable throughout adult life and rarely do healthy older people show signsof personality change during their final years.Reference: Page 17Rationale 4: Personality usually does not change radically even as a result of major lifestyle changessuch as retirement.Reference: Page 17Global Rationale:Cognitive Level:ApplyingClient Need:Psychosocial IntegrityClient Need Sub:Nursing/Integrated Concepts:Nursing Process: ImplementationLearning Outcome:5. Contrast several major theories of aging.Question 15Type:MCSAA patient voices concerns about her body weight despite diligently following a healthy diet. Whichage-related change would explain this patient’s issue with body weight?

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1.Body fat increases until middle age.2.Body weight increases after middle age.3.Fat is redistributed to the hips after middle age.4.Body fat promotes a pear-shaped appearance for aging women.Correct Answer:1Rationale 1: Body fat typically increases until middle age and then stabilizes until late life, whenweight tends to decline.Reference: Page 17Rationale 2: Body weight stabilizes after middle age.Reference: Page 17Rationale 3: With aging, fat is redistributed to the deeper organs.Reference: Page 17Rationale 4: With aging, fat is redistributed to the abdomen rather than to the hips. This promotes anapple shape rather than a pear shape.Reference: Page 17Global Rationale:Cognitive Level:ApplyingClient Need:Physiological IntegrityClient Need Sub:Physiological AdaptationNursing/Integrated Concepts:Nursing Process: DiagnosisLearning Outcome:5. Contrast several major theories of aging.Question 16Type:MCSAA 60-year-old patient in good health has asked the nurse about what steps can be taken to buildmuscle mass. What information should be provided to the patient?1.Exercise can slow the loss of muscle mass.2.Increasing protein and fat intake will increase muscle mass.3.Muscle mass declines by 40% between the ages of 30 and 70.4.There is little that can be done to reduce the loss of muscle mass associated with aging.Correct Answer:1Rationale 1: Without exercise muscle mass declines 22% for women and 23% for men between theages of 30 and 70. Exercise can slow this rate of loss.Reference: Page 17

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Rationale 2: Calories are burned more slowly during aging, and adding fats can promote fat build-up, not an increase in muscle mass.Reference: Page 17Rationale 3: Without exercise, muscle mass declines 22% for women and 23% for men between theages of 30 and 70.Reference: Page 17Rationale 4: Without exercise, muscle mass declines 22% for women and 23% for men between theages of 30 and 70. Exercise can slow this rate of loss.Reference: Page 17Global Rationale:Cognitive Level:ApplyingClient Need:Health Promotion and MaintenanceClient Need Sub:Nursing/Integrated Concepts:Nursing Process: ImplementationLearning Outcome:5. Contrast several major theories of aging.Question 17Type:MCMAThe nurse is planning a program about the Immunological Theory of Aging for a group of seniorcitizens. Which information should the nurse include in this program?Standard Text:Select all that apply.1.Restrict spending time with others who are ill.2.A healthy diet supports immune function in the older person.3.A healthy lifestyle supports immune function in the older person.4.Immune function improves after exposure to urinary tract infections and pneumonia.5.Obtaining an annual influenza vaccination supports immune function in the older person.Correct Answer:1,2,3,5Rationale 1: Limiting exposure to pathogens can support immune function in the older person.Reference: Page 19Rationale 2: A healthy diet can support immune function in the older person.Reference: Page 19Rationale 3: A healthy lifestyle supports immune function in the older person.Reference: Page 19

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