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Test Bank For Basic Geriatric Nursing, 5e (Wold, Basic Geriatric Nursing), 5th Edition

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    Chapter 01: Trends and Issues Wold: Basic Geriatric Nursing, 5th Edition Chapter 01: Trends and Issues Test Bank MULTIPLE CHOICE 1. The nurse explains that in the late 1960s, health care focus was aimed at the older adult because: a. disability was viewed as unavoidable. b. complications from disease increased mortality. c. older adults’ needs are similar to those of all adults. d. preventive health care practices increased longevity. ANS: D Increased preventive health care practices, disease control, and focus on wellness helped people live longer. DIF: Cognitive Level: Comprehension REF: 2 OBJ: 2 TOP: Aging Trends KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 2. The nurse clarifies that in the terminology defining specific age groups, the term aged refers to persons who are: a. 55 to 64 years of age. b. 65 to 74 years of age. c. 75 to 84 years of age. d. 85 and older.

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    ANS: C The term aged refers to persons who are 75 to 84 years of age. DIF: Cognitive Level: Comprehension REF: 2, Table 1-1 OBJ: 1 TOP: Age Categories KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 3. The nurse cautions that “ageism” is a mindset that influ ences persons to: a. discriminate against persons solely on the basis of age. b. fear aging. c. be culturally sensitive to concerns of aging. d. focus on resources for the older adult. ANS: A Ageism is a negative belief pattern that influences persons to discriminate against persons solely on the basis of age and can lead to destructive behaviors toward the older adult. DIF: Cognitive Level: Comprehension REF: 5 OBJ: 3 TOP: Ageism KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 4. The nurse points out that the most beneficial legislation that has influenced health care for the older adult is: a. Medicare and Medicaid. b. elimination of the mandatory retirement age. c. the Americans with Disabilities Act.

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    d. the Drug Benefit Program. ANS: A The broadest sweeping legislation beneficial to the older adult is Medicare and Medicaid. DIF: Cognitive Level: Application REF: 16 OBJ: 6 TOP: Legislation KEY: Nursing Process Step: Implementation MSC: NCLEX: N/A 5. The nurse clarifies that a housing option for the older adult that offers the privacy of an apartment with restaurant-style meals and some medical and personal care services is the: a. government - subsidized housing. b. long - term care facility. c. assisted - living center. d. group housing plan. ANS: C Assisted-living arrangements offer the privacy of an apartment or condominium with meals prepared and served, limited medical care, and a variety of personal services. DIF: Cognitive Level: Application REF: 14 OBJ: 9 TOP: Housing Options KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The 75-year-old man who has been hospitalized following a severe case of pneumonia is concerned about his mounting hospital bill and asks if his Medicare coverage will pay for his care. The nurse’s most helpful response is “Yes. Medicare:

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    a. pays 100% of all medical costs for persons older than 65.” b. Part B pays hospital costs and physician fees.” c. Part A pays for inpatient hospital costs.” d. Part D pays 80% of the charges made by physicians.” ANS: C Medicare Part A pays inpatient hospital costs, Part B pays 80% of physician’s charges, and Part D helps defray prescription drug costs. DIF: Cognitive Level: Application REF: 16 OBJ: 6 TOP: Medicare Provisions KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 7. The daughter of a patient who has been diagnosed with terminal cancer asks which documents are required to allow her to make health care decisions for her parent. The nurse’s most informative response is: a. “Advance directives indicate the degree of intervention desired by the patient.” b. “A ‘Do Not Resuscitate’ document signed by the patient transfers authority to the next of kin.” c. “A durable power of attorney for health care transfers decision - making authority for health care to a de d. “A living will transfers authority to the physician.” ANS: C A durable power of attorney for health care transfers the authority for decision making to a designated person. DIF: Cognitive Level: Application REF: 19 OBJ: 11

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    TOP: Advance Directives KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 8. The daughter of a resident in a long-term care facility is frustrated with her 80-year- old mother’s refusal to eat. The nurse explains that the refusal to eat is a behavior that is an: a. effort to maintain a portion of independence and self direction. b. indication of approaching Alzheimer disease. c. effort to gain attention. d. indication of the dislike of the institutional food. ANS: A Loss of independence and control is a significant issue for the older adult. Some residents will exercise whatever control they may retain. DIF: Cognitive Level: Application REF: 21 OBJ: 11 TOP: Loss of Independence KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 9. The nurse clarifies that the conditions of a living will go into effect when: a. the patient declares that desire in writing. b. a family member indicates the desire for curative therapy to cease. c. two physicians agree in writing that the criteria in the living will have been met. d. the physician and a family member agree that the criteria in the living will have been met. ANS: C

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    Two physicians must agree in writing that the criteria of the living will have been met before the document can go into effect. DIF: Cognitive Level: Application REF: 19 OBJ: 11 TOP: Living Wills KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 10. In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce hospital costs by: a. classifying various diagnoses as ineligible for hospitalization. b. allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis c. specifying particular physicians to treat specified diagnoses. d. using frequency of a particular diagnosis to set a payment schedule. ANS: B DRGs set up a system of preset hospitalization time and payment on the basis of the admitting diagnosis. DIF: Cognitive Level: Comprehension REF: 16 OBJ: 6 TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 11. When discussing extended care with a patient who has had a hip replacement and needs physical therapy, the nurse would recommend a(n): a. basic care facility. b. skilled care facility. c. subacute care facility.

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    d. assisted - living residence. ANS: B Skilled care facilities offer not only basic care but also services from trained licensed professionals such as nurses, physical therapists, speech therapists, and occupational therapists. DIF: Cognitive Level: Application REF: 16 OBJ: 9 TOP: Extended-Care Facilities KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 12. The 80-year-old woman who is recovering from a stroke is being sent to an extended-care facility. She is concerned about the expense. The nurse can allay anxiety by explaining that Medicare will cover extended-care facility costs: a. for a period of 30 days. b. for a period of 45 days for physical therapy. c. for a period of 100 days for needed skilled care. d. until she is able to be discharged home. ANS: C Medicare will cover extended-care costs for 100 days while skilled care is being applied to the resident. After 100 days, the resident must revert to private pay or ancillary long-term care insurance. DIF: Cognitive Level: Application REF: 16 OBJ: 8 TOP: Extended Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 13. The senior citizen political action group that uses volunteers and lobbyists to advance the interests of older adults is the:

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    a. American Association of Retired Persons (AARP). b. National Council of Senior Citizens (NCSC). c. National Alliance of Senior Citizens (NASC). d. Gray Panthers. ANS: A The AARP uses volunteers and lobbyists to advance the interests and welfare of older adults. DIF: Cognitive Level: Knowledge REF: 12 OBJ: 7 TOP: Political Action Groups KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 14. The nurse gives an example of the caregiver who is guilty of elder abuse as the: a. daughter who uses her mother’s Social Security money to purchase her mother’s medication. b. son who puts an alarm on the front door to prevent his mother from wandering out of the house. c. wife who allows her mentally competent husband to refuse to take a bath for a week. d. frail spouse who is unable to bathe or change the clothes of her physically dependent husband. ANS: D Unintentional abuse or neglect can occur when the caregiver lacks the stamina to meet care needs. Even though physically unable, the frail wife is guilty of elder abuse. The wife should seek assistance to prevent neglect. DIF: Cognitive Level: Analysis REF: 22 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation

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    MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 15. The nurse cautions that the most frequent response to elder abuse by the abused older adult is: a. anger. b. physical retaliation. c. notification of authorities. d. nothing at all. ANS: D Fear of retaliation or abandonment keeps most abused elders silent. DIF: Cognitive Level: Application REF: 25-26 OBJ: 14 TOP: Response to Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 16. Many nurses today do not seek careers in gerontology because: a. the physical work is too difficult. b. their technological skills are not used. c. there is not enough challenge. d. there are limited options for employment. ANS: B Many nurses feel that their technical skills will not be used in the care of the older adult. There are many employment options that offer challenge and fulfillment. DIF: Cognitive Level: Application REF: 5 OBJ: 2

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    TOP: Employment Options KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 17. The nurse clarifies that the term “baby boomers” refers to persons who: a. entered school in 1945. b. served in the military in World War II. c. were born between 1946 and 1964. d. were eligible for Social Security benefits in 2000. ANS: C Baby boomers are those born between 1946 and 1964. The impact of the retirement of this cohort is unprecedented in terms of the impact on society. DIF: Cognitive Level: Comprehension REF: 8 OBJ: 5 TOP: Baby boomers KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 18. Restraining an older adult in a recliner to prevent wandering is an example of: a. physical abuse. b. neglect. c. emotional abuse. d. self - neglect. ANS: A

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    Physical abuse is any action that causes physical pain or injury. Inappropriate use of drugs, force- feeding, physical restraints, or punishment of any kind are examples of physical abuse. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 19. Nonprovision of medical care because of lack of finances is an example of: a. physical abuse. b. neglect. c. emotional abuse. d. self - neglect. ANS: B Neglect is a passive form of abuse in which caregivers fail to provide for the needs of the older person under their care. Failure to provide necessary medical care may constitute neglect because with no means of going to the doctor or pharmacy, the older person may suffer or even die. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 20. Health care workers eating a resident’s candy without permission is an example of: a. physical abuse. b. neglect. c. emotional abuse.

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    d. self - neglect. ANS: C Emotional abuse is more subtle and difficult to recognize than physical abuse or neglect. It often includes behaviors such as isolating, ignoring, or depersonalizing older adults. Health care workers eating a resident’s candy without permission is an ignorant behavior that can be deper sonalizing. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A MULTIPLE RESPONSE 1. The nurse is aware that a person’s attitude about aging is influenced mainly by his or her __________. (Select all that apply.) a. life experiences b. income level c. level of education d. current age e. occupation ANS: A, D A person’s current age and life experiences are the main influences on his or her attitude relative to aging. DIF: Cognitive Level: Comprehension REF: 4 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

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    2. Gerontology encompasses application to __________. (Select all that apply.) a. appropriate housing b. health care c. public education d. business ventures e. government - sponsored pensions ANS: A, B, C, D Gerontological concerns extend and influence provision of appropriate housing, health care, public education, business ventures, and political stands relative to the welfare of the older adult. DIF: Cognitive Level: Application REF: 2 OBJ: 1 TOP: Gerontology KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. Medicare Part C allows eligible persons to receive Medicare benefits via the services of private insurance companies through the services of a __________. (Select all that apply.) a. health maintenance organization (HMO) b. preferred provider organization (PPO) c. provider - sponsored organization (PSO) d. private fee for service organization (PFFS) e. medical service organization (MSO) ANS: A, B, C, D Medicare Part C allows benefits via the services of managed care organizations. Medical service organization is not one of them.

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    DIF: Cognitive Level: Comprehension REF: 17 OBJ: 6 TOP: Medicare Part C KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. The nurse is aware that a family’s emotional response to an aging loved one’s attempts to cope with diminishing abilities and increased care needs would include __________. (Select all that apply.) a. grief b. anger c. frustration d. loss e. resentment ANS: A, B, C, D As the family witnesses the decline of a loved one and attempts to respond to the increasing care needs, the emotional responses are varied and changing. The responses include grief, anger, frustration, loss, and confusion. DIF: Cognitive Level: Application REF: 21 OBJ: 11 TOP: Impact of Aging on the Family KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 5. The nurse outlines the characteristics of the typical caregiver for an aging family member as __________. (Select all that apply.) a. 32 years of age b. female

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    c. having full - time employment d. having a care recipient older than 70 e. giving care for an average of 18 years ANS: B, C, D, E The average age of the caregiver is 46. DIF: Cognitive Level: Application REF: 20 OBJ: 11 TOP: Characteristics of Family Caregiver KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 6. The nurse reminds a family that indicators of self-neglect in the aging person include __________. (Select all that apply.) a. misbalanced check book b. reduced personal hygiene c. increased alcohol consumption d. irritability e. loss of weight ANS: A, B, C, E Indicators may be to manage personal finances, reduced hygiene, substance abuse, and loss of weight due to inability to obtain adequate food. Irritability is not a consistent characteristic. DIF: Cognitive Level: Application REF: 22 OBJ: 11 TOP: Self-Neglect KEY: Nursing Process Step: Implementation

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    MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 7. The nurse reminds a group of prospective caregivers that elder abuse may take the form of __________. (Select all that apply.) a. causing physical harm b. misappropriation of finances c. psychological intimidation d. emotional depersonalization e. abandonment ANS: A, B, C, D, E Elder abuse may take the form of physical injury, misusing the older person’s finances for personal gain, psychological intimidation, and depersonalization and abandonment. DIF: Cognitive Level: Application REF: 25-26 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk 8. The nurse explains that research done by the National Institute on Aging found that __________. (Select all that apply.) a. older patients receive less information regarding health management than younger patients b. inform ation on lifestyle changes were directed at younger people c. older patients were denied timely appointments for evaluation of acute illnesses d. rehabilitation programs offered limited services to the older adult e. older patients receive less evaluation and fewer treatment options for acute illnesses

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    ANS: A, B, D, E The study showed there was less information on health management and lifestyle changes. Rehabilitation programs were limited in their service to the older adult, and only 47% of physicians interviewed felt the older patient received the same evaluation for acute illnesses. DIF: Cognitive Level: Application REF: 5 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 9. The Nursing Competence in Aging initiative advocates enhancing nurses’ __________. (Select all that apply.) a. knowledge in gerontics b. skills in geriatrics c. opportunities for employment d. political sensitivity for the older adult e. attitudes related to the older adult ANS: A, B, E The Nursing Competence in Aging initiative advocates for all nurses greater knowledge, skills, and broader attitudes toward the older adult. DIF: Cognitive Level: Comprehension REF: 5 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: N/A MSC: NCLEX: N/A COMPLETION 1. The nurse clarifies that the term that refers to the promotion of high-level functioning and supportive care to older adults is __________.

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    ANS: gerontics DIF: Cognitive Level: Comprehension REF: 2 OBJ: 10 TOP: Gerontics KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 2. The nurse reminds a patient who was born in 1965 that eligibility for full Social Security benefits for persons of this age is now the age of __________. ANS: 67 DIF: Cognitive Level: Knowledge REF: 3 OBJ: 2 TOP: Change of Social Security Benefits KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 3. The nurse clarifies that the point at which a person on Medicaid Part D must assume full cost of medication is called the __________ __________. ANS: donut hole The “donut hole” is the point at which the insure d has used up the $2830 worth of coinsurance for drugs and must pay the full cost of medication until the amount of out-of-pocket expenses reaches $4550. DIF: Cognitive Level: Comprehension REF: 17 OBJ: 6 TOP: Donut Hole KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care Chapter 02: Theories of Aging Wold: Basic Geriatric Nursing, 5th Edition Chapter 02: Theories of Aging Test Bank MULTIPLE CHOICE

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    1. A theory differs from a fact in that a theory: a. proves how different influences affect a particular phenomenon. b. attempts to explain and give some logical order to observations. c. is a collection of facts about a particular phenomenon. d. shows a relationship among facts about a particular phenomenon. ANS: B A theory is an unproven concept that attempts to explain and give some logical order to observations. For a theory to become a fact, there must be reproducible evidence. DIF: Cognitive Level: Comprehension REF: 28 OBJ: 1 TOP: Fact vs. Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. The biological theory of aging uses a genetic perspective and suggests that aging is a programmed process in which: a. each person will age exactly like those in the previous generation. b. a “biological clock” ticks off a predetermined number of cell divisions. c. genetic traits can overcome environmental influences. d. age - related physical changes are controlled only by genetic factors. ANS: B The biological theory of programmed process su ggests that there is a “biologic clock” set with a predetermined number of cell divisions that will occur before the introduction of the aging process. DIF: Cognitive Level: Application REF: 28 OBJ: 2

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    TOP: Biological Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. The Gene Theory of aging proposes that: a. the presence of a “master gene” prolongs youth. b. genes interact with each other to resist aging. c. specific genes target specific body systems to initiate system deterioration. d. the acti vation of harmful genes initiates the aging process. ANS: D The Gene Theory suggests that there is an activation of harmful genes that initiate the aging process. DIF: Cognitive Level: Application REF: 28 OBJ: 2 TOP: Gene Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. The theory that identifies an unstable molecule as the causative factor in aging is the _____ theory. a. free radical b. molecular c. neuroendocrine d. crosslink ANS: A The free radical theory identifies free radicals — unstable molecules — that will cause aging after accumulation in the body.

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    DIF: Cognitive Level: Application REF: 29 OBJ: 2 TOP: Free Radical Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 5. The nurse assesses that the patient who uses good health maintenance practices believes in the aging theory known as the _____ theory. a. wear - and - tear b. free radical c. neuroendocrine d. molecular ANS: A The wear-and-tear theory suggests that health maintenance practices will prevent wear and tear on the cells of the body and will delay the aging process. DIF: Cognitive Level: Analysis REF: 29 OBJ: 2 TOP: Wear-and-Tear Theory KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 6. The nurse describes the neuroendocrine theory of aging as a complex process of: a. relating thyroid function to age - related changes. b. the effects of adrenal corticosteroids, which inhibit the aging process. c. stimulation and/or inhibition of the hypothalamus, c ausing age - related changes. d. adrenal medulla inhibition of epinephrine, causing age - related changes.

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    ANS: C The neuroendocrine theory proposes that the hypothalamus stimulates or inhibits the pituitary gland to produce hormones that initiate the aging process. DIF: Cognitive Level: Application REF: 29 OBJ: 2 TOP: Neuroendocrine Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 7. The nurse explains that psychosocial theories differ from biologic theories in that psychosocial theories: a. focus on methods to delay the aging process. b. are directed at decreasing depression in the older adult. c. are organized to enhance the perception of aging. d. attempt to explain responses to the aging process. ANS: D Psychosocial theories attempt to explain the various responses of persons to the aging process. DIF: Cognitive Level: Comprehension REF: 30 OBJ: 3 TOP: Focus of Psychosocial Therapies KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 8. The major objection to the disengagement theory is that the theory: a. justifies ageism. b. addresses the diversity of older adults. c. does not clarify the aging process.

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    d. diminishes the self - esteem of the older adult. ANS: A The disengagement theory seems to justify ageism by proposing that there is a mutual desire between the community and the older adult to be disengaged. According to the theory, this desire apparently does not diminish self-esteem because the older adult desires to be disengaged. DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Disengagement Theory KEY: Nursing Process Step: N/A MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 9. The 80-year-old who teaches Sunday school every week and delivers food for Meals on Wheels is following _____ theory. a. Newman’s developmental b. the life course c. the activity d. the disengagement ANS: C Purposeful activity increases self-esteem and maintains cognitive function well into older age. DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Activity Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 10. The nurse would recognize successful aging according to Jung’s theory when the nu rse notes that a resident at a long-term care facility:

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    a. takes special care to dress for dinner in a manner that pleases his tablemates. b. asks permission to sit on the patio with other residents. c. asks persons in his hall if his television is bothering them. d. wears a large cowboy hat at all times because he likes it. ANS: D Jung describes a successful adjustment to aging as being accepting and valuing of self regardless of the view of others. DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Jung’s Developmental Theory KEY: Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 11. The older adult female patient is positive that the free radical lipofuscin can be counteracted by: a. avoiding animal fat. b. use of antioxidants. c. building up muscle mass. d. outdoor exercise. ANS: B Individuals who follow this theory believe that free radicals can be reduced by antioxidants such as vitamins A, C, E, zinc, and phytochemicals. DIF: Cognitive Level: Comprehension REF: 29 OBJ: 2 TOP: Antioxidants KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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    12. A recently widowed woman moved to an assisted living community because of her hypertension and joined a group to learn how to do water color painting with other women her age. The nurse assesses that the patient is following the aging theory of: a. Jung. b. Havighurst. c. Erikson. d. Newmon. ANS: B Havighurst proposes that the process of aging is defined by adjusting to the loss of a spouse, establishing a relationship with one’s own age group, and establishing a satisfactory living arrangement. DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Havighurst KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease MULTIPLE RESPONSE 1. The nurse’s list of age -related illnesses thought to cause the accumulation of free radicals includes __________. (Select all that apply.) a. arthritis b. colon cancer c. osteoporosis d. diabetes

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    e. atherosclerosis ANS: A, D, E Cancer and osteoporosis are not considered to be diseases that accumulate free radicals. DIF: Cognitive Level: Application REF: 29 OBJ: 2 TOP: Free Radical Influence KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. The nurse emphasizes that the relatively new theory that correlates restricted caloric intake to slowing of the aging process would probably extend the life span of the person, provided that the person __________. (Select all that apply.) a. consistently eats high - nutrient, low - calorie foods b. maintains a regular exercise program c. consumes 2000 to 3000 mL of fluid a day d. supports the diet with adequate fat - soluble vitamins e. eats only organically grown foods ANS: A, B This new theory encourages high-nutrient, low-calorie foods combined with regular exercise to delay the aging process. DIF: Cognitive Level: Application REF: 30 OBJ: 2 TOP: Calorie Restriction Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. The nurse points out that the positive outcomes from a “life review,” according to Erikson, would include __________. (Select all that apply.)

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    a. wisdom and integrated self - image b. comparing self with others c. understanding self and relationships d. seeking another’s opinion of his or her achievement e. acceptance of self ANS: A, C, E Acceptance of self and understanding self and relationships with accumulated wisdom is the goal of Erikson. Seeking the opinion of others suggests that the older adult is experiencing doubt and gloom, which are negative outcomes according to Erikson. DIF: Cognitive Level: Application REF: 30 OBJ: 2 TOP: Erikson’s Developmental Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 4. When a patient asks what can be done to neutralize the free radicals in his system, the nurse responds that antioxidant therapy is thought to inhibit free radicals. Antioxidants include __________. (Select all that apply.) a. fruits b. vegetables c. organ meat d. folic acid e. vitamin D ANS: A, B, D

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    Antioxidants can be obtained largely from fruits and vegetables. Organ meat and vitamin D are not antioxidants. DIF: Cognitive Level: Comprehension REF: 29 OBJ: 4 TOP: Antioxidants KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease COMPLETION 1. The theory that proposes that defects in ribonucleic acid (RNA) protein production cause a progressive decline in the function of all cells is the __________ theory. ANS: error The error theory proposes that errors in ribonucleic acid protein synthesis cause changes such as decreased muscle mass, increased body fat, and changes in reproductive function. DIF: Cognitive Level: Comprehension REF: 28-29 OBJ: 2 TOP: Error Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. The nurse clarifies that the biologic theory that proposes that aging is based on the using up of a finite number of breaths or heartbeats is the __________ of __________ theory. ANS: rate; living The rate of living theory proposes that individuals have a finite number of breaths or heartbeats that are used up over a period of time. DIF: Cognitive Level: Comprehension REF: 28 OBJ: 2 TOP: Rate of Living Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease Chapter 03: Physiologic Changes Wold: Basic Geriatric Nursing, 5th Edition Chapter 03: Physiologic Changes

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    Test Bank MULTIPLE CHOICE 1. The nurse keeps the environment warmer for older adults because they are more sensitive to cold because of the age-related changes in their: a. metabolism rate. b. subcutaneous tissue. c. musculoskeletal system. d. peripheral vascular system. ANS: B The reduction of subcutaneous tissue as an age-related change causes sensitivity to cold because it is the main insulator of the body. DIF: Cognitive Level: Application REF: 36 OBJ: 1 TOP: Sensitivity to Cold KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. The nurse reassures the distressed 75-year-old male that the wartlike dark macules with distinct borders are not melanomas, but the skin lesions of: a. senile lentigo. b. cutaneous papillomas. c . seborrheic keratoses. d. xerosis. ANS: C

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    Dark, slightly raised macules are seborrheic keratoses, which may be mistaken for melanomas. DIF: Cognitive Level: Comprehension REF: 33 OBJ: 1 TOP: Seborrheic Keratosis KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The nurse is accompanying a group of older adults on a July 4th outing to monitor heat prostration. Older adults are intolerant of heat because of an age-related reduction of: a. melanin. b . perspiration. c. body temperature. d. capillary fragility. ANS: B Reduction in perspiration related to reduced sweat gland function results in possible heat intolerance from an inability to cool the body by evaporation. DIF: Cognitive Level: Analysis REF: 34 OBJ: 2 TOP: Heat Intolerance KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The nurse cautions the CNAs to use care when transferring or handling older adults because their vascular fragility will cause: a. altered blood pressure. b. pressure ulcers. c. pruritus.

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