The student nurse studying aging knows which theory was originally used to describe failures in

electronic equipment?
A) Error theory
B) Wear-and-tear theory
C) Run-out-of-program theory
D) Reliability theory of aging and longevity
The reliability theory of aging and longevity is a mathematical equation originally used to explain the
failure of electronic equipment. The error, wear-and-tear, and run-out-of-program theories were not
originally used with electronic equipment.REF: Page 28

The patient requests information on ways to prevent the damage associated with free radicals.
Information on which antioxidants would be most appropriate for the nurse to include? (Select all that
apply.)
A) Zinc
B) Copper
C) Selenium
D) Vitamin A
E) Vitamin C
F) Vitamin B12
Antioxidants such as zinc, selenium, and vitamins A, C, and E may help decrease the damage caused by
free radicals.REF: Page 28

The 45-year-old patient reports to the nurse he feels he is going through a "mid-life crisis." The nurse
recognizes this phenomenon refers to the theory developed by which psychologist?
A) Jung
B) Erikson
C) Newman
D) Havighurst
Carl Jung's theory of development proposes that an individual progresses through life searching and
setting goals for him or herself in an ongoing search for one's "true self." The "mid-life crisis" is the time
in which the individual reevaluates his or her life and progresses toward his or her true self. The theories
of Erikson, Newman, and Havighurst do not include a mid-life crisis. REF: Page 29

The patient in the clinic tells the nurse she can "feel her biologic clock ticking." The nurse knows the
patient views aging based on which theory?
A) Gene theory
B) Programmed theory
C) Rate of living theory
D) Somatic mutation theory
The programmed theory proposes that, at conception, a "biologic clock" begins ticking that determines
the number of cell divisions that occur before death. The rate of living theory postulates each person has
a finite number of heart beats. The gene theory discusses aging from the perspective of one or more
harmful genes that are activated over time and bring about age-related changes. The somatic mutation
proposes that aging is caused by environmental damage to DNA.REF: Page 27
The nurse in the long term care facility who cares for primarily older adults knows these adults are in
which stage of Erikson's developmental tasks?
A) Trust versus mistrust
B) Integrity versus despair
C) Industry versus inferiority
D) Generativity versus stagnation
The developmental stage for the older adult is integrity versus despair, where the individual looks back
on his or her life with pride that he or she had a positive impact or despair that his or her impact was
negative. Trust versus mistrust, integrity versus despair, and industry versus inferiority are stages for
younger individuals.REF: Page 29

The nurse working in the long term care facility plans care based on Havighurst's theory of aging. Which
task(s) should the nurse facilitate his patients to achieve? (Select all that apply.)
A) Adjusting to the loss of a spouse
B) Preserving and increasing strength
C) Adjusting to a decrease in income
D) Stabilizing one's self in one's social roles
E) Looking back on one's life with pride and contentment
Havighurst's theory of aging proposes tasks for older adults including adjusting to the loss of a spouse
and a decrease in income, adapting to new social roles flexibly, and establishing relationships with other
individuals of one's own age. Achieving the task of looking back on one's life with pride and contentment
is a part of Erikson's theory.REF: Page 29

The nurse in the long term care facility frequently observes older adults being separated from their
friends and family and excluded from society. This phenomenon is described in which psychosocial
theory of aging?
A) Activity theory
B) Life-course theory
C) Developmental theory
D) Disengagement theory
The disengagement theory describes the phenomenon in which older adults are separated from their
friends and become disengaged from society because they are perceived to no longer be a benefit to
society. The activity theory states successful aging requires continued activity. The life-course theories
include theories by Erikson, Havighurst, Newman, and Jung. The developmental theory uses Erikson's
eight stages of developmental tasks to describe aging.REF: Page 29

The aging patient requests information on the causes for the age-related changes he sees in his body. In
order to educate the patient using the neuroendocrine theory of aging, the nurse should discuss which
structure in the brain?
A) Cerebellum
B) Hippocampus
C) Hypothalamus
D) Anterior pituitary gland
The neuroendocrine theory of aging proposes that age-related changes are caused by chemical
interactions in the hypothalamus of the brain. The cerebellum, hippocampus, and anterior pituitary
gland are not the focus of the neuroendocrine theory of aging.REF: Page 28

The patient in the clinic tells the nurse she has heard about the dangers of free radicals and requests
more information. The nurse bases his response on an understanding that free radicals have been
associated with which age related change(s)?
Select all that apply.
A) Hypothyroidism
B) Atherosclerosis
C) Rheumatoid arthritis
D) Type 2 diabetes mellitus
E) Peripheral vascular disease
F) Chronic obstructive pulmonary disease (COPD)
Free radicals have been associated with atherosclerosis, diabetes, circulatory diseases such as peripheral
vascular disease, and arthritis. Rheumatoid arthritis is an autoimmune disease. Hypothyroidism and
COPD are not associated with free radicals.REF: Page 28

The nurse working with aging individuals knows the use of antioxidants to slow the aging process
corresponds to which theory?
A) Crosslink theory
B) Free radical theory
C) Somatic mutation theory
D) Connective tissue theory
Antioxidants are thought by some to reduce or prevent the damage to DNA caused by free radicals,
which are the cause of aging in the free radical theory. The crosslink theory and connective tissue
theories are the same. The somatic mutation theory discusses DNA mutations caused by exposure to
radiation and chemicals.REF: Page 28

The nurse is doing patient teaching for a 50-year-old woman. Based on the application of the
programmed theory of aging, which brochure is the nurse most likely to offer the patient?
A) "Perimenopause and Menopause: Most Frequently Asked Questions"
B) "Do the Benefits Outweigh the Risks of Antioxidant Supplements?"
C) "Exercise, Food, Sleep, and Fun: Healthy Lifestyle Tips for Older Adults"
D) "Healthy Nutrition Is More Than Just Counting Calories and Losing Weight"
The programmed theory suggests that a person experiences predictable changes according to a biologic
clock, such as menopause and graying of the hair. The free radical theory proposes that excess free
radicals in the body cause physiologic aging. The use of antioxidants is
thought to reduce the number of free radicals. The wear-and-tear theory suggests that good health
maintenance practices may slow the rate of wear on the body parts. A fairly new theory of aging
correlates aging to calorie intake, but the theory is based on animal studies. (p. 27)
Two nursing students are exhausted after studying about the biologic theories of aging. They decide to
have some fun and perform an action that is based on the rate of living theory. Which action do they
perform?
A) Go for a leisurely walk in the sunshine
B) Hold their breath for as long as they can
C) Share an apple and an orange
D) Give each other a facial and then use anti-aging cream
The rate of living theory proposes that individuals have a finite number of breaths or heartbeats that are
used up over time. The students are just having fun with this theory, by saving the number of breaths. (p.
27)

According to the disengagement theory, what is the nurse most likely to observe while assessing an older
adult?
A) Dryness of the skin with wrinkles and loss of elasticity
B) Decreased muscle mass and increased body fat
C) Decreased interest and involvement in social interactions
D) Adjustment to retirement and loss of income
The disengagement theory is a highly controversial psychosocial theory that
proposes that older adults desire to withdraw and society also withdraws for the mutual benefit of both.
Changes in skin or body composition are addressed by biologic theories. Havighurst's theory suggests
that adjustment to retirement and loss of income are tasks of aging. (p. 29)

The nurse is designing a group activity for a group of older women who have mild loss of self-esteem and
a reluctance to socialize. None have serious cognitive or physical impairments. Based on the activity
theory, which activity will the nurse suggest?
A) A weekly knitting group to make hats for premature infants
B) A daily game of unfolding and refolding a stack of towels
C) A weekly activity to sort buttons into different color groups
D) A daily group discussion about local politics
Knitting hats for infants is purposeful; this raises self-esteem, and sitting in a group while knitting allows
time for socialization. The knitting can stimulate conversation as the women help and compliment each
other. Sorting buttons and folding towels are more appropriate for persons with significant cognitive
impairment. These busywork activities will not stimulate intellect or increase self-esteem. A daily group
discussion about local politics may be very suitable for some, but for participants who show reluctance
to socialize, or for those whose selfesteem is further threatened by disagreement, the nurse is more
likely to start with other themes or topics for discussion. (p. 29)

According to Jung's theory, which statement by an older adult indicates successful aging?
A) "I have a strong belief that there is life after death. So I am not afraid of dying"
B) "I never experienced travel around the world, but I traveled in my imagination"
C) "I lost my wife several years ago; I still miss her, but I focus on the good memories"
D) "Well, when I look back at my life, I am happy to say that I did it my way
Successful aging, according to Jung, includes acceptance and valuing of the self without regard to the
view of others. (p. 29)
The wear-and-tear theory of aging is based on the belief that body cells and organs eventually wear out
like machinery. What type of theory is this?
A. Autoimmune Theory
B. Biologic Theory
C. Psychosocial Theory
D. Continuity Theory

Which theory suggests it is normal for older people and society to withdraw from each other?
A. Activity Theory
B. Disengagement Theory
C. Free-Radical Theory
D. Lifestyle Theory

Which older adult population is the fastest growing group?

A. Young Old
B. Middle Old
C. Chronic Old
D. Very Old

A physical change associated with aging is:

A. Increased blood flow to the brain
B. Heart and lungs being less efficient
C. Brain not adapting to injury
D. Older people having larger appetites

What is the most common chronic health problem in people over 75 years?
A. Hypertension
B. Heart disease
C. Arthritis
D. Lung disease

What is an early sign of dementia?

A. Weight loss
B. Poor appetite
C. Disordered thinking
D. Change in appearance

Which statement is true regarding older adults?

A. Ageism is illegal in the United States
B. Widowers adjust better to the death of a spouse then do widows
C. The majority of older adults live within 10 miles of one of their children
D. The primary type of elder abuse is physical abuse
An older patient with dementia-related memory problems will demonstrate:
A. Consistent depressive mood
B. Recent and remote memory losses being equal
C. Struggles to perform
D. Rapid progression of symptoms

Which factors contribute to longer life? (Select all that apply.)

A. Good hygiene
B. Education
C. Optimism
D. Cultural origin

___________ is specialists in the study of aging people

Gerontologist

Demographers in the United States predict increasing numbers of older people because: (Select all that
apply):
A. The baby boomers are healthier as they get older than were previous generations
B. Medical technology is extending life for many, especially those with heart disease
C. Most people today are much happier than previous generations
D. There are more wealthy people who can afford good health care
E. More vitamins and supplements are available to delay aging

The biologic clock theory of aging states that:

A. Body systems eventually wear out
B. Body class are destined to live a specific period of time
C. No one can live more than 110 years
D. There is little one can do to change one's life span

Natalie and her parents live with her grandparents, second-generation Italian immigrants, on several
acres of rural farmland. The family runs a pasta manufacturing plant on the property. This is an example
of:
A. An inter generational household
B. A suburban household
C. A single-family household
D. The economic downturn

To fulfill Erikson's psychosocial stage, older adults can be encouraged to:

A. Play with their grandchildren
B. Continue with hobbies and light exercise
C. Remain employed as long as possible
D. Review their lives, recalling accomplishments

The important behaviors that can help an older adult to age successfully include:
A. Moving closer to a child
B. Remaining physically and mentally active
C. Limiting exercise to conserve strength
D. Eating at least 2000 calories daily

To help parents plan for possible future changes, adult children should:
A. Investigate alternative housing arrangements
B. Keep communication lines open within the family
C. Choose a nursing home for the parent
D. Consult with the parent's physician

Depression in older adults: (Select all that apply)

A. Is a natural part of aging
B. Has been linked to high suicide rates in seniors
C. Is best treated with medication and counseling
D. Can be easily diagnosed by a MD
E. May be the result of a chronic illness or loss of body function

Signs of elder abuse include: (Select all that apply)

A. Fear of caregivers
B. Bruises and cuts in various stages of healing
C. Timid and withdrawn behavior
D. Forgetfulness
E. Disheveled appearance

When trying to teach an older adult, an important aspect is to:

A. Provide good illumination in the room
B. Present only one point per teaching session
C. Speak loudly and point as you talk
D. Use very simple language

The arthritis in the patient's knees could possibly be explained by which of the following biologic
theories of aging?
A. Biological clock theory
B. Free-radical theory
C. Immune system failure theory
D. Autoimmune theory

An 82-year-old man is alert and oriented and in good physical health except for some arthritic pain that
"slows me down, but I just keep moving." He lives alone in an apartment in a senior citizen complex but
enjoys the company of other residents and takes part in the social activities there. His lifestyle is an
example of ?
A. an exception to the expected norm.
B. the disengagement theory.
C. the activity theory.
D. the biologic theory.

The nurse understands that the best explanation of why a particular person lives into his 90s in relatively
good health is that the person:
A. had healthy parents who passed on to him "good" genes and no hereditary diseases.
B.has lived a healthful lifestyle, which has included preventative care, good nutrition, exercise, and a
positive outlook.
C. has treated illness with "old-fashioned" home remedies while avoiding the use of many prescription
drugs.
D. reads a lot about the newest advances in health care and tries these approaches as soon as they are
publicized.

An 85-year-old widow who lives alone has fallen several times in the last month and has been noted by
her children to be confused about her medications and to frequently "forget" what is cooking on the
stove until it is burned. These observations indicate that:
A. she needs to be hospitalized to determine the cause of her confusion and falls.
B. home delivery of a hot meal each day would solve her cooking risk.
C. nursing home placement would be the best solution to her problems of aging.
D. further assessment is needed to evaluate an increased level of assistance.

The nurse clarifies that the immune system failure theory states that:
A. the elderly lose their ability to effectively respond to infections and are more likely to die from them.
B. the body no longer recognizes itself and begins to attack itself, causing illness.
C. toxins and harmful chemicals (free radicals) in the environment cause damage to body cells.
D. the diminished activity of the elderly make them susceptible to illness.

The nurse seeks out residents with whom they reminisce in an interview regarding the resident's life
story. The value of this activity is that:
A. it gives the staff more time to care for other residents and perform routine care.
B. it can affirm the positives of the resident's life and lead to ego integrity for the resident.
C. nursing home residents have long days to pass, and any activity helps the time pass more quickly.
D. students learn about the "good old days" and better appreciate the modern conveniences available
today.

The home health aide who visits an older adult reports to the nurse that the patient has many new
bruises on her arms and face. The patient states that her daughter "has a temper and got mad" when
she visited the day before. The nurse should:
A. call the daughter for clarification.
B. notify her nursing supervisor to report the incident to the authorities.
C. tell the aide to report it to the nursing supervisor.
D. plan to visit the patient when the daughter will be present.
A 76-year-old neighbor confides to the nurse that she is having to get up in the middle of the night to
void and often wets herself before she can get to the bathroom during the day. The nurse's best
explanation would be:
A. "As you get older, your bladder muscle loses tone and you can hold less urine."
B. "You are probably drinking too much during the day and especially before bedtime."
C. "You probably have a bladder infection that should be treated with antibiotics."
D. "With age, the urine becomes very concentrated and causes the bladder to empty spontaneously."

A nurse making a home visit to a 75-year-old woman discovers that the patient stays in bed or on the
couch most of the time because she is afraid of falling. The nurse should arrange for a:
A. sitter to stay with the woman during the day.
B. wheelchair to increase mobility.
C. physical therapist to teach resistance training.
D. special cushion for the chair and bed to reduce the risk of decubiti.

The home health nurse assesses an 80-year-old who has fallen twice in the last 10 days. The nurse
discovers that the patient uses a cane for ambulation stability, drinks up to 6 cups of coffee a day, has
altered depth perception because of cataracts, and has recently carpeted her home with a smooth tight
weave carpet. The nurse suspects the cause of her recent falls to be the:
A. use of the cane.
B. new carpet.
C. large intake of caffeine.
D. altered depth perception.

A 70-year-old widower continues to work part time in a demanding business, while traveling in his free
time with a 68-year-old widow to visit longtime friends and relatives. He remains an active member of
several community organizations. His life is an example of a person who:
A. is acting like a younger person to prove to himself that he is not "old."
B. is adjusting well to the changes of benign senescence.
C. should slow down and enjoy retirement while he is still healthy.
D. is avoiding the psychosocial tasks of aging such as retirement and slowing down.

A 78-year-old man is admitted to the hospital after a fall from his bed at home that resulted in a
fractured hip and several fractured ribs. He states, "I don't know how I broke so many bones. I only fell
out of bed." The nurse can explain that:
A. loss of calcium from bone occurs in older adults and can result in fractures from minor trauma.
B. it is likely that an underlying disease made him more susceptible to fractures.
C. the bedside table near the bed added to his injuries.
D. the height of the bed will need to be lowered when he goes home to prevent further injuries.

An 84-year-old patient who is hospitalized for pneumonia says to the nurse, "I don't know why I've lived
so long. All my friends are gone, my children and grandchildren are all independent and successful—
nobody needs me anymore." An appropriate response by the nurse is:
A. "You have a lot to live for. Your children and grandchildren really love you."
B. "You must have inherited good genes. You should be thankful you're still alive."
C. "Tell me about your children and what it was like when you were raising them."
D. "The pneumonia has made you feel morbid. Things will look up!"

An 80-year-old man has no chronic diseases and is alert, oriented, and physically active. Which of the
following nursing diagnoses is likely to be present as a result of the normal aging process?
A. Poisoning, risk for, related to the many medications an older person must take.
B. Suffocation, risk for, related to declining respiratory function.
C. Hopelessness, related to recognition of the end of life drawing near.
D. Constipation, related to slowed peristalsis.

The nurse warns that infection after exposure to respiratory illness in the older adult:
A. is more likely to result in serious lower respiratory infection related to weakened respiratory muscles
and fewer cilia.
B. is likely to be fatal due to the older person's low resistance.
C. results in rates of infection similar to those in the younger adult.
D. can be easily prevented with the use of antibiotics when the adult is exposed.

When the nurse is conducting a class for senior citizens at a local assisted living facility, to enhance
physical health, he encourages the older residents to engage in some form of exercise for at least:
A. 1 hour every other day.
B. 10 minutes at a time several times a day.
C. 30 minutes a day, five times a week.
D. 1 hour every morning.

The nurse points out that there are many myths about the elderly that are not true. The statement that
reflects the most accuracy about the elderly is:
A. most old people live in nursing homes.
B. genetics is the main factor in longevity.
C. the optimistic, happy person generally lives longer.
D. most old people are isolated from their families.

When the 75-year-old patient tells the nurse that he has had a good and rewarding life and has enjoyed
every minute of it, the nurse is aware that the patient has attained the Eriksonian stage of:
A. generativity.
B. autonomy.
C. integrity.
D. intimacy.

When a 68-year-old recent retiree confides in the health clinic nurse that he has felt depressed and
withdrawn since retirement, the nurse suggests that he:
A. talk with the physician about anti-depression medication.
B. arrange his day so that he is able to take a nap in the afternoon.
C. set a small goal for himself to be met every day.
D. eat three regular meals as he did when he was employed.

An 85-year-old has been increasingly confused and disoriented to place and time over the last several
months. He also has difficulty remembering what he ate, who visited, and where the recreation room is.
This behavior is indicative of ___________.
Dementia

A 67-year-old submitted a job application at a local gas station. The station manager said, "Aren't you
retired? I can't hire you. You're too old to be working!" This is an example of _____________.
Ageism

The home health nurse assesses the older patients in her case load for signs of abuse. The nurse is aware
that the primary incidence of abuse is _________.
Neglect

To promote cognitive health for a 79-year-old, the nursing student should encourage the patient to do
which of the following? (Select all that apply.)
A. Read the newspaper.
B. Put together puzzles.
C. Take naps when tired.
D. Write letters.
E. Toilet independently.

A 76-year-old recently lost her spouse. They lived in a large house with a yard that they managed well
until her spouse's sudden death. She is in good health and stays active but is becoming concerned about
her ability to maintain the large house by herself. The nurse's most helpful suggestion would be to:
(Select all that apply.)
A. recommend living with her daughter who lives 2 hours away.
B. encourage her to investigate apartment rentals.
C. encourage her to check herself into a skilled nursing facility.
D. hire a gardener and a housekeeper to maintain the property.
E. encourage her to involve family in any decisions related to her living arrangements.

An 82-year-old patient expresses concern of always being cold. Based on knowledge of the physical
changes associated with aging, the nurse could appropriately respond: (Select all that apply.)
A. "Wrap up warmly, because the cold feeling is a result of decreased bone calcium that occurs with
aging."
B. "Chronic constipation can lead to a sense of cold because of the reduced peristalsis."
C. "Subcutaneous fat is reduced as part of aging. This fat that helps to keep you warm decreases."
D. "A low level of thyroid hormone causes you to feel cold."
E. "Eat more protein foods to help your body generate heat."
The nurse points out elements in our culture that support longevity in older people, which include:
(Select all that apply.)
A. reducing stress from regular exercise on the body in younger years.
B. being actively involved in their own health care.
C. taking of antibiotics through their lifetime.
D. increasing education about health matters.
E. avoiding the eating of red meat.

Which one of the following is a myth about older people?

A. Skin becomes thinner and more fragile
B. Most older people are unhappy
C. The brain has less blood flow with old age
D. Older people worry about breaking a hip

One reason the patient might feel cold in rooms where younger people feel warmer is that
A. Her thyroid function has increased
B. She is not as active as she used to be
C. She has less subcutaneous fat at this age
D. The skin thins with advanced age

The patient's appetite has waned. Her appetite might be improved by (select all that apply)
A. Sharing meals with others
B. Using a microwave oven to heat meals
C. Adding additional seasonings to foods
D. Increasing the amount of fresh vegetables at meals
A. Sharing meals with others

Patient teaching includes using various methods for instruction. A variety of teaching aids can also be
utilized. In preparation for teaching the older adult, it is wise to be certain that the patient has his
_______________ and any needed _______________in place before beginning
Glasses and hearing aides

The older patient is having trouble with recent memory. One technique that can assist with
remembering things is to
A. Repeat what she needs to remember out loud
B. Concentrate on what needs to be remembered for 10 seconds
C. Tell someone else to remind her of what she needs to remember
D. Make written lists or mark appointments on a calendar

One factor that may contribute to ego integrity for the older adult is
A. Setting goals for the future
B. Being proud of the children she raised
C. Regretting that she did not go to college
D. Wishing that she had ahead a career

The older patient has a better chance of adjusting to continued aging in positive ways if he or she
A. Remains actively involved with others
B. Curtails her activities to prevent fatigue
C. Depends on her daughter to do her errands
D. Has a living I'll in place with her doctor

Activities that can help the older adult maintain good health and prevent falls might be
A. Taking lots of additional supplements and herbs
B. Exercising daily with resistance training
C. Walking daily with the aid of a cane
D. Having someone come and live with him or her at age 70

The patient's daughter would know that her mother needs more assistance if
A. The dishes are not done before noon
B. The clothes she wears are often soiled
C. She starts spending all of her time at the senior center
D. She repeats stories about the trips she has made

A nurse is caring for an older adult client. The nurse should recognize the client is at risk for which of the
following physiological changes? (select all that apply)
a. decreased gastric motility
b. decreased skin elasticity
c. increased pain threshold
d. increased metabolic rate
e. increased cardiac output

A nurse is teaching a class of older adults about the expected physiologic changes of aging. Which of the
following changes should the nurse include in the discussion? (select all that apply)
a. more difficulty seeing due to a greater sensitivity to glare
b. decreased cough reflex
c. decreased bladder capacity
d. decreased systolic blood pressure
e. dehydration of interveterbal discs

A nurse is obtaining a history on an older adult. Which finding will the nurse most typically find?
a. lives in a nursing home
b. lives with a spouse
c. lives divorced
d. lives alone

A nurse is developing a plan of care for an older adult. Which information will the nurse consider?
a. Should be standardized because more geriatric patients have the same needs
b. needs to be individualized to the patient's unique needs
c. focuses on the disabilities that all aging persons face
d. must be based on chronological age alone

Which information from a co-worker on a gerontological unit will cause the nurse to intervene?
a. most older people have dependent functioning
b. most older people have strengths we should focus on
c. most older people should be involved in care decisions
d. most older people should be encouraged to have independence

A nurse suspects an older-adult patient is experiencing caregiver neglect. Which assessment findings are
consistent with nurse's suspicions?
a. flea bites and lice infestation
b. left at a grocery store
c. refuses to take a bath
d. cuts and bruises

A nurse is teaching a group of older-adult patients. Which teaching strategy is best for the nurse to use?
a. provide several topics of discussion at once to promote independence and making choices
b. avoid uncomfortable silences after questions by helping patients complete their statements
c. ask patients to recall past experiences that correspond with their interests
d. speak in a high pitch to help patients hear better

An older patient has fallen and suffered a hip fracture. As a consequence, the patient's family is
concerned about the patient's ability to care for self, especially during this convalescence. What should
the nurse do?
a. stress that older patients usually ask for help when needed
b. inform the family that placement in a nursing center is a permanent solution
c. tell the family to enroll the patient in a ceramics class to maintain quality of life
d. provide information and answer questions as family members make choices among care options

A nurse is caring for an older adult. Which goal is priority?

a. adjusting to career
b. adjusting to divorce
c. adjusting to retirement
d. adjusting to grandchildren

A nurse is observing skin integrity of an older adult. Which finding will the nurse document as a normal
finding?
a. oily skin
b. faster nail growth
c. decreased elasticity
d. increased facial hair in men
An older-adult patient in no acute distress reports being less able to taste and smell. What is the nurse's
best response to this information?
a. notify the health care provider immediately to rule out cranial nerve damage
b. schedule the patient for an appointment at a smell and taste disorders clinic
c. perform testing on the vestibulocochlear nerve and a hearing test
d. explain to the patient that diminished senses are normal findings

T or F: 65-75 y/o are the fastest growing age group in the U.S?
F; 85 yo and up is fastest growing group

T or F: Most older people live in institutions

F; only 5% live in nursing homes and most live with spouses, near children, etc.
Most want to stay in home and communities

T or F: Confusion is a normal part of aging

F; can be caused by Alzheimer's or other things can lead to confusion
Most of these that cause confusion can be cured

T or F: Older adults should exercise strenuously

F; strengthen heart, lung, muscle strength
Lessen bone osteoporosis and active but not strenuous

T or F: The risk of heart disease in the aged relates primarily to men

F; risk of heart disease increased after menopause in women
chest pain is not always a heart problem- sometimes GI
#1 killer for older aged people

T or F: Older adults sleep less and require less sleep

F; sleep efficiency changes and quality
sleep efficiency changes to 70% (not as refreshing)
healthy adults take naps (improves alertness)

T or F: Weight gain is most common as people age

True; need fewer calories
Go out to eat more
Balanced diet is important
Higher risk for malnutrition

T or F; Most older people are depressed

F; 1/3 people show depression symptoms and can go untreated
Can be caused by meds, stress, etc.

T or F: Most older people die of cancer

F; heart disease is #1
cancer can be cured if caught early
screening

T or F: older people consume the largest percent of medications

T; combination of conditions that require drugs and may have problems with adverse reactions

T or F: older adults are no longer interested in sex

F; can have a normal sex life
decrease can be because of health problems
erectile dysfunction meds increase and have been a cause of sexually transmitted disease

T or F: Alzheimer's disease is an inherited disease

F; not determined at present

T or F: Diet and activity can help prevent osteoporosis

T; eat rich in calcium and exercise (weight bearing)

T or F: Personality changes as people age

F; one of the few constants of life

T or F: urinary incontinence is a common disease in the elderly

F; symptom not a disease
can result from infections, meds, pregnancy, etc.

T or F: suicide is not a clinical concern in the elderly

F; suicide is most prevalent 65 yo and older especially in white men
always ask if they have a plan

T or F: Motor vehicle accidents are the most common injury in older adults
F; most common = falls

T or F: all older adults get cataracts

F; not everyone though many do between the ages of 65-75 yo and continue to increase
surgery can fix

T or F: older adults are more at risk for hypothermia and heatsroke

T; deterioration of control mechanism (shiver or vasodilate)
decrease metabolism

T or F: once people reach a certain age, they can no longer learn new information or skills
F; people at any age can obtain new skills just many take longer
The nurse is setting up an education session with an 85-year-old patient who will be going home on
anticoagulant therapy. Which strategy would reflect consideration of aging changes that may exist with
this patient?
A. Show a colorful video about anticoagulation therapy.
B. Present all the information in one session just before discharge.
C. Give the patient pamphlets about the medications to read at home.
D. Develop large-print handouts that reflect the verbal information presented.
Rationale: Option D addresses altered perception in two ways. First, by using visual aids to reinforce
verbal instructions, one addresses the possibility of decreased ability to hear high-frequency sounds. By
developing the handouts in large print, one addresses the possibility of decreased visual acuity. Option A
does not allow discussion of the information; furthermore, the text and print may be small and difficult
to read and understand.

When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse
should
A. use a standardized geriatric nursing care plan.
B. plan for likely long-term-care transfer to allow additional time for recovery.
C. consider the preadmission functional abilities when setting patient goals.
D. minimize activity level during hospitalization.
Rationale: The plan of care for older adults should be individualized and based on the patients current
functional abilities. A standardized geriatric nursing care plan is unlikely to address individual patient
needs and strengths. A patients need for discharge to a long-term-care facility is variable. Activity level
should be designed to allow the patient to retain functional abilities while hospitalized and also to allow
any additional rest needed for recovery from the acute process.

Which information obtained by the home health nurse when making a visit to an 88-year-old with mild
forgetfulness is of the most concern?
A. The patient's son uses a marked pillbox to set up the patient's medications weekly.
B. The patient has lost 10 pounds (4.5 kg) during the last month.
C. The patient is cared for by a daughter during the day and stays with a son at night.
D. The patient tells the nurse that a close friend recently died.
Rationale: A 10-pound weight loss may be an indication of elder neglect or depression and requires
further assessment by the nurse.

A 70-year-old client asks the nurse to explain to her about hypertension. An appropriate response by the
nurse as to why older clients often have hypertension is due to:
A. Myocardial muscle damage
B. Reduction in physical activity
C. Ingestion of foods high in sodium
D. Accumulation of plaque on arterial walls

In reviewing changes in the older adult, the nurse recognizes that which of the following statements
related to cognitive functioning in the older client is true?
A. Delirium is usually easily distinguished from irreversible dementia.
B. Therapeutic drug intoxication is a common cause of senile dementia.
C. Reversible systemic disorders are often implicated as a cause of delirium.
D. Cognitive deterioration is an inevitable outcome of the human aging process.
Rationale: Delirium is a potentially reversible cognitive impairment that is often due to a physiological
cause such as an electrolyte imbalance, cerebral anoxia, hypoglycemia, medications, tumors,
cerebrovascular infection, or hemorrhage.

Which of the following interventions should be taken to help an older client to prevent osteoporosis?
A. Decrease dietary calcium intake.
B. Increase sedentary lifestyles
C. Increase dietary protein intake.
D. Encourage regular exercise.
Rationale: Key word in question is prevent
Weight-bearing exercises helps to fight off degeneration of bone in osteoporosis

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 health 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.
D. Adults older than 65 years of age are the greatest users of prescription medications.
Rationale: Approximately two thirds of older adults use prescription and nonprescription drugs with one
third of all prescriptions being written for older adults

The nurse is aware that the majority of older adults:

A. Live alone
B. Live in institutional settings
C. Are unable to care for themselves
D. Are actively involved in their community

The nurse works with elderly clients in a wellness screening clinic on a weekly basis. Which of the
following statements made by the nurse is the most therapeutic regarding their mobility?
A. "Your shoulder pain is normal for your age."
B. "Continue to exercise your joints regularly to your tolerance level."
C. "Why don't you begin walking 3 to 4 miles a day, and we'll evaluate how you feel next week."
D. "Don't worry about taking that combination of medications since your doctor has prescribed them."

A long-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 affects, 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."
Rationale: The nurse should encourage the older adult to question the physician and/or pharmacist
about all prescribed drugs and over-the-counter drugs. The older adult should be taught the names of all
drugs being taken, when and how to take them, and the desirable and undesirable effects of the drugs.

In performing a physical assessment for an older adult, the nurse anticipates finding which of the
following normal physiological changes of aging?
A. Increased perspiration
B. Increased airway resistance
C. Increased salivary secretions
D. Increased pitch discrimination
Rational: Normal physiological changes of aging include increased airway resistance in the older adult.
The older adult would be expected to have decreased perspiration and drier skin as they experience
glandular atrophy (oil, moisture, sweat glands) in the integumentary system. The older adult would be
expected to have a decrease in saliva. A normal physiological change of the older adult related to hearing
is a loss of acuity for high-frequency tones (presbycusis).

There are factors that influence the musculoskeletal system associated with aging. The nurse recognizes
that with age:
A. Men have the greatest incidence of osteoporosis
B. Muscle fibers increase in size and become tighter
C. Weight-bearing exercise reduces the loss of bone mass
D. Muscle strength does not diminish as much as muscle mass

Which of the following statements, made by the daughter of an older adult client 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."
C. "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."

The nurse, preparing to discharge an 81-year-old client from the hospital, recognizes that the majority of
older adults:
A. Require institutional care
B. Have no social or family support
C. Are unable to afford any medical treatment
D. Are capable of taking charge of their own lives

Which of the following responses by an older-adult client is most reflective of a need for further
education by the nurse regarding the physiological changes associated with the older adult?
A. "I call a cab if I want to go out after dark."
B. "I can't help worrying about becoming forgetful."
C. "I have my eyes checked regularly. Can't afford to fall."
D. "I really enjoy eating good vanilla ice cream, but I have cut way down." 0%

Which of the following statements made by a family member of a client recently diagnosed with early
stages of Alzheimer's disease is most reflective of an understanding of this disease process?
A. "Dad has always been a fighter; he'll fight this too. He won't give up."
B. "We have an appointment with his care provider to see about medication therapy."
C. "Good thing we found out about this early so we can prevent this from getting worse."
D. "We have a made arrangements to discuss nursing home placement for dad."

The nurse is planning client education for an older adult being prepared for discharge home after
hospitalization for a cardiac problem. Which nursing action addresses the most commonly determined
need for this age-group?
A. Suggest that he purchase an emergency in-home alert system.
B. Arrange for the client to receive meals delivered to his home daily.
C. Encourage the client to use a compartmentalized pill storage container for his daily medications.
D. Provide only written document describing the medications the client is currently prescribed.

An assisted living facility has provided its clients with an educational program on safe administration of
prescribed medications. Which statement made by an older-adult client reflects the best understanding
of safe self-administration of medications?
A. "I don't seem to have problems with side effects, but I'll let my doctor know if something happens."
B. "I'm lucky since my daughter is really good about keeping up with my medications."
C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand something."
D. "It shouldn't be too hard to keep it straight since I don't have any really serious health issues."

Which of the following client statements regarding self-medication administration by an older-adult

client requires follow-up teaching by the nurse?
A. "I take all the pills ordered once a day at bedtime, so I'm less likely to forget them."
B. "I have one pill that needs cut in half. I am going to ask the pharmacist to do that for me."
C. "The pharmacist said to keep my pills away from the sunlight, so I put them inside the kitchen
cabinet."
D. "My daughter comes over each morning and puts my pills into a container that sorts them by the time
they are due."

Which of the following statements made by an older-adult client poses the greatest concern for the
nurse conducting an assessment regarding the clients adjustment to the aging process?
A. "I use to enjoy dancing and jogging so much, but now I have arthritis in my knees so that it's hard to
even walk."
B. "I've given my grandchildren money for college so they can live a better life than I had."
C. "Growing old certainly presents all sorts of challenges. I wish I knew then what I know now."
D. "As I age I've found its harder to do the things I love doing, but I guess it will all be over soon enough."

Of the following options, which is the greatest barrier to providing quality health care to the older-adult
client?
A. Poor client compliance resulting from generalized diminished capacity
B. Inadequate health insurance coverage for the group as a whole
C. Insufficient research to provide a basis for effective geriatric health care
D. Preconceived assumptions regarding the lifestyles and attitudes of this group

A patient is taking delayed-release omeprazole (Prilosec) capsules for the treatment of gastroesophageal
reflux disease (GERD). Which statement will the nurse include in the teaching plan about this
medication?
A. "Take this medication once a day after breakfast."
B. "You will only have to be on this medication for 2 weeks for a life long treatment of the reflux
disease."
C. "The medication may be dissolved in a liquid for better absorption."
D. "The entire capsule should be taken whole, not crushed, chewed, or opened."

The nurse defines ageism most accurately as:

A. The undervaluing of individuals based on their age.
B. Perception of a person's worth based on productivity
C. Biases directed towards individuals considered aged
D. Discrimination based on an individual's increasing age

A nurse is caring for an older adult client preparing for discharge to a nursing center after having hip
surgery. Which of the following nursing responses is most therapeutic with a client's concern that she,
will never go back home?
A. "What makes you think that this transfer to the nursing center will be permanent?"
B. "The reason for this transfer is only to support you while you continue to recuperate."
C. "The decision to stay in the nursing center is yours to make. When you want to leave no one will stop
you."
D. "The nursing center is a lovely place with a wonderful staff of caring people. Just give it a chance. You
may like it."

A nurse caring for older adults in an assistive living facility recognizes that a clients quality of life needs
are best determined by:
A. Excellent physical, social, and emotional nursing assessments
B. A working knowledge of this age-group's developmental needs
C. A therapeutic nurse-client relationship that facilitates communication
D. The client's need for complete physical, emotional, and cognitive care

Which of the following statements made by a nurse reflects the best understanding of the health value
of conducting a blood pressure (BP) screening at a senior citizens centers health fair?
A. "This is a high risk group, so assessing BP allows us to identify clients at risk and send them for
treatment."
B. "Older adults enjoy health fairs, so it's a good place to screen substantial numbers of clients for
hypertension."
C. "Hypertension doesn't present symptoms early on, so screening elder adults is a wonderful preventive
measure."
D. "Blood pressure problems are common among this group, so it's a good way to monitor the
effectiveness of their medications."

The three common conditions affecting cognition in the older adults are:
A. Stroke, MI, Cancer
B. Cancer, Alzheimer's disease, Stroke
C. Delirium, Depression, Dementia
D. Blindness, Hearing loss, Stroke

A client has been recently diagnosed with Alzheimer's disease. When teaching the family about the
prognosis, the nurse must explain that:
A. Diet and exercise can slow the process considerably
B. It usually progresses gradually with a deterioration of function
C. Many individuals can be cured if the diagnosis is made early
D. Few clients live more than 3 years after the diagnosis

An overall, general assessment of an older adult patient is best performed in which setting?
A. During a meal.
B. During assessment of vital signs.
C. While assisting a patient with a bath.
D. When assisting a patient during a walk.

When caring for the older adult, it is important to:

Student Response Value Correct Answer Feedback
A. Repeat oneself often because older adults are forgetful.
B. Treat the client as an individual with a unique history of his or her own.
C. Be aware that older adults are no longer interested in sex.
D. Disregard the older adult's experiences because older people are too old-fashioned to be of value
today.

When administering a mental status examination to a patient with delirium, the nurse should
A. give the examination when the patient is well-rested.
B. choose a place without distracting environmental stimuli.
C. reorient the patient as needed during the examination.
D. medicate the patient first to reduce anxiety.

When performing a comprehensive geriatric assessment of an older adult, focus of the nursing
assessment is on the patient's:
A. Physical signs of aging.
B. Immunological function.
C. Functional abilities.
D. Chronic illness.
Of the following, which describes dementia?
A. Quick onset, irreversible
B. Slow onset, chronic
C. Acute onset, reversible
D. Progressive, terminal

When a fall results in injury and hospitalization, a cycle of disuse may occur over time. When establishing
a care plan for the patient and family to prevent this, it is important to remember disuse is most likely a
result of:
A. Decreasing muscle strength.
B. Decreased joint mobility.
C. Fear of repeated falls.
D. Changes in sensory perception.

What is the best resource (of those listed below) for identifying information regarding an older adult's
current functional ability?
A. Psychological tests and related exams
B. Diagnostic x-rays and lab tests
C. Family members who visit occasionally and call weekly
D. Neighbor who visits daily and helps the person to the store weekly.

When caring for an older adult patient, the nurse uses the following interventions to accommodate
visual changes with age:
A. Eye glasses in the bedside table.
B. Adequate lighting and uncluttered walkways.
C. Draw drapes in room to prevent glare.
D. Keep bedside rails down.

The primary reason an older adult client is more likely to develop a pressure ulcer on the elbow as
compared to a middle-age adult is:
A. A reduced skin elasticity is common in the older adult
B. The attachment between the epidermis and dermis is weaker
C. The older client has less subcutaneous padding on the elbows
D. Older adults have a poor diet that increases risk for pressure ulcers

While bathing an elderly client who has limited abilities for self-care, the nurse notices several patches of
dry skin on the clients heels, elbows, and coccyx. The nurse cleans and dries all the areas well and
applies a moisturizing lotion. The most appropriate immediate follow-up by the nurse to ensure
appropriate nursing care for this clients skin is to:
A. Revise the client's care plan to show the need for the application of moisturizing lotion
B. Assume personal responsibility to apply the moisturizing lotion daily to the client's skin
C. 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

A 76-year-old adult female is brought to a neighborhood client after being found wandering around the
local park. The client appears disheveled and reports being hungry. Which of the following assessment
and interview findings would cause the nurse to suspect elder abuse? (Select all that apply.)
A. Falls asleep in the examination room
B. Repeatedly states, "Don't hurt me."
C. Chafing around wrists and ankles
D. Bruises in various stages of healing

One reason for medication problems in the elderly is that

1. Regular use of laxatives increases absorption of medications
2. Decreased renal function slows excretion of drugs
3. Enhanced sense of taste of medications
4. Increased perception of pain from injections

You are caring for a 78 year-old female cardiac patient. In preconference, your clinical instructor asks you
what is an age-related change in the cardiac system of the older adult? Your best response would be
Student Response Value Correct Answer Feedback
1. Decreased blood pressure
2. Decreased cardiac output
3. Increase ability to respond to stress
4. Increased heart recovery rate

The most common affective or mood disorder of old age is

1. dementia.
2. depression.
3. delirium.
4. Alzheimer's.

Your patient assigned to you has pneumonia. You are reviewing the age-related changed involved with
the older adult. Select all age-related changes of the respiratory system that apply.
1. Decreased in residual lung volume
2. Decreased gas exchange
3. Decreased cough efficiency
4. Increased gas exchange

The leading cause of injury and preventable source of mortality and morbidity in older adults is
1. presbycusis.
2. car accidents.
3. pneumonia.
4. falls.
Which medication prevents the breakdown of a brain chemical important for memory and thinking and
may slow the progress of Alzheimer's disease.
1. memantine (Namenda)
2. ozazepam (Serax)
3. donepezil (Aricept)
4. citalopram (Celexa)

Which statement is true regarding falls in the elderly?

A. Most falls occur in the garage.
B. Hip fractures resulting from falls are a leading cause of placement in long-term care facilities.
C. Fall risk decreases with addition of medications.
D. Sedatives reduce the risk of falls.
C. encourage fluids to decrease the urine concentration so it is less irritating.

Appropriate nursing care for a patient with urinary incontinence is to:

A. insert an indwelling Foley catheter.
B. order oxybutynin chloride (Ditropan).
C. encourage fluids to decrease the urine concentration so it is less irritating.
D. recommend herbal approaches to reduce incontinence.

A nursing intervention for a patient with constipation is to:

A. avoid the urge to defecate.
B. limit fluid intake.
C. give prune juice with a noncarbonated drink.
D. encourage bran cereal or whole-grain breads.

A patient with dysphagia is:

A. fed only for pleasure.
B. at low risk for nutritional deficits.
C. at higher risk for pneumonia.
D. able to drink thin liquids.

Age-related eye changes may include:

A. increased visual accommodation.
B. macular degeneration.
C. non-preventable blindness as a result of glaucoma.
D. decreased ability of pupil to respond to light changes.

Nurses' knowledge of sexuality in the older adult population should include:

A. Chronic illness may affect the ability to participate in sexual activity.
B. Sexual response time is unchanged.
C. Ability to achieve orgasm declines.
D. Dryness of the vaginal walls is associated with pelvic inflammatory disease.
What is the initial nursing intervention in preventing polypharmacy?
A. Obtain a thorough medication history.
B. Discontinue all herbal preparations.
C. Refer the patient to a geriatric practitioner.
D. Consult a pharmacist to review all medications.

What should the nurse include in the teaching plan for self-medication practices of older adults?
A. Eliminate unnecessary medications.
B. Substitute herbal preparations for certain prescribed medications.
C. Develop a drug reminder system and schedule.
D. Pharmacy shop for the cheapest medications.

Which age-related changes predispose the elderly patient to drug toxicity and extended duration of
action of drugs? (Select all that apply.)
A. Decreased body water
B. Increased ratio of muscle to fat
C. Low serum albumin
D. Reduced blood flow to liver

________ is the use of multiple medications, often inappropriately and excessively, at the same time.
polypharmacy

Which mental change is associated with aging?

A. Confusion
B. Gradual decline in cognitive skills
C. Depression
D. Inappropriate behavior

An elderly patient has acute confusion after undergoing abdominal surgery. The patient most likely has:
A. delirium.
B. anxiety.
C. dementia.
D. depression

A patient is taking a psychotropic medication for agitation associated with dementia. What is a common
side effect of psychotropics?
A. Accelerated hypertension
B. Orthostatic hypotension
C. Diarrhea
D. Chest pain

Alzheimer's disease may be suggested in its early stages by:

A. magnetic resonance imaging (MRI).
B. computed tomography (CT).
C. positron emission tomography (PET).
D. autopsy.

Medications taken early in Alzheimer's disease to improve memory and alertness work by:
A. increasing dopamine in the frontal lobe.
B. decreasing dopamine in the frontal lobe.
C. increasing acetylcholine in the cerebral cortex.
D. decreasing acetylcholine in the cerebral cortex.

Chronological age is your age based on:

a) how well you feel
b) the passage of time
c) if you floss your teeth
d) how fabulous you look

An experienced nurse tells a younger nurse who is working in a retirement home that older adults have
"outlived their usefulness." What is the term for this type of prejudice?
a) racism
b) agism
c) harassment
d) whistle blowing

A nursing instructor teaching classes in gerontology to nursing students discusses myths related to the
aging of adults. Which statement is a MYTH about older adults?
a) most older adults live in their own homes
b) healthy older adults enjoy sexual activity
c) old age means mental deterioration
d) older adults want to be attractive to others

Why do we separate the young-old from the old-old?

a) to determine social security costs
b) needs and resource use differs
c) the young-old are more heterogenous
d) we love statistics and graphs

A nursing intervention directed toward primary prevention in the older adult focuses on:
a) disease management
b) routine health screenings
c) controlling symptoms of illness
d) teaching positive health behaviors

Which of the following are characteristics of a chronic illness (select all that apply)
a) has reversible pathologic changes
b) has a consistent, predictable clinical course
c) results in permanent deviation from normal
d) is associated with stable and unstable phases
e) always starts with an acute illness and then progresses slowly

An important nursing action to help a chronically ill older adult is to:

a) avoid discussing future lifestyle changes
b) assure the patient that the condition is stable
c) treat the patient as a competent manager of the disease
d) encourage the patient to "fight" the disease as long as possible

The nurse teaches a student nurse about health care disparities and older adult women. Which
statement, if made by the student nurse, would indicate an understanding of the teaching?
a) "Women tend to have a shorter life expectancy than men."
b) "Women tend to have fewer financial resources than men."
c) "Women are less likely to be a caregiver to their spouses."
d) "Women are more likely to have age-related cognitive impairments."

Why do some older adults not seek healthcare for their complaints?
a) prefer to be left alone
b) poor health literacy
c) think it's a normal part of aging
d) hate clinic appointments

What is one reason polypharmacy exists among older adults?

a) counter act side effects
b) older adults are very good at taking medication
c) older adults like taking medication
d) health care providers don't coordinate the medication regimes

The nurse identifies the presence of age-associated memory impairment in the old adult who says:
a) "I just can't seem to remember the name of my new granddaugther."
b) "I make out lists to help me remember what I need to do, but I can't seem to use them."
c) "I forget movie stars' names more often now, but I can remember them later after the conversation is
over."
d) "I forgot that I went to the grocery store this morning and didn't realize it until I went again this
afternoon."

Older adults who become ill are more likely than younger adults to:
a) complain abt symptoms of their problems
b) refuse to carry out lifestyle changes to promote recovery
c) seek medical attention because of limitation on their lifestyle
d) alter their daily living activities to accommodate new symptoms
A nurse who is interested in providing care for older adults should identify that most chronic illnesses are
managed in:
a) hospice care
b) homeless shelters
c) the community setting
d) an acute care hospital

An appropriate care choice for an older adult who lives with an employed daughter, but requires help
with activities of daily living is a/an:
a) nursing home
b) adult day care center
c) assisted living facility
d) acute rehabilitation facility

To reduce the risk of stress relocation syndrome upon admission to a long-term care facility, the nurse
should encourage the caregiver to:
a) give the patient a tour of the facility
b) bring in some familiar items from home
c) leave right away to allow time for adjustment
d) make all decisions for the patient to reduce stress

Examples of primary prevention strategies include:

a. colonoscopy at age 50
b. avoidance of tobacco products
c. intake of a diet low in saturated fat in a patient with high cholesterol
d. teaching the importance of exercise to a patient with hypertension
B - Primary prevention refers to measures such as proper diet, suitable exercise, and timely
immunizations that prevent the occurrence of a specific disease.

A characteristic of a chronic illness is that (select all that apply):

a. has reversible pathologic changes
b. has a consistent, predictable clinical course
c. results in permanent deviation from normal
d. is associated with many stable and unstable phases
e. always starts with an acute illness and then progresses slowly
C and D - The following are characteristics of chronic illness: permanent impairments or deviations from
normal, irreversible pathologic changes, residual disability, requirements for special rehabilitation, and
need for long-term medical or nursing management (or both). Chronic illness may have stable and
unstable periods.

Ageism is characterized by:

a. denial of negative stereotypes regarding aging
b. positive attitudes toward the elderly based on age
c. negative attitudes toward the elderly based on age
d. negative attitudes toward the elderly based on physical disability
C - Ageism is a negative attitude based on age.

An ethnic older adult may feel a loss of self worth when the nurse:
a. informs the patient about ethnic support services
b. allows a patient to rely on ethnic health beliefs and practices
c. has to use an interpreter to provide explanations and teaching
d. emphasizes that a therapeutic diet does not allow ethnic foods
D - An older adult with strong ethnic and cultural beliefs may experience loss of self if nurses deny or
ignore ethnic and cultural practices and behaviors.

An important nursing action to help a chronically ill older adult is to:

a. avoid discussing future lifestyle changes
b. assure the patient that the condition is stable
c. treat the patient as a competent manager of the disease
d. encourage the patient to "fight" the disease as long as possible
C - Chronically ill older adults should understand and manage their own health. Self-management is the
individual's ability to manage his or her symptoms, treatment, physical and psychosocial consequences,
and lifestyle changes in response to living with a long-term disorder

Older adults who become ill are more likely than younger adults to:
a. complain about the symptoms of their problems
b. refuse to carry out lifestyle changes to promote recovery
c. seek medical attention because of limitations on their lifestyle
d. alter their daily living activities to accommodate new symptoms
D - Older adults may underreport symptoms and treat these symptoms by altering their functional
status.

An appropriate care choice for an older adult who lives with an employed daughter but requires help
with activities of daily living is:
a. adult day care
b. long term care
c. a retirement center
d. an assisted living facility
A - Adult day care (ADC) programs provide daily supervision, social activities, and assistance with
activities of daily living (ADLs) for persons who are cognitively impaired and persons who have problems
with ADLs. ADC centers provide physical and emotional relief for the caregiver and allow the caregiver to
pursue continued employment.

Nursing interventions directed at health promotion in the older adult are primarily focused on:
a. disease management
b. controlling symptoms of illness
c. teaching positive health behaviors
d. teaching regarding nutrition to enhance longevity
C - A high value should be placed on health promotion and positive health behaviors.

What is most appropriate for the nurse to do when interviewing an older patient?
a. ensure all assistive devices are in place.
b. interview the patient and caregiver together.
c. perform the interview before administering analgesics.
d. move on to the next question if the patient does not respond quickly.
A - All assistive devices, such as glasses and hearing aids, should be in place when interviewing an older
patient. It is best to interview the patient and caregiver separately to ensure a reliable assessment
related to any possible mistreatment. The patient should be free from pain during the assessment and
may need extra time to respond to questions.

Which assessment findings would alert the nurse to possible elder mistreatment (select all that apply)?
a. agitation
b. depression
c. weight gain
d. weight loss
e. hypernatremia
A, B, D and E - Agitation and depression may be manifestations of psychologic abuse or neglect.
Hypernatremia may signify dehydration caused by physical neglect. A loss of body weight, rather than
weight gain, is another clinical manifestation of physical neglect.

A 67-year-old woman who has a long-standing diagnosis of incontinence is in the habit of arriving 20
minutes early for church in order to ensure that she gets a seat near the end of a row and close to the
exit so that she has ready access to the restroom. Which tasks of the chronically ill is the woman
demonstrating (select all that apply)?
a. controlling symptoms
b. preventing social isolation
c. preventing and managing a crisis
d. denying the reality of the problem
e. adjusting to changes in the course of the disease
A and C - The woman's efforts to ensure that she can continue in her lifestyle of church attendance while
accommodating the frequent elimination caused by her health problem are an example of controlling
her symptoms and preventing a personal crisis.

A 70-year-old man has just been diagnosed with chronic obstructive pulmonary disease (COPD). At what
point should the nurse begin to include the patient's wife in the teaching around the management of the
disease?
a. as soon as possible
b. when the patient requests assistance from his spouse and family
c. when the patient becomes unable to manage his symptoms independently
d. after the patient has had the opportunity to adjust to his treatment regimen
A - In the management of chronic illness, it is desirable to include family caregivers in patient education
and symptom-management efforts as early in the diagnosis as possible.
A nurse who is providing care for an 81-year-old female patient recognizes the need to maximize the
patient's mobility during her recovery from surgery. What accurately describes the best rationale for the
nurse's actions?
a. continued activity prevents deconditioning.
b. pharmacokinetics are improved by patient mobility.
c. lack of stimulation contributes to the development of cognitive deficits in older adults.
d. regularly scheduled physical rehabilitation provides an important sense of purpose for older patients.
A - Older adults are highly susceptible to deconditioning, a process that can be slowed or prevented by
regular physical activity. This consideration supersedes any possible effect on pharmacokinetics,
prevention of cognitive deficits, or the patient's sense of purpose.

Which criterion must a 65-year-old person meet in order to qualify for Medicare funding?
a. being entitled to Social Security benefits
b. a documented absence of family caregivers
c. a validated need for long-term residential care
d. a history of failed responses to standard medical treatments
A - In order to qualify for Medicare, an individual must be entitled to receive Social Security benefits.
Absence of caregivers and inadequate responses to treatment are not qualification criteria for Medicare,
and the program does not cover residential care services.

A male patient has a history of hypertension and type 1 diabetes mellitus. Because of these chronic
illnesses, the patient exercises and eats the healthy diet that his wife prepares for him. Which factors will
most likely have a positive impact on his biologic aging (select all that apply)?
a. exercise
b. diabetes
c. social support
d. good nutrition
e. coping resources
A, C, D and E - Biologic aging is the progressive loss of function. Obesity, diabetes, hypertension, and
cancer are all associated with the effects of aging. Exercise, good nutrition, social support, stress
management, and coping resources are all positive factors related to the aging process.

A 60-year-old female patient has had increased evidence of dementia and physical deterioration. What
would be the best assistance to recommend to her caregiver husband who is exhausted?
a. long-term care
b. adult day care
c. home health care
d. homemaker services
B - Adult day care provides social, recreational, and health-related services in a safe, community-based
environment that would keep this patient safe and decrease the stress on the husband. Long-term care
is used when the patient has rapid deterioration, the caregiver is unable to continue to provide care, and
there is an alteration in or loss of the family support system. Home health care is used when there is
supportive caregiver involvement for patients with health needs. Homemaker services provide services,
but do not care for the patient.

What should be included when planning care for an older adult?

a. patient priorities should be the only focus of care.
b. additional time related to declining energy reserves
c. reduction of disease and problems should be the focus.
d. tobacco cessation will help the patient cope with other illnesses.
B - Additional time is required with older patients with declining energy reserves. Patient priorities are
considered to best meet the patient needs but will not be the only focus of care. Focusing on strengths
and abilities as well as physical and mental status will facilitate goal setting to reduce disease or
problems. As with all patients, safety is a primary concern, and decreasing tobacco use will improve all of
the patient's body functioning.

Aging primarily affects the _________of drugs.

a. excretion
b. absorption
c. metabolism
d. distribution
C - Because the liver mass shrinks and hepatic blood flow and enzyme activity decrease in older adults,
metabolism of drugs drops 1/2 to 2/3 of the rate of young adults. This increases the chance of drug
toxicity and adverse drug events.

A nurse is caring for an adult who sustained a severe traumatic brain injury following a motor vehicle
accident. Once the patient recovers from the acute aspects of this injury and is no longer ventilator-
dependent, discharge planning would include that this patient will be transferred to what type of
practice setting?
a. assisted living
b. acute rehabilitation
c. long-term acute care
d. skilled nursing facility
B - Acute rehabilitation practice settings provide a post-acute level of care specializing in therapies for
patients with neurologic or physical injuries, such as those with head trauma, spinal cord injury, or
stroke.

Which of the following statements most accurately conveys aspect of the error theory of aging?
Perpetuation of DNA mutations results in organ and system malfunction

The error theory of aging purposes a cause-and-effect relationship between the genetic activity of body
cells and the effects of aging. Place the following steps in the error theory for aging in the correct
chronological order.
1) DNA mutation
2) Perpetuation of mutation during cell divisions
3) Decline in body functions
4) Organ, tissue, and systems malfunction
5) Overall decline in body functions

A nurse is explaining to an order adult client that many of the changes in his body that are currently
causing him frustration may have their origins in genetic changes that may have in fact benefited him
during his younger years. Which of the following theories of aging underline the nurse's explanation?
Antagonistic pleiotropy theory

An 80-year-old female who enjoys good health explains to her primary care provider that she attributes
her health status to her regular berries, fruit juices, and green tea, which she states "help cleanse the
damaging molecules out of my body." Which of the following theories of aging underlies the client's
health behaviors?
Free radical theory

A nurse is discussing an older adult client's apparent increased susceptibility to infection with his family.
Which of the following statements by the nurse would be most congruent with current thought around
the autoimmune role in the aging process?
"Older adults often have more difficulty fighting off infections because of their weaker immune systems,
and their bodies can even attack themselves."

A hospital clinical educator is espousing disengagement theory of aging when teaching staff how best to
meet the needs of older clients. Which of the nurse's teaching points best captures the disengagement
theory of aging?
"Older adults often benefit from a gradual and controlled withdrawal of their own interests from
society's interests."

Which of the following directives by the directives by the head nurse at a long-term care facility is most
reflective of the activity theory for aging?
"We have to treat our residents like younger people and keep them engaged in meaningful acts."

Which of the following tasks are components of Erikson's description of the old age tasks of reconciling
ego integrity with despair? Select all that apply
An 80-year-old man is struggling to determine his identity apart from his lifelong career as a business
leader
An 80-year-old man reveals in his large, happy family rather than focusing on his mobility limitations
resulting from Parkinson disease.
A 77-year-old man is trying to determine whether his life has had deep significance and meaning

Which of the following actions by a nurse who works with older adult clients in an assisted living facility
is most likely to inhibit healthy aging?
Placing a bib on each client during meal times to ensure clients maintain a clean appearance.
A nurse notes that a 90-year-old male client on a geriatric medical unit of the hospital has been talking
about death frequently. Given that the nurse has good rapport with the client, what is the nurse's most
appropriate response?
"I've noticed you've brought up the issue of dying a lot. How do you feel about that?"

Nurses need to understand the aging process in order to help their patients:
Postpone the negative consequences of the aging process

Mrs. H and Mrs. J are the same age while in the doctor's waiting in the doctor's waiting room, they
discuss their ailments and their beliefs about aging. Mrs. H argues that Mrs. J must be older because she
has more aliments. The nurse settles the argument by stating a cornerstone of all biological theories of
aging. Which of the following statements did the nurse most likely make?
No two individuals age identically.

Which of the following statements is evidence that supports the programmed theory of aging?
In cultures, cells go through a finite number of cell divisions before dying.

Which of the following statements form components of both the error theory of aging and the cross-
linking theory for aging?
Changes in DNA lead to organ malfunctions

Which of the following statements underlie both the error theory of aging and the free radical theory of
aging?
Biochemical damage accumulates over time, leading to cell death.

The nursing staff at a nursing home works closely with the staff in the Endocrinology Department at a
local hospital. This relationship is maintained for the welfare of the nursing home residents, because a
failing immune system in the elderly might account for:
The increased incidence of cancer among the aged

Although the immune system is affected by the aging process, the elderly are not the only individuals
who have autoimmune disorders. These occur in populations of all ages because autoimmune disorders
involve:
An attack of antibodies on body cells

A magazine geared toward elderly women contains an advertisements for an anti-wrinkle cream
purported to remove wrinkles caused by the drying effects of years of soap use. Knowledgeable nurses
can keep their elderly female clients from being duped by this advertisement by explaining that the
wrinkling of facial skin in old age results primarily from:
Repeated exposure to ultraviolet light

Mr. B, age 72, has a history of heart disease. He insists that his high-fat diet is permissible, however,
because he takes a daily supplement of gugulipid, an herb purported to reduce blood cholesterol levels.
In talking with the patient, what should Mr. B's nurse do first?
Review with Mr. B the benefits associated with limiting dietary fat

Ms. E, an 80-year-old, is gradually withdrawing from society and wants society to gradually withdraw
from her. She believes that this mutual withdrawal will free her from societal roles and give society the
means for transferring power from the old to the young. Ms. E's grown children are concerned and say
her belief has no scientific basis. On which of the following theories of aging can Ms. E say bases her
belief?
Disengagement theory

A state committee is looking to improve the lives of the state's elderly. It wants to recommend that the
health care facilities that cater to the elderly population be required to base their practices on the
activity theory of aging?
The assumption that older people want to maintain their middle-aged lifestyle

Mr. D was friendly and active as a young adult. Now, as a 75-year-old, he enjoys visiting with his
neighbors and attending a variety of sporting and cultural events. Mr. D's behavior is most consistent
with which theory of aging?
Continuity theory

Nurse Z takes ample time to explain all medical options to her elderly patients and to ensure they have
the information they need to make informed decisions about their care. What is Nurse Z's best reason
for taking these actions?
Empowerment has a positive effect on health status