WORKBOOK (GERIA)

c. Pink and blue

1. Paulina is a 76 year old patient with urinary tract infection. The most
dependable sign of infection in the older patient is:
a. Change in mental status
b. Fever and chills
c. Pleuritic chest pain during inspiratory phase
d. Decreased breath sounds with crackles
2. A 67 year old female client is currently admitted for breast cancer. However,
during examination, you observed that the patient has shallow respirations but
no sign of respiratory distress. Which of the following isn’t ABNORMAL
physiologic change related to aging?
a. Increased elastic recoil of the lungs
b. Increased number of functional capillaries in the alveoli
c. Decreased residual volume
d. Decreased vital capacity
3. Tatay Clarito has been experiencing urinary incontinence. You know that her
risk of urinary incontinence increases because of which of the following
changes?
a. Dilated urethra
b. Shrinkage of penis
c. Diuretic use
d. Decreased bladder capacity
4. Nurse Delia works in a nursing home. In order to care for the fragile skin
among the elderly, she should exclude the following:
I. Apply lotion or cream on the skin
II. Daily full bath
III. Provide sponge bath alternately with full bath
IV. Rub wash cloth briskly on the skin
a. 1 only
b. 2 and 4
c. 4 only
d. 1 and 3
5. Orlando is a 78 years old who had been bedridden for almost a year due to
generalized weakness. The following are appropriate nursing actions to
prevent postural hypotension in an elderly client except:
a. Advise to get out of bed gradually
b. Instruct to have a daily fluid intake of 3 glasses a day
c. Advise to avoid straining at stool
d. Advise to avoid bending down and suddenly standing up again
6. Eufemia is an 87 year old patient who verbalized to the nurse that she feels
like she hasn’t lived her purpose in life at all. In order to respond accordingly,
you have to know the developmental task of the patient at this point.The
developmental task of the older adult according to Erickson is:
a. Identity vs. role confusion
b. Intimacy vs. isolation
c. Ego integrity vs. despair
d. Generativity vs. stagnation
7. A booster dose of a COVID-19 vaccine is about to be administered to
Rodelia, an 87 year old healthy geriatric patient. by the nurse. The nurse
should remember that an older client has:
a. less subcutaneous tissue and muscle mass than a younger client
b. more subcutaneous tissue and less muscle mass than a younger
client
c. less subcutaneous tissue and more muscle mass than a younger client
d. more subcutaneous tissue and muscle mass than a younger client
8. A client was given photo albums to look at during her downtime. Which of
the following colors do older people see BEST?
a. Blue, green and purple
b. Red, yellow, and orange
d. Fuchsia, Magenta, Burgundy
9. Mario came to the clinic for a monthly wellness consultation. Which of the
following is NOT expected to be seen in an elderly male?
a. Enlarged prostate
b. Presbyopia
c. Absence of bowel sounds
d. Diminished lung expansion
10. Lillia was diagnosed with Alzheimer’s Disease at 65. You are currently
supervising a student nurse. During your planning, which of the following
should be included EXCEPT?
a. Have clocks or calendars in the environment
b. Provide consistent routine of activities
c. Spend time with the client and listen to concerns
d. Address the patient by calling him “grandpa”
11. Resurreccion was found to be still awake at 11 PM by a nurse doing hourly
rounds. Which statement, if made by the client, indicates that teaching about
improving sleep is necessary?
a. “I drink hot chocolate before bedtime.”
b. “I have stopped smoking cigars.”
c. “I swim three times a week.”
d. “I read for 40 minutes before bedtime.”
12. In meeting physiological and physical needs of an elderly, the nurse should
I. Keep client ambulatory as long as possible
II. Maintain optimal nutritional/vitamin status
III. Expose to sources of infection
IV. Maintain bowel and bladder elimination through routine consistent toilet
training
a. Institute safety measures
b. 1, 2
c. 3, 4
d. All but 3
e. 4,5
13. Delia, an 85-year-old woman, has just been admitted to a nursing home.
During your initial assessment, the nurse should plan special measures to
accommodate age-related sensory losses such as
a. Increased hearing sensation
b. Increased sensitivity to heat
c. Diminished sensation of pain
d. Heightened response to stimuli
SITUATION:
Marlene, 89 years old, is a new resident of the nursing home. She has been
observed to be easily irritated and speaks louder than normal. She does not
prefer to socialize with other residents and no longer bothers to answer
telephone calls because of deterioration of her hearing.
14. The nurse aide assigned to Marlene complains that she is becoming very
loud and becomes aggressive at times. You explain that this is a:
a. Beginning indifference to the world around her
b. Overcompensation for hearing loss
c. Behavior indicative of unresolved repressed conflict of the past
d. Attempt to maintain authoritative role
15. You will edit your plan of care accordingly by setting a goal which is to:
a. Increase her self esteem to maintain her authoritative role
b. Adjust to the loss of sensory and perceptual function
c. Accept the steady loss of hearing that occurs with aging
d. Participate in conversation and other social situations

1
16. A hearing aid was soon fitted for Marlene. She understood the proper use 24. Rene, aged 77, wants to have a cardiac assessment since he has a strong
and wearing of this device when she says that the battery should be functional, family history of myocardial infarction. To look for cardiac ischemia, which of
the device is turned on and adjusted to a the following is a most likely sign?
a. Audible level a. ST-T wave changes
b. Therapeutic level. b. Very high creatinine kinase level
c. Comfortable level. c. Chest pain radiating to the left arm
d. Prescribed level. d. Acute confusion

17. Upon assessment of Marlene’s situation, the physician is considering 25. In screening geriatric clients for infection, which of the following signs
presbycusis. Which of the following manifestations would support this should you look for?
diagnosis? a. Change in mental status
a. The elderly usually rub her ear and has frequent headaches b. Fever
b. She usually talks loudly because she cannot hear her own voice c. Pain
c. The presence of impacted ear wax upon otoscopic exam d. Decreased breath sounds with crackles
d. She usually presents with yellowish-greenish secretion draining from the
ears 26. Nestor, 72-year-old, is admitted in a community hospital for diagnostic
workup. He was found to be loitering in the hall at 1 am. He complained of
SITUATION: difficulty sleeping. To improve a client's sleeping pattern, the nurse should put
Eustacio, aged 66, was diagnosed with Alzheimer’s Disease. He has a history the LAST priority to which of the following nursing measures?
of sundowning. a. Lessen need to awaken client for medication
b. Use of sedatives and anxiolytics
18. Eustacio asks you, “What time is it?” The best response of the nurse to c. Increase physical activity in late PM and early evening
make is d. Limit napping during the day
I. “I don’t know too. Where are we?”
II. “Don’t worry Eustacio, You are safe. No one will harm you while I am here.” 27. Experts in the field of pain management have conducted that if pain
III. “You are Eustacio. Welcome to your new home” perception is diminished in the elderly person, it is most likely secondary to a:
IV. “You are placed in this institution because you are a bad boy.” a. Disease process
a. 1, 3 and 4 b. Developmental process
b. 3 only c. Chronic intake of medications
c. 3 and 4 d. Mental process
d. None of the above
28. Yuriko is a 65 year old who frequently wears sweaters and jackets despite
19. Which of the following would be an appropriate strategy in reorienting a hot weather. , The ability to feel differences in temperature is decreased in the
confused client, Eustacio, to where his room is? elderly because of:
a. Remind Mr. Andrade where his room is a. Inefficient heat regulating mechanism
b. Let the other nurses know where Mr. Andrade’s room is b. Deficient diaphoresis mechanism
c. Place pictures of his family on the bedside stand c. Decrease ability of discrimination
d. Put Mr. Andrade’s name in large letters on his forehead d. Illness effect

20. Eustacio has had difficulty sleeping since admission. Which of the following 29. Retchie complains to you that she can no longer read a text message in
would be the best intervention? her phone without drawing it near her eyes. This is a manifestation of:
a. Provide him with a glass of warm milk before sleeping Oa. Nystagmus
b. Ask the physician for a mild sedative and restraints b. Strabismus
c. Encourage him to take naps during the day c. Presbyopia
d. Offer a bucket of red horse beer to induce sleep d. Diplopia

21. Hypoxia may occur in the older patients because of which of the following 30. Paulina’s daughter complained to you that she feels like her mother
physiologic changes associated with aging? disregards what she says. But in your assessment, you found out that he has a
a. Ineffective airway clearance decreased ability to hear high pitched sounds. You know that thus is termed
b. Decreased alveolar surface area as:
c. Decreased anterior-posterior chest diameter a. Tinnitus
d. Hyperventilation b. Presbycusis
c. Otosclerosis
22. The older patient is at higher risk for incontinence because of: d. None of the above
a. Dilated urethra
b. Increased glomerular filtration rate 31. You proceeded to assess Paulina’s skin. You noticed that the skin appears
c. Diuretic use to be dry, wrinkled and has a poor skin turgor; this will prompt you to be aware
d. Decreased bladder capacity that the patient already has?
a. Hypothermia
23. Poling, due to her arthritis, spends most of her day lying on her bed. When b. Diminished collagen in the body and decreased sweat glands
she tries to rise up from the bed, she complains of dizziness when he stands c. Diminished sweat glands only
up. This may indicate: d. improved sweat glands that presents good thermoregulation
a. Dementia
b. A visual problem
c. Functional decline
d. Drug toxicity

2
32. During your conference with the team, after the observation of Paulina’s
skin, which of the following should you include except:
a. Apply lotion or cream on the skin
b. Avoid applying alcohol on the skin
c. Provide sponge bath alternately with full bath
d. Rub wash cloth briskly on the skin
33. Jaclyn has postural hypotension. You therefore include the following
interventions in an elderly client except:
a. Advise to get out of bed gradually
b. Instruct to have a daily fluid intake of 3 glasses a day
c. Advise to avoid straining at stool
d. Advise to avoid bending down and suddenly standing up again
34. The following are expected reproductive changes among the elderly, which
one is not?
a. decrease breast tissue mass resulting to breast sagging
b. lengthening of the penis but decreasing testicular size
c. decrease vaginal fluids causing vaginal dryness
d. enlargement of prostate gland leading to BPH
35. The nurse was performing her rounds at 2 am when she saw Marites, a 75
year old female, still wide awake. Which statement by the client indicates the
need for further teaching regarding measures to improve sleep?
a. "I swim three times a week."
b. "I have stopped smoking cigars."
c. "I drink hot chocolate before bedtime."
d. "I read for 40 minutes before bedtime.
36. The nurse is performing an assessment on Martha, a 76 year old female
who is bedridden due to spinal cord injury. Which assessment data would
indicate a potential complication associated with the skin?
a. Crusting
b. Wrinkling
c. Deepening of expression lines
d. Thinning and loss of elasticity in the skin
37. Elisa is a 50 year old with acute heart failure and was prescribed
antidysrhythmic drugs. Risks and benefits are both considered. When does the
need for the drug outweigh the risks?
a. When there is impairment in cardiac output.
b. When the dysrhythmia becomes chronic.
c. If the heart rate is 50 to 60 beats per minute
d. After the heart rate reaches a rate faster than 100 beats per minute
38. Nurse Rita, a home health nurse, is visiting Rosalinda, a 67 year old client,
for the first time. While assessing her medications, it is noted that there are 17
prescriptions and several over-the-counter medications that the client has been
taking. Which intervention should the nurse take first?
a. Check for medication interactions.
b. Determine whether there are medication duplications.
c. Call the prescribing health care provider (HCP) and report
polypharmacy.
d. Determine whether a family member supervises medication
administration
39. Jun, a 76 year old patient with heart failure, is being discharged after the
insertion of a permanent pacemaker. Which statement made by the patient
indicates an understanding regarding appropriate self-care?
a. Every morning I will perform moderate to vigorous arm and shoulder
stretches
b. Each day I'll take my pulse and record it in a log
c. I'll have to get rid of my microwave oven because it is unsafe for my
pacemaker.
d. I won't be able to use my electrical blanket anymore.
40. You are currently performing an admission assessment on Luisa, a 88 year
old patient with heart failure who is taking propranolol (Inderal) for
supraventricular tachycardia. Which assessment finding is an indication the
patient is experiencing an adverse effect of this drug?
a. Dry mouth
b. Bradycardia
c. Urinary retention
d. Paresthesia
41. Which laboratory finding should you monitor for Luisa who is at risk for
cardiac dysrhythmias?
a. BUN and creatinine
b. Sodium, potassium, and calcium
c. Hemoglobin and hematocrit
d. PT and INR
42. Nurse Helena, a charge nurse, tells Nurse Aya that she should be more
patient with people like older adults who have "outlived their usefulness." What
is the term for this type of prejudice?
a. Racism
b. Ageism
c. Harassment
d. Whistle blowing
43. Nurse Felisa 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."
44. Conrad, 81 years old, had been in pain for 3 months but did not consult the
clinic. Which of the following reasons is most likely the cause of the late
consultation?
a. prefer to be left alone
b. poor health literacy
c. think it's a normal part of aging
d. hate clinic appointments
45. The Baby Boom generation:
a. Born between 1940 and 1960
b. Is better off financially than the previous generations
c. Shares many social goals and political values with each other
d. Often provides care to aging parents and grandchildren
46. Nurse Luding is conducting a health teaching session with an 85-year-old
patient who will be going home on heparin 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.
47. Nurse Jelly is currently 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.
3
48. Nurse Queenie is a home health nurse. She visited Tatay Esming, a 77
year old with a history of stroke. Which of the following 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.

49. Nanay Lorelie asks the nurse why a lot of older people have 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

50. 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.