1. You are performing an initial assessment on an 80-year-old male patient admitted for an infected right hand.

The man tells you that he can no longer do as many things as he used to be able to do. What do recognize as impacting your patient's life? A) An infectious-disease state B) Loss of independence C) Age-related changes D) Loneliness 2. A gerontologic nurse practitioner has a large patient population with heart-disease problems. This nurse practitioner is aware that heart disease is the leading cause of death in the aged. What is the cause of this trend? A) Heart muscle and arteries lose their elasticity. B) Systolic blood pressure decreases. C) Resting heart rate decreases with age. D) The aged are less likely to adopt a healthy lifestyle. 3. An occupational health nurse overhears an employee talking to his manager about a 65year-old coworker. What would the nurse be concerned about when she hears the employee state, He should retire and make way for some new blood? A) Intolerance B) Ageism C) Dependence D) Nonspecific prejudice 4. The nurse is caring for a 65-year-old patient diagnosed with hypertension. Which of the following blood pressure readings demonstrates hypertension? A) 140/90 mm Hg B) 132/88 mm Hg C) 129/75 mm Hg D) 120/68 mm Hg 5. You are the nurse caring for a 75-year-old patient who has been hospitalized for a fractured radius. The patient's daughter has accompanied the patient to the hospital and asks you what her father can do for his very dry skin. What would be your best response? A) Bathe one to two times a week. B) Use makeup to cover the wrinkles. C) Avoid prolonged use of sunscreens. D) Drink more milk.

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6. An elderly patient has come in to the clinic for her yearly physical. The patient tells the nurse that she is having difficulty with bowel movements. What intervention could the nurse suggest? A) Stress reduction B) Increasing caloric intake C) Adequate privacy D) Increasing intake of water 7. An 84-year-old patient has returned from the PACU. The patient is oriented to name only. The patient's family is very upset because before having surgery, the patient knew the family. The patient is diagnosed with delirium. What should the nurse explain to the patient's family? A) There is nothing to worry about. B) Delirium involves a progressive decline in memory loss. C) Delirium usually lasts only a short time. D) Delirium is generally more prevalent in women. 8. The nurse is doing patient teaching with a patient with early stage Alzheimer's disease and her family. The patient has been prescribed tacrine hydrochloride. What should the nurse explain to the patient and family about the potential side effect of the drug? A) Liver toxicity B) Dental caries C) Depression D) Sexual impotence 9. A nurse is caring for an 86-year-old female patient who is very frail and unsteady on her feet. During the assessment, the patient indicates that she has fallen three times in the month. She has not injured herself to date. What is the nurse aware of a high potential for? A) A hip fracture B) A fracture of the mandible C) An increased likelihood of confusion D) Noncompliance with preventive teaching 10. You are a case manager working with a patient newly admitted to a rehabilitation facility. When developing a care plan for this older adult, which factors should the nurse consider as being positive in this age group? (Mark all that apply.)

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11. The nursing instructor is teaching first-semester nursing students about administering IM injections to an older patient. What does the instructor stress to her students? A) An older patient has less subcutaneous tissue and muscle mass than a younger patient. B) An older patient has more subcutaneous tissue and less muscle mass than a younger patient. C) An older patient has less subcutaneous tissue and more muscle mass than a younger patient. D) An older patient has more subcutaneous tissue and muscle mass than a younger patient. 12. An elderly patient, while being seen in an urgent care facility for a possible respiratory infection, asks the nurse if Medicare is going to cover the cost of the visit. The nurse realizes that the patient is concerned about the financial aspects of this illness. What information can the nurse give the patient to help allay her concerns? A) Medicare has a copayment for many of the services it covers. This requires the patient to pay a part of the bill. B) Medicare pays for 100% of the cost for acute-care services so the cost of the visit will be covered. C) Medicare will only pay the cost for acute-care services if the patient is very poor. D) Medicare will not pay for the cost of acute-care services so the patient will be billed for the services provided. 13. The admissions department at a local hospital is registering an elderly man for an outpatient test. The admissions nurse asks the man if he has an advanced directive. The man responds that he does not want to complete an advanced directive because he does not want anyone controlling his finances. What would be appropriate information for the nurse to share with this patient? A) Advanced directives are not legal documents, so you have nothing to worry about. B) Advanced directives are limited only to health care instructions and directives. C) Your finances cannot be managed without an advanced directive. D) Advanced directives are implemented when you become incapacitated, and then you will use a living will to allow the state to manage your money. 14. A nurse is planning discharge teaching for an 80-year-old patient with some short-term memory loss. The discharge teaching will include how to do his dressing change. What should the nurse plan to do? A) Set long-term goals with the patient B) Provide some music to aid learning C) Keep visual cues to a minimum D) Keep teaching periods short

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15. You are the nurse planning an educational event on the topic of the normal signs of aging to a group of senior citizens. What would you include in your teaching plan? A) An enhanced sense of smell B) A decrease in muscle mass C) The disappearance of sexual desire for both men and women D) An increase in sebaceous and sweat glands for both men and women 16. A home health nurse makes a home visit to a 90-year-old patient who has cardiovascular disease. During the visit the patient asks the nurse, Can you see the little green bugs that have been singing to me? The patient is also exhibiting signs of confusion and agitation. What should the home health nurse do? A) Have the patient's home care increased B) Have a family member check in on the patient in the evening C) Have the patient see his physician D) Refer the patient to an adult day program 17. The home health nurse is making an initial home visit to a 76-year-old male widower. During the assessment, the nurse finds that the patient is taking multiple medications. The patient states that he has also been taking some herbal remedies. What should the nurse be sure to include in the patient's teaching? A) Herbal remedies are holistic. B) Herbal remedies are often cheaper than prescribed medicine. C) The importance of avoiding herbal remedies D) The need to inform his physician and pharmacist about the herbal remedies 18. You are the nurse caring for an elderly patient who is confused and agitated. When the patient's family comes to visit the patient, you ask them how long the patient has been confused. The family states that the patient has been confused for a long time, and the confusion is getting worse. The patient is subsequently diagnosed with dementia. What is the most common cause of dementia in an elderly patient? A) Delirium B) Depression C) Excessive drug use D) Alzheimer's disease

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19. You are caring for a patient with late-stage Alzheimer's disease. The patient's wife tells you that the patient has become very dependent and that she feels guilty if she takes any time for herself because the patient cries out for her. What outcomes would be appropriate for the nurse to develop to assist the patient's wife? A) The caregiver learns to explain to the patient why she needs time for herself. B) The caregiver distinguishes obligations she must fulfill from those that can be controlled or limited. C) The caregiver leaves the patient at home alone for short periods of time to encourage independence. D) The caregiver avoids asking other family members to help for fear of imposing on them. 20. A 47-year-old patient who has come to the physician's office for his annual physical is being assessed by the office nurse. The nurse is doing routine screening on this patient. The nurse is aware that one of the first physical signs of aging is what? A) Having more frequent aches and pains B) Failing eyesight, especially close vision C) Increasing loss of muscle tone D) Accepting limitations while developing assets 21. The population in the United States is changing. As the elderly population grows, which factor is most dramatically increasing in this age group? A) More families are having to provide care for their aging members. B) Adult children find themselves being sandwiched between their own children and their parents. C) There is a growing number of people who live to a very old age. D) Elderly people are having more accidents, increasing the cost of health care. 22. As the population of the United States ages, research has shown that this aging will occur across all racial and ethnic groups. In what population is the rate of growth of the aging population expected to rise the fastest? A) Asian-American B) White non-Hispanic C) Hispanic D) African-American

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23. National surveys indicate that as much as 20% of the population 65 years of age or older report what? A) Good health B) Declining faculties C) A chronic disability D) A chronic disease 24. Even with the elderly population increasing, the majority of people aged 75 years of age and over remains functionally independent. What is this trend attributed to? A) Early detection and increasing risk factors B) Health-promotion and disease-prevention activities C) Decrease in treatment of factors like hypertension and serum cholesterol levels D) Increase in number of risk factors such as rising numbers of smokers 25. Health promotion and preventive health care are a major focus for the nursing professional. The challenge for nursing is to promote positive lifelong health behaviors in all segments of the population. What is the impact on the population if this challenge is not met? A) Declining longevity B) Increased disabilities C) Chronic disease D) Increased numbers of risk factors 26. Approximately 50% of the deaths in the 65 and older age group are caused by heart disease and cancer. However, over the past 50 years, a noticeable decline in overall deaths, especially from heart disease and cancer, has been noted. What has most caused this decline in deaths? A) Health care awareness in the elderly population B) Healthier lifestyles in the elderly population C) An increase in exercise and better nutrition among the aging population D) Improvements in the prevention and early detection and treatment of diseases 27. On which factor does the well-being of older adults depend? (Mark all that apply.) 28. The perceptions of the elderly by other segments of the population are sometimes negative. How do some people see older people? (Mark all that apply.)

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29. You are caring for a 72-year-old male patient who was recently admitted to the long-term care facility in which you work. Since admission he has become withdrawn and anxious. You know that anxiety in the elderly can be the result of what? A) Loss of dependence B) Fear of being visited in the hospital C) Mental sharpness D) Economic concerns 30. The interactions between disabilities and aging are not yet clearly understood. The nurse knows this interaction varies depending on what? A) Socioeconomics B) Nutritional status C) Social situations D) Decade of life 31. Gerontologic nursing is a specialty area of nursing that provides care for the elderly in our population. What goals of care are included in this population? A) Helping older adults determine how to best find their functional status B) Helping older adults use their strengths to achieve optimal independence C) Helping older adults promote independent living D) Helping older adults identify their weaknesses 32. The use of gerontologic advanced practice nurses (GAPNs) in long-term care has proven beneficial to both the patients and the communities in which they live. Using current knowledge based on evidence-based research conducted on clinical problems specific to the elderly population, what has occurred? A) Research has identified the major health problems of the chronically ill elderly population. B) The elderly are experiencing more long-term health problems. C) Less deterioration in the overall health issues of patients has occurred. D) The elderly are better taken care of in long-term care facilities than at home. 33. Even with health care programs such as Medicare and Medicaid, the poor and near-poor elderly populations are negatively impacted by out-of-pocket health care expenses. How much of the income of this population is spent on out-of-pocket health care expenses? A) 38% B) 33% C) 28% D) 23%

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34. The strains of providing care for an elderly family member with a chronic condition can sometimes be more than the family or caregiver can bear. If the nurse suspects that there is a potential problem with abuse of an elderly person, preventive measures should be taken. What might early detection and prevention provide for this potential problem? A) Sufficient resources to decrease risk for patient safety B) Support classes for the elderly patient C) Aging parenting classes for caregivers D) New ways to prevent the abuse of the elderly 35. You are the nurse caring for an elderly patient with cardiovascular disease. The patient comes to the clinic with a suspected respiratory infection and is diagnosed with pneumonia. As the nurse, what do you know about the altered responses of older adults? A) Treatments for older adults need to be rapid and less intense than treatments used in the younger population. B) The altered responses of older adults reinforce the need for the nurse to monitor all body systems to ascertain signs of impending systemic complication. C) The altered responses of older adults define the nursing interactions with the patient. D) Older adults become hypersensitive to antibiotic treatments for infectious-disease states. 36. You are the nurse caring for patients in the urology clinic. A new patient, 68 years old, presents with complaints of urinary incontinence. An anticholinergic is prescribed. Why might this type of medication be an inappropriate choice in the elderly population? A) Gastrointestinal hypermobility can be an adverse effect of this medication. B) Detrusor instability can be an adverse effect of this medication. C) Confusion can be an adverse effect of this medication. D) Increased symptoms of urge incontinence can be an adverse effect of this medication. 37. The elderly population has not been left out of the HIV/AIDS epidemic. What are common AIDS-indicator disease processes in the elderly population? (Mark all that apply.) A) Wasting syndrome B) Kaposi's sarcoma C) Tuberculosis D) Encephalopathy E) Pneumocystis pneumonia (PCP) 38. Falls are a major health problem in the elderly population and occur from multifactorial causes. What is a factor in the rate of falls in the elderly population? (Mark all that apply.)

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39. Older people have many altered reactions to disease that are considered age-related changes. When the nurse observes physical indicators of illness in the older population, that nurse must remember what? A) Potential life-threatening problems in the older adult population are not as serious as they are in a middle-aged population. B) Indicators that are useful and reliable in younger populations cannot be relied on as indications of potential life-threatening problems in older adults. C) The same physiologic processes that indicate serious health care problems in a younger population indicate mild disease states in the elderly. D) Middle-aged people do not react to disease states the same as a younger population does. 40. You are the nurse caring for a 91-year-old patient admitted to the hospital for a fall. The patient complains of incontinence and tells you he falls when he tries to get to the bathroom. You assess the patient as frail and prone to falls. You know that this patient most likely has a diagnosis of what? A) Impaired cognitive functioning B) Environmental hazards C) A geriatric syndrome D) An age-related health deficit

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Answer Key
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. C A B A A D C A A Decreased risk taking A A B D B C D D B B C C C B C D Environmental As being selfless and self-absorbed D A B C C A B C D Medication effects B C

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