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Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019), Chapter 1-24 | All Chapters
Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019), Chapter 1-24 | All Chapters
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TEST BANKGerontological Nursing
Patricia A. Tabloski
4th Edition Table of Contents
Chapter 1 Principles of Gerontology 1
Chapter 2 Contemporary Gerontological Nursing 17
Chapter 3 Principles of Geriatrics 37
Chapter 4 Cultural Diversity 58
Chapter 5 Nutrition and Aging 77
Chapter 6 Pharmacology and Older Adults 96
Chapter 7 Psychological and Cognitive Function 116
Chapter 8 Sleep and the Older Adult 129
Chapter 9 Pain Management 146
Chapter 10 Violence and Elder Mistreatment 163
Chapter 11 Care at the End of Life 181
Chapter 12 The Integument 198
Chapter 13 The Mouth and Oral Cavity 212
Chapter 14 Sensation Hearing, Vision, Taste, Touch, and Smell 227
Chapter 15 The Cardiovascular System 243
Chapter 16 The Respiratory System 259
Chapter 17 The Genitourinary and Renal Systems 281
Chapter 18 The Musculoskeletal System 295
Chapter 19 The Endocrine System 312
Chapter 20 The Gastrointestinal System 330
Chapter 21 The Hematologic System 343
Chapter 22 The Neurologic System 366
Chapter 23 The Immune System 382
Chapter 24 Caring for Frail Elders with Comorbidities 399 https://www.stuvia.com/en-us/user/AllStudyGuides Gerontological Nursing, 4e (Tabloski) Chapter 1 Principles of Gerontology 1) The nurse is preparing to discharge an older cli ent with instructions on smoking cessation. The nurse states to a colleague, "This client has been smoking for years and isn't going to stop now." Which negative stereotype of aging does the nurse's statement most reflect? 1. Old people are expected to be sick. 2. Old people are set in their ways. 3. Old people do not value health promotion educati on. 4. Old people are a drain on societal resources. Answer: 3 Explanation: 1. Many older adults have chronic dis ease but function well. 2. Often people characterize the elderly in a negat ive way, believing that after a certain age, things cannot be changed. Older people can learn ne w things and take up new hobbies they can enjoy and give life meaning and pleasure. 3. Although it may not be possible to reverse all t he damage, it is never too late to stop smoking cigarettes. People who quit smoking at an older age enjoy better health outcomes. 4. Older people contribute greatly to society by vo lunteering, helping with grandchildren, mentoring others, and continue working. Page Ref: 4 Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: High-Risk Behaviors Nurs/Integ Conc.: Nursing Process: Planning Learning Outcome: 3. Identify common myths of agin g and their contribution to ageism. 2) The nurse is planning to conduct education for o lder adult clients regarding preventative health screenings. Which type of screening does the nurse anticipate educating this population on? 1. Glaucoma 2. Nutrition 3. An annual mammogram 4. Prostate-specific antigen Answer: 3 Explanation: 1. A glaucoma screening is recommende d annually for those at risk for glaucoma. 2. Nutritional assessment and counseling are encour aged for those with diabetes or renal disease. 3. The nurse will discuss the importance of annual mammograms. Older women are the fastest growing population in the United States. 4. A prostate-specific antigen is recommended yearl y for men under the age of 70. Page Ref: 7 Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Health Screening Nurs/Integ Conc.: Nursing Process: Planning Learning Outcome: 1. Interpret demographic data ac cording to race, gender, and age. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
1 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides 3) While completing an admission assessment, the nu rse learns that a female adult patient has smoked a pack of cigarettes daily for 20 years and works at a chemical plant. From this information, what is this patient most at risk for? 1. Decline in muscle mass 2. Nutritional deficiencies 3. Depression and social isolation 4. Occupational hazard shortening life expectancy Answer: 4 Explanation: 1. While muscle mass does naturally d ecline in older adults, there is no indication that she is not physically active. 2. In older adults, adequate nutrition can be a con cern, yet there is no indication that she is not adequately nourished. 3. In older adults, depression and social isolation are a risk, yet there is no indication that she is not socially active. 4. Exposure to occupational risk factors has been k nown to affect life expectancy in men and will have the same effect on women given similar circums tances. Page Ref: 8-17 Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: High-Risk Behaviors Nurs/Integ Conc.: Nursing Process: Diagnosis Learning Outcome: 2. Relate leading causes of morb idity and mortality among older adults. 4) The nurse is caring for an older adult with a ch ronic disease. Which is reflective of a tertiary intervention to help slow down the progression of t he client's illness? 1. Assess the client's mobility 2. Integrate physical therapy 3. Discuss injury-prevention measures within the ho me 4. Obtain a referral for occupational therapy Answer: 2 Explanation: 1. Assessment of the client's mobilit y is reflective of secondary prevention. 2. The integration of physical therapy for a client with chronic disease reflects a tertiary intervention to promote restoration and prevent or slow down further debilitation. 3. Discussing injury prevention is health promotion or primary prevention. 4. Obtaining a referral for an occupational therapi st reflects a secondary measure of prevention in which there is an early diagnosis and prompt treatm ent. Page Ref: 9 Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Reduction of Risk Potential Nurs/Integ Conc.: Nursing Process: Assessment Learning Outcome: 4. Describe the effects of chron ic disease. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
2 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides 5) The nurse is caring for an older client with hea rt disease that is experiencing fatigue. Which will the nurse initially implement to enhance the o verall quality of life and functional ability of the client? 1. Assess the need for assistive devices 2. Provide education on health screenings 3. Reinforce the importance of rehabilitation 4. Instruct the client on techniques for self-manag ement Answer: 3 Explanation: 1. Assistive devices may be necessary to increase the independence of the client. The assessment for an assistive device occurs durin g the rehabilitation time. 2. Education regarding health screenings focuses on prevention of disease. 3. Rehabilitation after a chronic illness can enhan ce the quality of life and functional ability of the client. Managing chronic fatigue that occurs wi th heart disease can require rehabilitation. 4. Techniques of self-management can reduce pain an d cost of chronic disease by teaching the client to manage their own chronic condition. Page Ref: 8-13 Cognitive Level: Applying Client Need: Psychosocial Integrity Client Need Sub: Support Systems Nurs/Integ Conc.: Nursing Process: Planning Learning Outcome: 4. Describe the effects of chron ic disease. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
3 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides 6) The nurse is assessing an older female patient a dmitted to the hospital for generalized weakness and a cough. Which assessment findings ind icate normal changes of aging? Select all that apply. 1. Blood pressure of 160/90 2. Needing to urinate every 3 hours 3. Needing to wear eye glasses for reading 4. Pulse rate 110 bpm 5. Respiratory rate 22 per minute after walking a s hort distance Answer: 2, 3, 5 Explanation: 1. Even though the arteries stiffen w ith age, an elevation in blood pressure needs to be investigated and not assumed that it is a normal change related to aging. 2. With aging, bladder capacity declines. Needing t o urinate every 3 hours would be evidence of reduced bladder capacity. 3. With aging, difficulty focusing up close would n ecessitate the need for reading glasses. This would be considered a normal change with aging. 4. Even though the heart muscle thickens with age, a pulse rate of 110 needs to be investigated and not assumed that it is a normal change related to aging. 5. Maximum breathing capacity may decline by about 40% between the ages of 40 and 70. A respiratory rate of 22 per minute after walking a s hort distance can be considered a normal change related to aging. Page Ref: 17 Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Aging Process Nurs/Integ Conc.: Nursing Process: Assessment Learning Outcome: 5. Contrast several major theori es of aging. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
4 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides 7) The family of an older male patient asks why the patient needs to be hospitalized for pneumonia when the youngest daughter had the same i nfection a few months ago and was treated at home. How should the nurse respond to th e family? 1. "The patient has chronic illnesses that put him at risk." 2. "I don't think you can compare your grandfather to yourself." 3. "There are some differences between men and wome n and illness." 4. "Aging decreases the body's ability to restore b alance to body systems with an infection." Answer: 4 Explanation: 1. There is not enough information to determine if the patient has chronic illnesses. 2. This response does not address the issue that bo dy systems return to balance slower after an illness as a part of aging. 3. This response does not address that the patient' s age impacts the body's ability to fight an infection and return to homeostasis. 4. The loss of organ reserve that can occur with ag ing can lead to the concept of homeostenosis or inability of the body to restore homeostasis aft er even minor environmental challenges, such as trauma or infection. An older person may die fro m pneumonia, which may have only been a minor illness to a younger person. Page Ref: 17 Cognitive Level: Applying Client Need: Physiological Integrity Nurs/Integ Conc.: Nursing Process: Implementation Learning Outcome: 5. Contrast several major theori es of aging. 8) A patient takes herbal and vitamin supplements i n order to "slow down" the aging process. The nurse realizes that the patient believes in the use of antioxidants to slow down cell damage. Which is associated with the biological theory of a ging? 1. Cross-link 2. Wear-and-tear 3. Free radical 4. Emerging biological Answer: 3 Explanation: 1. The cross-link theory states that cross-linked proteins resulting from binding of glucose to proteins causes various problems associa ted with nutrition. 2. The wear-and-tear theory sees the human body as a machine and cellular function slows down with time. 3. The free-radical theory states that accumulated damage caused by oxygen radicals causes cells, and eventually organs, to lose function and organ reserve. The use of antioxidants and vitamins is believed to slow this damage. 4. The emerging biological theory states that there are specific genes responsible for human aging. Page Ref: 19 Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Aging Process Nurs/Integ Conc.: Nursing Process: Evaluation Learning Outcome: 5. Contrast several major theori es of aging. 9) Jung's theory of individualism focuses on the cl ient's inner psychological state in regards to ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
5 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides aging. When assessing an older client, the nurse mi ght find which thoughts? Select all that apply. 1. Signs of sadness and depression 2. Questions about nutrition and vitamins 3. Regrets on not accomplishing more in life 4. A belief that past injuries have altered their a bilities 5. Concerns that damaged cells are slowing down the ir body Answer: 1, 3 Explanation: 1. Jung's theory of individualism sta tes that with aging the focus is away from the external world and moves toward the inner experienc e. This is a psychosocial theory of aging and would be applicable to use for a patient experi encing these emotions. 2. The free-radical theory focuses on aging as a re sult of accumulated damage caused by oxygen radicals causes cells, and eventually organs, to lo se function and organ reserve. 3. Jung's theory of individualism states that with aging the focus is away from the external world and moves towards the inner experience. This is a p sychosocial theory of aging and would be applicable to use for a patient experiencing these emotions. 4. The wear-and-tear theory focuses on aging as a r esult of cells and organs wearing out after years of use. Proponents of this theory see the hum an body as a machine. They believe that a "master clock" controls all organs and that cellula r function slows down with time. 5. The programmed longevity theory focuses on aging as a result of changes in gene function which is a biological theory. This patient is demon strating psychosocial changes with aging. Page Ref: 17-20 Cognitive Level: Analyzing Client Need: Psychosocial Integrity Client Need Sub: Coping Mechanisms Nurs/Integ Conc.: Nursing Process: Planning Learning Outcome: 5. Contrast several major theori es of aging. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
6 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides 10) A 62-year-old former professional football play er is in the hospital for a total knee replacement as a result of wear and tear and a medi cal diagnosis of osteoarthritis. Which biological theory of aging would help explain this patient's current health problem? 1. Cross-link 2. Free radical 3. Wear-and-tear 4. Somatic DNA damage Answer: 3 Explanation: 1. The cross-link theory is related t o the accumulation of cross-linked proteins causing disease. This theory does not explain the d amage done to the patient's joint from playing football. 2. The free-radical theory states that cell damage is a result of accumulation of oxygen radicals. This theory does not explain the damage done to the patient's joint from playing football. 3. Osteoarthritis is characteristic of degeneration that results from joint usage. This disease is characteristic of the aspects of the wear-and-tear theory, which states that there is a "master clock" that controls all organs and cellular functi ons, which becomes less efficient over time. Abusing one organ or bodily system through repeated injury that occurs with contact sports may result in premature aging and diseases such as oste oarthritis. 4. The somatic DNA damage theory states that geneti c mutations occur and accumulate with increasing age. This theory does not explain the da mage done to the patient's joint from playing football. Page Ref: 19 Cognitive Level: Analyzing Client Need: Psychosocial Integrity Client Need Sub: Coping Mechanisms Nurs/Integ Conc.: Nursing Process: Assessment Learning Outcome: 5. Contrast several major theori es of aging. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
7 | P a g e https://www.stuvia.com/en-us/user/AllStudyGuides 11) An older patient is refusing to receive the inf luenza and pneumococcal vaccinations because he believes he is "too old." How should the nurse r espond to this patient? 1. "I understand your feelings." 2. "I will report your concerns to the physician." 3. "You are likely to get sick if you do not take t he vaccines." 4. "It is never too late in life to begin health pr omotion activities." Answer: 4 Explanation: 1. Telling the patient that the nurse understands the patient's feelings does not help the patient understand the importance of health pro motion activities. 2. Reporting the concerns to the physician does not help the patient understand the importance of health promotion activities. 3. While the patient has an increased likelihood of developing an illness if the vaccines are not taken, stating this does little to meet the patient 's voiced concerns. 4. Receiving vaccinations for communicable diseases is a form of health promotion. The patient should be advised that age should not restrict heal th-saving activities. Page Ref: 9-10 Cognitive Level: Applying Client Need: Health Promotion and Maintenance Nurs/Integ Conc.: Nursing Process: Implementation Learning Outcome: 6. Evaluate the natural history of disease using principles of epidemiology. 12) A nursing student is preparing a program to rev iew health concerns for seniors. Which statement should the student include in the present ation? 1. "Heart disease is the leading cause of death for senior citizens." 2. "Decreases have been shown in the rate of Alzhei mer's disease." 3. "The rate of heart-disease death for senior citi zens is steadily increasing." 4. "Cancer is currently steady within the senior ci tizen population." Answer: 1 Explanation: 1. Heart disease is the leading cause of death in the senior population, even though it has decreased by 2.4% between 2009 and 2010. 2. The death rate increased significantly from 2009 to 2010 for Alzheimer's disease. 3. The rate of heart disease in the senior populati on has decreased by 2.4% between 2009 and 2010. 4. Cancer is among the top causes of death but is n ot the number one cause of death. Page Ref: 12 Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Health Promotion and Disease Prev ention Nurs/Integ Conc.: Nursing Process: Planning Learning Outcome: 4. Describe the effects of chron ic disease. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Gerontological Nursing, 4th Edition (Tabloski, 2019)
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