NURS 6540 - Advanced Practice Care of Frail Elders Exam Study Set Q & A

NURS 6540 - Advanced Practice Care of Frail Elders

Exam Study Set Q & A

An 80-year-old patient is in the terminal stage of Alzheimer disease. The treatment team meets with the patients who are angry and complain about a recent incident in which

their parent's dentures were misplaced. The team members realize that:

• anger at staff is a symptom of grief and needs to be addressed.
• anxiety about the meeting may have interfered with the children's affect.
• material items are the focus for the children at this time.
• the focus of control should shift to the parent.

When relocating from a family home to a continuing care community, the most crucial

factor in an older person's adjustment is his or her:

• level of economic independence.
• perceived control of the move.
• physical proximity to remaining family.
• risk-taking ability.

A 78-year-old male resident at a long-term care facility, who is a former business executive, has been smoking and extinguishing cigarettes in a paper cup in areas where smoking is prohibited. He has been informed repeatedly of the designated

smoking areas. The resident's behavior indicates an attempt to:

• express self-transcendence.
• maintain autonomy by exercising control.
• maintain his previous professional role.
• react against the facility's ageism.

A gerontological nurse is caring for an older adult who has been confined to home for the last 10 weeks due to illness. The patient is anxious, has multiple somatic complaints, and has become unable to follow instructions. The nurse knows that this

phenomenon commonly occurs with:

• environmental overload.
• protective isolation.
• selective inattention.
• sensory deprivation.

The gerontological nurse facilitates the benefits of life review by:

• assisting the older adult to accept death as the inevitable last stage.
• changing the topic when a patient talks about his or her morbid past.
• encouraging reminiscence, oral histories, and storytelling.
• helping the older adult explore how spiritual involvement assists with stress relief.

The holiday season is approaching and a woman is admitted to a psychiatric unit. She reports that her husband of 45 years passed away four weeks ago. She frequently cries, eats poorly, periodically complains of back and stomach aches, and has begun isolating herself. What type of grief is this woman exhibiting?

• Acute
• Anticipatory
• Disenfranchising
• Dysfunctional

A 92-year old patient, who recently underwent a below-the-knee leg amputation, is resisting attempts at rehabilitation. The most likely reason for the resistance is that the

patient:

• has goals that differ from the rehabilitation care plan.
• has too many disabilities to realistically plan for rehabilitation.
• is too old to undergo rehabilitation.
• requires a psychiatrist's assistance to deal with the loss.

When the gerontological nurse in a clinic asks a 70-year-old man about his sexual activity, he begins to cry and says, "I feel so bad for my wife; she is only 60, and I can't seem to satisfy her as often as I used to." Which is the nurse's most appropriate response?

• "At your age, sexual activity diminishes because of changes in your circulation. I

will explain this to your wife."

• "Certain body functions, such as erections, slow down with age. Could you tell

me more about your sexual relations? For instance, how often do you have intercourse?"

• "Your problem is probably an emotional one. If you could relax, you would be as

sexually active as you were 10 years ago."

• "Your problem is probably due to a decrease in your sexual hormones. This

occurs naturally as people age."

An alert and oriented 82-year-old woman, who lives with her daughter, has been admitted to the hospital with bruises about the face and head. The daughter reports that her mother fell. Which behavior by the daughter raises the greatest suspicion of elder abuse?

• Becoming defensive when questions are asked
• Complaining about care delivered by hospital staff
• Giving an illogical account of her mother's fall
• Refusing to leave her mother alone to answer questions

In teaching an older adult client, the gerontological nurse's most appropriate initial

strategy is to:

• assess the client and individualize the teaching methods.
• set a slow learning pace and begin teaching simple concepts.
• teach slowly and use repetition.
• use demonstration and provide ample opportunity for practice.

In preparing a presentation for older adults, a gerontological nurse keeps in mind that:

• older adults are unlikely to participate in educational programs due to lack of

interest.

• older adult learners are heterogeneous due to diverse educational experiences

and learning strategies.

• the ability to acquire knowledge from a verbal presentation decreases with age

more than the ability to acquire knowledge through reasoning.

• the age-related decline in intellectual performance creates obstacles for acquiring

new information.

Members of a family are caring for their father at home. Which statement by a family member indicates a need for teaching and caregiver instruction?

• "Dad has gotten lazy about his bathroom habits. He blames his arthritis

medication for his toileting accidents."

• "Dad's room is close to the bathroom and we keep a light on for him at night."
• "It's inconvenient, but we stop other activities to remind Dad to go to the

bathroom on a regular schedule."

• "We try to avoid coffee and tea at night, but Dad really likes a cup of coffee for

breakfast."

When hospital quality assurance indicators are assigned, the nursing staff strives to:

• avoid emphasizing performance deficits.
• decrease patient falls.
• focus on achieving 100% compliance.
• identify high-risk, high-volume, or problem-prone areas.

The most appropriate environment for a person with chronic dementia is one that:

• changes often to decrease boredom.
• contains familiar objects.
• is limited in color and sound.
• is stimulating so as to challenge thought.