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NURS 306 GERONTOLOGICAL NURSING FINAL
EXAM SAMPLE QUESTIONS AND ANSWERS|90Qs&As
WITH RATIONALES|GRADED A+
Robert, an 86-year-old man comes into the emergency department with his adult son. His adult son explains that he was visiting his father and found him lying on the kitchen floor. Which one of these nursing actions avoids the adoption of ageist institutional policies? (select all that apply) a) Ask the patient how many times he has fallen in the past b) Suggest the patient uses a walker at home and hires homecare c) Ask the son if he would be able to move in with his father, if not an immediate LTC referral is needed d) Do an emergency falls risks assessment e) Do a head-to-toe assessment, as well as a thorough neurological assessment f) Ask the patient to explain what happened, then talk to the patient about the success he has in performing ADLs Answer: e & f E is correct because this is what you would do for any patient. The older population deserves to have the standard of care. F is correct because what if this was the first time he had a fall? We cannot assume he has had falls before, or that he is at risk for falling. Young people fall occasionally as well, but they are not stigmatized by it. Doing a more thorough assessment of the event and inquiring about the patient's daily life will give the nurse a bigger picture of what is really going on. This comes from the March 28th guest lecture about the SCOA.
The World Health Organization's Age-friendly City Model addresses: (select all that apply) a) Community-based clinics so that older adults can receive treatment for chronic illnesses such as diabetes, kidney disease, and hypertension. b) Issues such as housing, transportation, and social inclusion. c) The necessity of community-based clinics that specialize in physical health and require their staff to take courses specific to the unique profile of older adults. d) The need for a walking club to promote better cardiac health. e) The design of outdoor spaces and buildings that are age-friendly. Answer: b & e The model provided by the WHO does not emphasize physical health. It emphasizes the infrastructure within the city, and how it can be adapted to the aging population. This comes from the March 28th guest lecture about the SCOA. The older adult population is not homogeneous. Within the population exists multiple generations, which of these statements is correct? a) The first generation is adults from age 60-75 and it is the fastest growing group b) The third generation is adults who are age 85+ and it is the fastest growing group. c) The first generation is adults from age 60-80 and it is the fastest growing group d) The second generation is adults who are age 80+ and it is the fastest growing group Answer: b
b) Explain to the patient that palliative care is only offered during the last 2- 3 weeks of life because of the high demand c) Assess what kind of symptoms the patient wants to manage and collaborate with her to create the best management plan. d) Ask the patient if she wants her EOL care in the hospital or at home. Answer: c Is the correct answer; all the other answers are talking about EOL care and they are not an appropriate nursing action currently. EOL care and palliative care are two different things and should be treated as such. C includes collaboration, and this is vital for care of any patient. This is from Week 6 class discussion about EOL care.
- What is Standard V (five) of Integrating Gerontological Competencies? a) Health Systems b) Relationship Care c) Physiological Health d) Safety and Security Answer A Integrating gerontological competencies Found in January 3 Lecture - exploring chronicity and aging slide 24 "Gerontological nurses are aware of economic and political influences by providing or facilitating care that supports access to and benefit from the health care delivery system"
What concerns exist for Benzodiazepines administered to Geriatric Patients? a) Sedation, confusion, anticholinergic effects b) Reduced renal clearance can cause serious toxicity c) Confusion, depression, anticholinergic effects d) Confusion, ataxia, slurred speech, diplopia Answer C Potentially inappropriate medications in geriatrics Found January 17 Lecture - Pharmacology: Older Adults and Pain Management slide 28 What drug(s) are potentially inappropriate medications in geriatrics? a) Antihistamines b) Digoxin (cardiac glycoside) c) NSAIDs d) Phenytoin e) A and C f) All of the above Answer F Potentially inappropriate medications in geriatrics Found January 17 Lecture - Pharmacology: Older Adults and Pain Management slide 28
f) A, B and C g) All of the above Answer F Delirium Cases Found in Week 2 Lecture - Physiological Health Guest Speaker: Erin Boyce Slide 16 Hypoactive delirium may include _______? a) Restlessness (for example, pacing), agitation, rapid mood changes or hallucinations. b) Inactivity or reduced motor activity, sluggishness, abnormal drowsiness or seeming to be in a daze. c) Agitation, sluggishness, hallucinations or abnormal drowsiness. d) None of the above. Answer B Delirium Types Found in Week 2 Lecture - Physiological Health Guest Speaker: Erin Boyce Slide 19
- What are the symptom(s) of depression?
a) Change in appetite b) Increased concentration c) Decreased anxiety d) Constant sleep patterns e) B, C, and D f) All of the above Answer A Found in Week 2 Lecture - Physiological Health Guest Speaker: Erin Boyce Slide 30 others include: Change in sleep pattern, Change in activity, Fatigue and/or loss of energy, Guilt and/or feeling of worthlessness, Diminished concentration, Suicidal thoughts
- What percentage of COPD is caused by smoking? a) 50-60% b) 20-30% c) 70-80% d) 80-90%
d) Death e) None of the above f) All of the above Answer F Found in March 21 Lecture - Security and Safety slide 15 Exploitation of older adults involves: a) Lack of provision of basic necessities - food, water, medical care b) Physical and sexual assault c) Abandonment d) Use of older adult's resources without knowledge or consent Answer D Found in March 21 Lecture - Security and Safety slide 7
- Meleis' Transition Theory is NOT based on which key concept(s):
a) Nature b) Transition conditions c) Patterns of symptoms d) Therapeutic interventions in nursing e) A, B, and C f) A, B, and D g) All of the above Answer C It is patterns of response - Meleis' Transition Theory Found in March 7 Lecture - Interprofessional Teams and Patient Engagement Slide 24 "A conceptualisation of transition that reveals a holistic understanding of the conditions that influence the transition experience for patients"... contains patterns of response from discharge, but not "symptoms" What are the top 4 health problems? a) Aging or frailty, Cardiovascular Disease, Cancer, Alzheimer's or Dementia b) Obesity, Cardiovascular Disease, Cancer, Alzheimer's or Dementia c) Aging or frailty, Cardiovascular Disease, Ebola, Drug addiction
reviewing the medications she is takeing, she explains that it all began when she was diagnosed with hypertension and was prescribed metoprolol, after this she began feeling depressed and was prescribed citalopram, an SSRI, after this she began experiencing significant tremors and has been on levodopa for a month now. You understand this series of events as... a) A normal, and a doctor should add additional medication to address the orthostatic hypotension b) A normal process of aging, this patient should be admitted into long term care, as she is a fall risk c) This is a prescribing cascade, a normal process that occurs with aging d) This is a prescribing cascade, an interdisciplinary team should be put together, including you, a physician, pharmacist, and the patient Answer is D Information found on Jan 4th, slide from Courtney Quiring "process whereby the side effects of drugs are misdiagnosed as symptoms of another problem resulting in further prescriptions and further side effects and unanticipated drug interactions. This may lead to further misdiagnoses and further symptoms." Which of the following factors contribute to global population aging? Select all that apply:
a) Longevity Revolution b) Great Depression c) Baby Bust d) Baby Boom Answers: A, C, D B: this is not correct as this actually dramatically reduced birth rates before the baby boomer generation. From the video showed March 28th in class Longevity Revolution: life expectancy is increasing due to vaccinations, public health programs. Increased from 48 to 77 years' old Baby boom (1946- 64'): factors that decided how many children families would have in the 30's and 40's in the great depression; when the war ended soldiers came home and lots of babies were made! Baby bust: young families having fewer children For the older adult diagnosed with diabetes, what recommended monitoring tests will you plan to discuss with the patient. Select all that apply: a) Urine tests for microalbumin b) Serum lipid levels c) Blood pressure
If BP drops too low it can increase risk for falls via hypotension (thats what google says) Which of the following is not a type of resilience? a) Cognitive b) Health c) Spiritual d) Emotional Answer C Week 5 Communication, Resilience and Interdependence Resilience: "Ability to spring back from a physical, emotional, financial or social change" Types: o Health o Psychological o Emotional o Cognitive
Which of the following is not a gerontological competency? a) Safety and Security b) Communication Systems c) Health Systems d) Responsive Care Answer B Week 1 Exploring Chronicity and Aging others include: physiological health, optimizing functional health, and relationship care What are three useful concepts in Motivational Interviewing? a) Responsiveness, Readiness and Ambivalence b) Readiness, Responsiveness and Resilience c) Ambivalence, Readiness and Resistence d) Ambivalence, Resilience, Responsiveness Answer C Week 9 Interprofessional Teams and Patient Engagement
a) Disenfranchised Grief b) Persistent Grief c) Acute Grief d) Anticipatory Grief Answer: A Disenfranchised grief refers to grief that is not acknowledged by society. No one knows about it, so you can't put it out there and share. February 7, 2018: Lecture: Responsive Care - Slide 9 Lorna is a 75-year-old woman. 9 months ago, Lorna suffered a hip fracture after slipping on ice outside of her home. Since the fall, Lorna has done physiotherapy daily. With the help of her family, in the 9 months following her fall she has moved back to her home and begun to live independently again. Lorna displays which type of resilience: a) Psychological Resilience b) Emotional Resilience c) Cognitive Resilience d) Health Resilience Answer: D
Health Resilience. Health resilience refers to maintaining functional independence. January 31, 2018: Communication, Resilience, and Interdependence - Slide 5 Which of the following is a pull factor for older adults in deciding to move? a) independence loss b) loss of spouse c) environmental amenities d) environmental stress Answer: C Found in the March 28 lecture - future of growing older slide 19. The other choices are all examples of push factors for deciding to move. Push: Independence loss Loss of spouse Environmental stress Pull: Retirement amenities Relocated friendship and/or kinship networks 'successful' relocation by friend(s)
