Chapter 11: The Older Patient
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. How is the term old age or aged best defined?
a.
Person’s state of mind
b.
Person older than 65 years of age
c.
Process of growing older
d.
Person of advanced age
2. How is aging recognized by gerontologists as a developmental process?
a.
Measured in chronologic years
b.
Directly related to heredity
c.
Related to behavioral characteristics
d.
Begins at the time of birth
3. What understanding is a prerequisite for a nurse working with the geriatric patient?
a.
Specialized knowledge is needed.
b.
Geriatric patients are physically impaired.
c.
Most geriatric patients will develop dementia.
d.
Geriatric patients need to be closely supervised.
4. A 78-year-old resident of a long-term care facility insists on wearing high heels and miniskirts
to the dining room for meals and will not leave her room without first applying glamorous
makeup. What should the gerontologic nurse assess as the reason for this behavior?
a.
Insecurity about her appearance
b.
Trying to cope with the changes of aging
c.
Denial concerning her advancing age
d.
Her fashion consciousness
5. What does Butler, a well-known gerontologist, relay regarding ageism?
a.
It dehumanizes older individuals.
b.
It is based on the biologic theory of aging.
c.
It is based on natural and purposeful occurrences.
d.
It continues to change as the population ages.
6. What are the effects of aging on the nervous system?
a.
Accelerated loss of neurons in the brain
b.
Gradually declining loss of intellectual capability
c.
Decreased conduction speed of neurons
d.
Loss of long-term memory
7. A nurse is caring for older adult patients with mild cognitive impairment (MCI). What are
these patients more likely to develop?
a.
Dementia, non-Alzheimer type
b.
Alzheimer dementia
c.
Parkinson disease
d.
Psychotic disorders
8. What is the most appropriate nursing action when planning activities to improve short-term
memory for an older adult patient experiencing memory deficits?
a.
Maintain the same daily schedule.
b.
Rehearse memory training.
c.
Provide a varied and stimulating daily schedule.
d.
Conduct deep-breathing exercises.
9. What is the best example of normal memory change or lapse of memory?
a.
Relying on another person to remember names or important events
b.
Occasional forgetfulness or inability to recall names or facts
c.
Difficulty in recalling recent events
d.
Difficulty in recalling past events
10. Which facts are generally accepted for most older adults?
a.
Intellectual capabilities are impaired.
b.
Functional brain activities decrease.
c.
Functional intellectual capability is maintained.
d.
Creativity and judgment are severely impaired.
11. What factor increases the risk of respiratory infection for older adults?
a.
Decreased ciliary action
b.
Decreased physical activity
c.
Inadequate hydration
d.
Poor personal hygiene
12. A nurse is caring for an older person whose renal changes make it impossible to concentrate
or dilute urine. For what is this patient at the greatest risk?
a.
Urinary infection
b.
Dehydration
c.
Incontinence
d.
Renal failure
13. Which assessment is the greatest priority to report when considering the gastrointestinal (GI)
changes that take place in the geriatric patient?
a.
24-hour urinary output of 1450 mL
b.
24-hour dietary intake of 75% of meals
c.
Last bowel movement 4 days ago
d.
Weight loss of 2 lb since admission 2 months ago
14. Which assessment made by the nurse is a major sign of renal changes related to age?
a.
Hematuria
b.
Nocturia
c.
Urgency incontinence
d.
Renal calculi
15. What should be the most significant assessment when gathering data concerning the
musculoskeletal system?
a.
Slow gait
b.
Degree of motion of all joints
c.
Enlarged joints
d.
Crepitus in joints
16. What is the most appropriate nursing intervention for a patient with presbycusis?
a.
Speak clearly and distinctly while facing the patient.
b.
Announce your presence when entering the patient’s room.
c.
Place needed articles within easy reach.
d.
Orient the patient to time and place as needed.
17. What should the nurse suspect a patient is developing when he is observed holding his Bible 6
inches from his face and turns his head to read out of the corner of his eyes?
a.
Cataracts
b.
Glaucoma
c.
Presbyopia
d.
Macular degeneration
18. What is true regarding the chemosensory changes observed in older adults?
a.
They are directly related to the aging process.
b.
They are most often caused by disease.
c.
They begin in the fifth decade of life.
d.
They affect more women than men.
19. A nurse explains to family members that the final developmental stage is ego integrity. What
should occur in the older adult, according to Erikson, if this stage is not mastered?
a.
Needs to repeat a previous stage
b.
Experiences despair
c.
Inability to advance past the present stage
d.
Experiences disappointment
20. What is the best nursing action when assisting an older patient to relieve the discomfort of
pruritus related to dry skin?
a.
Encourage the patient to talk to the primary care physician about the problem.
b.
Encourage the patient to take a tepid bath and use moisturizers.
c.
Teach the patient that pruritus is an expected consequence of aging.
d.
Establishing a medication regimen to control the discomfort.
21. A newly admitted 72-year-old resident of a long-term care facility naps frequently during the
day, stating that he is tired. What is the best action by the nurse?
a.
Obtain an order from the primary caregiver for a sedative.
b.
Ask the patient if he is sleeping well at night.
c.
Plan activities to keep the patient awake during the day.
d.
Tell the patient that he cannot take any more naps.
22. What is the best reason that drug toxicity can occur as a result of an age-related change in the
liver?
a.
Increased liver size
b.
Decreased liver enzyme activity
c.
Rapid blood flow through the liver
d.
Fluid accumulation in the portal vein
23. A 77-year-old recently admitted to a long-term care facility refuses to join in activities or go
to the dining room for meals. How should the nurse interpret this behavior?
a.
Stubbornness
b.
Depression
c.
Fear
d.
Exhaustion
MULTIPLE RESPONSE
24. Which concepts are the basis of the error theories of aging? (Select all that apply.)
a.
The rate of aging is related to the rate of living.
b.
Aging is a result of purposeful events governed by genetic structure.
c.
External events cause damage to cells.
d.
The organism becomes immune to the body’s restorative processes.
e.
Cumulative damage causes organ malfunction.
25. What are included in age-related cardiovascular changes? (Select all that apply.)
a.
Cardiac murmurs
b.
Widened pulse pressure
c.
Pulse decreasing in force
d.
Dyspnea
e.
Chest pain
