Andersons Caring for Older Adults Holistically 6th Edition by Tamara R. Dahlkemper – Test Bank

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Andersons Caring for Older Adults Holistically 6th Edition by Tamara R. Dahlkemper – Test Bank

Chapter 2: The Aging Experience

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The fastest growing segment of the population in the United States is

1) Teenagers
2) Babies
3) People older than 85 years of age
4) People between the ages of 20 and 40

 

 

____    2.   An 88-year-old retired school principal who lives alone has neighbors who believe his home is dark, dirty, smelly, and without modern conveniences. The neighborhood children think he is a “crazy old man.” What does this describe?

1) Racism
2) Sexism
3) Ageism
4) Patriotism

 

 

____    3.   Which statement reflects respect for people who are older?

1) Getting old is a hopeless downward spiral toward death.
2) As people get older, they become very self-centered.
3) Older people maintain unique and individual characteristics.
4) Older people become very rigid and are unable to learn new things.

 

 

____    4.   Normal physiological aging is

1) A predictable and uniform process
2) Reflective of individual diversity
3) Accompanied by extreme mood swings and predictable depression
4) Primarily related to chronic disease processes

 

 

____    5.   What is LEAST likely to affect the aging process?

1) Life experiences
2) Financial resources
3) Stress management style
4) Social support system

 

 

____    6.   The normal aging process is accompanied by

1) Potential problems in functional ability
2) Chronic disease processes
3) Regression from previous social activities
4) A characteristic depression related to multiple losses

 

 

____    7.   The leading cause of death in older adults is

1) Stroke
2) Heart disorders
3) Cancer
4) Pneumonia

 

 

____    8.   Which theory is NOT considered to be a psychological theory of aging?

1) Subcultural theory
2) Wear and tear theory
3) Developmental tasks theory
4) Continuity theory

 

 

____    9.   According to Erik Erikson’s eight stages of life theory, the task of old age is

1) Integrity vs. Despair
2) Industry vs. Inferiority
3) Identity vs. Role Confusion
4) Generativist vs. Stagnation

 

 

____  10.   Which is NOT a characteristic of physiological theories of aging?

1) Genetics
2) Nutrition
3) Personality
4) Wear and tear of the body

 

 

____  11.   What is considered normal aging of the cardiovascular system?

1) Strengthened heart contractions
2) Decreased cardiac output
3) Flaccid and thinned heart valves
4) Dilation of blood vessels

 

 

____  12.   What determines an older adult’s ability to function?

1) Driving a car
2) Quality of life
3) Working, driving, shopping, and exercising as usual
4) Performance of activities of daily living (ADLs), instrumental ADLs, and quality of life

 

 

____  13.   Which does NOT contribute to increased residual lung volume in an older patient?

1) Kyphosis
2) Decreased elastic recoil
3) Decreased number of functioning alveoli
4) Decreased efficiency of gas exchange in the alveoli

 

 

____  14.   One of the best ways for the nurse to promote normal respiratory function with older adults is to

1) Encourage daily walks.
2) Encourage frequent naps and rest periods.
3) Discourage strenuous lifting and physical activity.
4) Teach the use of inhalers in case of respiratory emergencies.

 

 

____  15.   Which is NOT an expected age-related change affecting the respiratory status of an older patient?

1) Weakened abdominal muscles
2) Elongation of the thoracic spine
3) Increased rigidity of the rib cage
4) Increased thickness of the alveolus capillary membrane

 

 

____  16.   Which is NOT considered a common complication of inactivity in an older adult?

1) Decreased energy
2) Decreased bone mass
3) Decreased muscle mass
4) Decreased joint range of motion

 

 

____  17.   What effect do age-related changes of the skin have on an older patient?

1) Effects joint mobility
2) Alters temperature regulation
3) Impacts the ability to ambulate
4) Influences clothing style choices

 

 

____  18.   Which is one of the most effective ways to minimize the aging changes of the skin?

1) Wash the skin daily with soap.
2) Avoid excessive sun exposure.
3) Use a vitamin E-fortified lotion every day.
4) Use rose milk lotion on the skin every day.

 

 

____  19.   What can slow musculoskeletal changes in an older adult?

1) Exercising
2) Restricting calcium intake
3) Napping throughout the day
4) Eating a diet high in carbohydrates

 

 

____  20.   What is the best advice for an older person who complains of never being hungry?

1) Try eating six small meals throughout the day.
2) Force yourself to eat at least three meals a day.
3) As people get older, they may need to eat only one meal a day.
4) Avoid eating roughage and drinking large amounts of fluid.

 

 

____  21.   Which body system is most highly influenced by previous life patterns and environmental conditions?

1) Circulatory
2) Integumentary
3) Respiratory
4) Gastrointestinal

 

 

____  22.   Which statement is most true about enlargement of the prostate gland in older men?

1) It is a normal aging change.
2) It indicates the presence of cancer.
3) It is related to a high incidence of impotence for older men.
4) It decreases the incidence of urinary incontinence for older men.

 

 

____  23.   Incontinence is a problem for many older women. The normal aging change that contributes to stress incontinence for older women is

1) Decreased bladder capacity
2) Decreased renal blood flow
3) Reduced glomerular filtration rate
4) Loss of mass and strength of perineal muscles

 

 

____  24.   Painful intercourse and vaginal infections can be associated with

1) Loss of pubic hair
2) Urinary incontinence
3) Decreased vaginal secretions
4) Decreased perineal muscle mass

 

 

____  25.   What sleep pattern change is most stressful to older adults?

1) Frequent wakening
2) Shorter sleeping time at night
3) Inability to nap during the day
4) Feeling of being less rested after sleeping all night

 

 

____  26.   Which are the most common gastrointestinal problems for older adults?

1) Indigestion, diarrhea, and anorexia
2) Constipation, bulimia, and indigestion
3) Indigestion, constipation, and anorexia
4) Flatulence, diarrhea, and intestinal cramps

 

 

____  27.   How do older adults adapt to their slowed response time?

1) Giving up activities such as driving
2) Increasing accuracy of their responses
3) Avoiding situations that require quick responses
4) Using ambulation aids to decrease the chance of falling

 

 

____  28.   Decreased tearing of the eyes increases the incidence of

1) Glaucoma
2) Eye infections
3) Corneal abrasions
4) Cataract formation

 

 

____  29.   Which is an age-related change in hearing for older adults?

1) Loss of low-frequency tones
2) Loss of high-frequency tones
3) Generalized loss of all frequencies
4) Loss of high-frequency and low-frequency tones

 

 

____  30.   What should the nurse do to help an older patient improve hearing?

1) Speak loudly.
2) Speak slowly in a normal tone.
3) Speak slowly with an increased pitch.
4) Mouth words slowly so that the older adult can read lips.

 

 

____  31.   Which are the preferred colors to use for signs, curb markings, and stair edgings for older adults?

1) Red and green
2) Blue and green
3) Yellow and red
4) Blue and yellow

 

 

____  32.   Which change in the aging eye increases risk of falling?

1) Decreased tearing
2) Yellowing of the lens
3) Increased sensitivity to glare
4) Decreased dark and light accommodation

 

 

____  33.   A 78-year-old patient has both ears impacted with cerumen. Why is the incidence of cerumen impaction increased for older adults?

1) Increased keratin in cerumen
2) Increased production of cerumen
3) Decreased bathing because of skin dryness, so ears do not get cleaned as often
4) Older adults are less likely to be in the habit of using cotton-tipped applicators to clean out their ears

 

 

____  34.   An 84-year-old patient is experiencing decreased reaction time while driving and some dizziness when getting out of his car. What should the nurse realize about this patient’s symptoms?

1) Secondary to diet
2) Indicative of senile dementia
3) Part of the normal aging process
4) Indicative of decreased mental capabilities

 

 

____  35.   Which is NOT included during the assessment of ADLs?

1) Eating
2) Moving
3) Cooking
4) Dressing

 

 

____  36.   Which would NOT be included when assessing instrumental activities of daily living (IADLs)?

1) Toileting
2) Cleaning
3) Managing finances
4) Taking medications

 

 

____  37.   Which are NOT considered to be signs of wear and tear on the body as the result of aging?

1) Slow gait
2) Replaced knees
3) Use of a walker
4) Chronic diseases

 

 

____  38.   What information does NOT need to be collected when first interviewing an elderly patient?

1) Nutrition
2) Family history
3) Chronic diseases
4) Number of friends

 

 

____  39.   Why is it common for an older adult to feel colder and have decreased diaphoresis, even with an elevated body temperature?

1) Increased body fluid
2) Alterations in appetite
3) Decreased subcutaneous fat
4) Difficulty with bowel elimination

 

 

____  40.   An older patient is experiencing skin breakdown. What should the nurse identify as the reason for this health problem?

1) Clustering of melanocytes
2) Decreased sweat production
3) Decreased subcutaneous fat
4) Dryness and reduced skin elasticity

 

 

____  41.   What should the nurse realize is the reason for an older patient to have an increase in blood pressure?

1) Reduced blood volume
2) Increased rigidity of heart valves
3) Increased rigidity of vascular walls
4) Diminished strength of cardiac muscle

 

 

____  42.   An older patient is experiencing a drop in blood volume. What should the nurse realize is the age-related reason for this?

1) Decreased physical activity
2) Increased daily urine output
3) Reduced oral intake of fluids
4) Decreased amount of total body water

 

 

____  43.   What should the nurse identify as the reason for an older patient to have a decrease in hematocrit and hemoglobin levels?

1) Increased oral fluid intake
2) Decreased rigidity of heart valves
3) Increased rigidity of blood vessels
4) Reduced bone marrow production

 

 

____  44.   The nurse is preparing to assess the respiratory status of an older patient. What should the nurse realize about this status in relation to cardiovascular functioning?

1) The degree of changes within both systems will be minimal.
2) The changes within both systems appear suddenly, causing acute health problems.
3) Changes in the respiratory system are gradual and the older patient will compensate.
4) Changes in the cardiovascular system are gradual and the older patient will compensate.

 

 

____  45.   An older patient has osteoporosis. What effect should the nurse expect this health problem to have on the patient’s respiratory status?

1) Improved cough reflex
2) Improved lung capacity
3) Reduced lung space and air flow
4) No change to the respiratory status

 

 

____  46.   What impact do good nutrition, exercise, and stress control have on longevity according to the genetic theory of aging?

1) Experiencing an early death
2) Adding 15 years to life expectancy
3) Reducing risk factors for chronic disease
4) Prolonging or improving the quality of life

 

 

____  47.   What concept is used to describe today’s nursing homes?

1) Hospice care
2) Palliative care
3) Custodial care
4) Rehabilitative care

 

 

____  48.   Which nursing statement takes the concept of ageism into consideration when caring for an 85-year-old patient with renal failure?

1) “Mr. Martin, how are you doing this morning?”
2) “Now, you know you shouldn’t do that, baby doll.”
3) “Hon, how would you like your eggs in the morning?”
4) “You are doing such a good job with dialysis, sweetie.”

 

 

____  49.   The nurse is caring for an 80-year-old patient with lung disease. Which action indicates that the nurse understands the wear and tear theory of aging when caring for this patient?

1) Reviews the importance of a daily intake of adequate calcium
2) Asks the patient at what age the patient’s mother and father passed away
3) Stops and rests for a few seconds when walking with the patient down the hall
4) Suggests that the patient use a wheelchair to reduce the time needed to get to physical therapy

 

 

____  50.   An older patient used to be a teacher but after being diagnosed with a health problem the patient began to write educational materials. Which theory explains this patient’s actions?

1) Continuity
2) Subculture
3) Wear and tear
4) Developmental tasks

 

 

____  51.   Which statement can be used to define health for an older adult?

1) Expecting to enjoy perfect health until death
2) Realizing that no one leaves this life alive and death occurs to us all
3) Understanding that the body wears out and nothing can be done about it
4) Functioning at the highest potential in the presence of age-related changes

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  52.   The nurse suspects that an older patient is having difficulty with the developmental task of integrity vs. despair. Which behaviors caused the nurse to make this clinical determination? Select all that apply.

1) Anger
2) Depression
3) Reading the newspaper
4) Feelings of inadequacy
5) Laughing with grandchildren

 

 

____  53.   What should the nurse realize about the normal aging process? Select all that apply.

1) Normal aging does not indicate decline.
2) People become more diverse as they age.
3) Age-related changes are the same in everyone.
4) Normal aging and disease cannot be separated.
5) Adapting to the aging process is accomplished by many adults.

 

 

____  54.   An older patient is experiencing shortness of breath with household activities. Which respiratory changes with aging could explain this patient’s symptoms? Select all that apply.

1) Loss of lung elastic recoil
2) Larger and thinner alveoli
3) Increased surface area for gas exchange
4) Thickening of the alveolar-capillary membrane
5) Reduction in the number of functioning alveoli

 

 

____  55.   The nurse is concerned that an older patient is experiencing age-related changes to the gastrointestinal system. What findings caused the nurse to have this concern? Select all that apply.

1) Loose teeth
2) Poor appetite
3) Feeling thirsty
4) Weak gag reflex
5) Feeling of fullness

 

 

____  56.   An older patient is experiencing functional changes caused by decreased bladder capacity. What should the nurse assess for in this patient? Select all that apply.

1) Nocturia
2) Frequency
3) Incontinence
4) Renal calculi
5) Urinary retention

 

Chapter 2: The Aging Experience

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 1. Define the term ageism.

Chapter page reference: 21

Heading: Introduction

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Diversity; Nursing

Difficulty: Easy

  Feedback
1 Teenagers are not the fastest growing segment of the U.S. population.
2 Babies are not the fastest growing segment of the U.S. population.
3 People older than 85 years of age are the fastest growing segment of the U.S. population.
4 People between the ages of 20 and 40 are not the fastest growing segment of the U.S. population.

 

 

PTS:   1                    CON:  Diversity | Nursing

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 1. Define the term ageism.

Chapter page reference: 23

Heading: Ageism

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Analysis [Analyzing]

Concept: Diversity; Nursing

Difficulty: Moderate

  Feedback
1 Racism is believing that one race is superior to another.
2 Sexism is believing that one gender is superior to another.
3 Ageism is a systematic stereotyping of and discrimination against people simply because they are old.
4 Patriotism is upholding the rights and responsibilities of being a citizen of a country.

 

 

PTS:   1                    CON:  Diversity | Nursing

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 1. Define the term ageism.

Chapter page reference: 24

Heading: Ageism

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Comprehension [Understanding]

Concept: Diversity; Nursing

Difficulty: Easy

  Feedback
1 Getting older is not a hopeless spiral toward death. This statement does not respect older people.
2 Believing that older people are self-centered does not respect older people.
3 Older people do have unique and individual characteristics. This statement respects older people.
4 Older people are not rigid and unable to learn new things. This statement does not respect older people.

 

 

PTS:   1                    CON:  Diversity | Nursing

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 25

Heading: Normal Aging Process

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing

Difficulty: Easy

  Feedback
1 Individuals age in different ways.
2 Although aging is a universal experience, each individual older person represents a different pattern of aging.
3 Older adults may experience depression, but this is not a normal aging experience.
4 Older adults may experience chronic diseases, but these are not normal aging experiences.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 25

Heading: Physiological Theories of Aging

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Stress; Nursing

Difficulty: Easy

  Feedback
1 How a person ages depends on life experiences.
2 Aging is not dependent on a person’s financial resources.
3 How a person ages depends on stress management style.
4 How a person ages depends on social support systems.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in body systems.

Chapter page reference: 27

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing

Difficulty: Easy

  Feedback
1 Changes in functional ability, or the ability of the older adult to perform activities of daily living, can be influenced by normal aging changes.
2 Many older adults have chronic disease processes, but disease processes are not a normal consequence of aging.
3 Aging is often viewed as a series of losses. The process is gradual, and older adults generally adapt well and maintain their social activities.
4 Older adults are not generally depressed by the aging process.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems. Cardiovascular

Chapter page reference: 28

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Knowledge [Remembering]

Concept: Cellular Regulation

Difficulty: Easy

  Feedback
1 Cardiovascular diseases leading to strokes used to be a leading cause of death among older adults, but older people have learned to take better care of themselves.
2 Cardiovascular diseases leading to heart disorders used to be a leading cause of death among older adults, but older people have learned to take better care of themselves.
3 Cancer is now the leading cause of death among older adults.
4 Pneumonia is not a leading cause of death, however, it is a serious concern in older adults.

 

 

PTS:   1                    CON:  Cellular Regulation

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 26

Heading: Psychological Theories

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing

Difficulty: Easy

  Feedback
1 The subculture theory of aging describes aging as being a subculture complete with cultural norms, standards, beliefs, and expectations.
2 The wear and tear theory is a physiological theory of aging.
3 Erikson developed the developmental stages theory, which states that people work through various stages of development through life.
4 The continuity theory states that as people age, their basic personalities do not.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 26

Heading: Psychological Theories

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Knowledge [Remembering]

Concept: Development; Nursing

Difficulty: Easy

  Feedback
1 The task for old age, according to Erikson, is integrity vs. despair. If older adults can find meaning in the life they have lived and are living, they will have the ego integrity to adjust to the process of aging.
2 Industry vs. inferiority is a task for a school-age person.
3 Identity vs. role confusion is a task for adolescence.
4 Generativity vs. stagnation is a task for a middle-aged adult.

 

 

PTS:   1                    CON:  Development | Nursing

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 24

Heading: Physiological Theories of Aging

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing

Difficulty: Easy

  Feedback
1 One physiological theory of aging focuses on genetics, stating that people are born with a genetic program that predetermines life span.
2 One physiological theory of aging focuses on a person’s nutrition during his or her life span.
3 Personality does not relate to a physiological theory of aging.
4 One physiological theory of aging focuses on the fact that bodies are all fine-tuned machinery and that body parts wear out or become less effective as they are repeatedly used.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Cardiovascular

Chapter page reference: 28

Heading: Cardiovascular System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Perfusion

Difficulty: Easy

  Feedback
1 The aging heart is slower and weaker.
2 Cardiac output is decreased as a result of the slowed heart rate and weaker cardiac contractions. This is not usually a noticeable problem unless older persons are exposed to stressors that exceed their reserves.
3 Heart valves in the aging heart are thicker and more rigid.
4 Blood vessels in the aging cardiovascular system thicken and become less elastic.

 

 

PTS:   1                    CON:  Nursing | Perfusion

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes to the body systems.

Chapter page reference: 28

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Promoting Health

Difficulty: Easy

  Feedback
1 Driving a car might be an instrumental activity of daily living, however, function is more than performing this one function.
2 Quality of life is one aspect of functioning.
3 The level of functioning may not be as it was when the person was younger.
4 The definition of function is the ability to perform ADLs and instrumental ADLs, taking into consideration quality of life.

 

 

PTS:   1                    CON:  Nursing | Promoting Health

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Respiratory

Chapter page reference: 29

Heading: Respiratory System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Oxygenation

Difficulty: Easy

  Feedback
1 Kyphosis is a normal change in aging that increases residual lung volume in an older patient.
2 Decreased elastic recoil is a normal change in aging that increases residual lung volume in an older patient.
3 A decreased number of functioning alveoli is a normal change in aging that increases residual lung volume in an older patient.
4 Decreased efficiency of gas exchange in the alveoli affects the efficiency of oxygen availability.

 

 

PTS:   1                    CON:  Nursing | Oxygenation

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Respiratory

Chapter page reference: 29

Heading: Respiratory System

Integrated Processes: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Nursing; Oxygenation

Difficulty: Moderate

  Feedback
1 Exercise and activity are necessary to promote respiratory health.
2 Frequent naps and rest periods discourage physical activity.
3 Avoiding strenuous lifting and physical activity does not promote respiratory health.
4 The use of inhalers is not a routine intervention to promote respiratory health in an older adult.

 

 

PTS:   1                    CON:  Nursing | Oxygenation

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Respiratory

Chapter page reference: 29

Heading: Respiratory System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Oxygenation

Difficulty: Moderate

  Feedback
1 In the normal aging process, abdominal muscles weaken, decreasing inspiratory and expiratory efforts.
2 With aging the thoracic spine shortens.
3 In the normal aging process, the rib cage becomes rigid because of calcification of cartilage.
4 In the normal aging process, alveolus capillary membranes thicken, decreasing the surface area for gas exchange

 

 

PTS:   1                    CON:  Nursing | Oxygenation

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Musculoskeletal

Chapter page reference: 29

Heading: Musculoskeletal System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Mobility

Difficulty: Moderate

 

  Feedback
1 Exercise would increase an older adult’s energy level, but inactivity does not cause decreased energy.
2 Inactivity decreases bone mass.
3 Inactivity decreases muscle mass.
4 Inactivity decreases joint range of motion.

 

 

PTS:   1                    CON:  Nursing | Mobility

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Integumentary

Chapter page reference: 30

Heading: Integumentary System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Thermo-Regulation

Difficulty: Moderate

  Feedback
1 This is a musculoskeletal system change.
2 The decrease in sweat production and loss of the insulating fat layer underlying the skin makes an older adult prone to hyperthermia and hypothermia.
3 This is a musculoskeletal system change.
4 Some older adults who are self-conscious of age spots on their arms may choose not to wear short-sleeved or sleeveless shirts. Older adults may find that because of changes in their muscle mass and fat distribution, their clothing does not fit as well.

 

 

PTS:   1                    CON:  Nursing | Thermo-regulation

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Integumentary

Chapter page reference: 30

Heading: Integumentary System

Integrated Processes: Nursing Process: Planning

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Nursing; Skin Integrity

Difficulty: Moderate

  Feedback
1 Washing the skin daily with soap will not guarantee that age changes of the skin will be less.
2 Sun exposure intensifies the normal aging changes and increases an older adult’s risk of developing skin cancer.
3 Using vitamin-E fortified lotion daily will not guarantee that age changes of the skin will be less.
4 Using rose milk lotion daily will not guarantee that age changes of the skin will be less.

 

 

PTS:   1                    CON:  Nursing | Skin Integrity

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Musculoskeletal

Chapter page reference: 30

Heading: Musculoskeletal System

Integrated Processes: Nursing Process: Planning

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Nursing; Mobility

Difficulty: Moderate

  Feedback
1 Exercise assists in increasing endurance and muscle strength, which affects functional ability.
2 Calcium supplements help prevent porous, brittle bones that are susceptible to fractures; this assists in functional ability.
3 Napping encourages inactivity, which does not contribute to maintaining a healthy musculoskeletal system.
4 A diet rich in carbohydrates would cause weight gain, placing greater strain on joints and bones.

 

 

PTS:   1                    CON:  Nursing | Mobility

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Gastrointestinal

Chapter page reference: 31

Heading: Gastrointestinal System

Integrated Processes: Nursing Process: Planning

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Nursing; Digestion

Difficulty: Moderate

  Feedback
1 Slowed gastric emptying may cause an older person to have feelings of fullness and a lack of appetite. Eating smaller, more frequent meals may decrease this discomfort.
2 Forcing oneself to eat is not good nutritional advice.
3 Eating one meal a day is not good nutritional advice.
4 Roughage and fluid are important to promote bowel function.

 

 

PTS:   1                    CON:  Nursing | Digestion

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Integumentary

Chapter page reference: 30

Heading: Integumentary System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Skin Integrity

Difficulty: Moderate

  Feedback
1 The circulatory system is not the most influenced by previous life patterns and environmental conditions.
2 Exposure to sun, earlier health practices regarding diet, grooming, physical activity, genetic factors, and biochemical and environmental factors affect the integumentary system.
3 The respiratory system is not the most influenced by previous life patterns and environmental conditions.
4 The gastrointestinal system is not the most influenced by previous life patterns and environmental conditions.

 

 

PTS:   1                    CON:  Nursing | Skin Integrity

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Genitourinary

Chapter page reference: 31

Heading: Genitourinary System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Urinary Elimination

Difficulty: Easy

  Feedback
1 Benign enlargement of the prostate is a normal aging change.
2 Prostate enlargement is not always related to the presence of cancer.
3 Prostate enlargement is not related to impotence.
4 Enlargement of the prostate can cause urethral obstruction and is the primary cause of overflow incontinence and urinary dribbling.

 

 

PTS:   1                    CON:  Nursing | Urinary Elimination

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Genitourinary

Chapter page reference: 31

Heading: Genitourinary System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Urinary Elimination

Difficulty: Easy

  Feedback
1 Decreased bladder capacity is a normal age-related change of the urinary system, but it does not affect stress incontinence.
2 Decreased renal blood flow is a normal age-related change of the urinary system, but it does not affect stress incontinence.
3 Reduced glomerular filtration rate is a normal age-related change of the urinary system, but it does not affect stress incontinence.
4 Stress incontinence, or loss of urine when intra-abdominal pressure is increased, can be increased with weak pelvic floor muscles.

 

 

PTS:   1                    CON:  Nursing | Urinary Elimination

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Genitourinary

Chapter page reference: 32

Heading: Genitourinary System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Female Reproduction

Difficulty: Easy

  Feedback
1 Loss of pubic hair is not related to painful intercourse and vaginal infections.
2 Urinary incontinence can increase the incidence of vaginal infections.
3 Decreased vaginal secretions decrease the natural lubrication of the vagina, which can cause painful intercourse and increase the potential for vaginal infections.
4 Decreased perineal muscle mass is not related to painful intercourse and vaginal infections.

 

 

PTS:   1                    CON:  Nursing | Female Reproduction

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Neurological

Chapter page reference: 32

Heading: Nervous System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Nursing; Neurological Regulation

Difficulty: Moderate

  Feedback
1 Frequent wakening is annoying, but not the most stressful to older adults.
2 Shorter sleeping time at night is annoying, but not the most stressful to older adults.
3 Older adults rarely complain of not being able to nap during the day.
4 Waking in the morning and still feeling tired is related to the decrease in REM and stage IV sleep.

 

 

PTS:   1                    CON:  Nursing | Neurological Regulation

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Gastrointestinal

Chapter page reference: 31

Heading: Gastrointestinal System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Digestion

Difficulty: Easy

  Feedback
1 Diarrhea is not a common gastrointestinal problem for an older adult.
2 Bulimia is not a common gastrointestinal problem for an older adult.
3 Decreased peristalsis, caused by the decrease in smooth muscle tone, delays gastric emptying, leading to indigestion and decreased appetite. Decreased peristalsis also allows more water absorption in the large intestine, creating constipation.
4 Flatulence, diarrhea, and intestinal cramps are not common gastrointestinal problems for older adults.

 

 

PTS:   1                    CON:  Nursing | Digestion

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Neurological

Chapter page reference: 32

Heading: Nervous System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Neurological Regulation

Difficulty: Easy

  Feedback
1 Older adults may choose to quit driving, but this is not a general reaction to increased reaction time.
2 Studies have shown that older adults compensate for increased reaction times by increasing the accuracy of their responses.
3 Older adults may avoid situations that require quick responses, but this is not a general reaction to increased reaction time.
4 Older adults may use ambulation aids to decrease the risk of falling, but this is not a general reaction to increased reaction time.

 

 

PTS:   1                    CON:  Nursing | Neurological Regulation

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Special senses

Chapter page reference: 33

Heading: Special Sense Organs

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Sensory Perception

Difficulty: Easy

  Feedback
1 Glaucoma is not related to eye dryness.
2 Dryness of the eyes can lead to irritation and eye infections.
3 Eye dryness is usually not severe enough to cause corneal abrasions.
4 The development of cataracts is not related to eye dryness.

 

 

PTS:   1                    CON:  Nursing | Sensory Perception

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Special senses

Chapter page reference: 33

Heading: Special Sense Organs

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Sensory Perception

Difficulty: Easy

  Feedback
1 The loss of low-frequency tones is not an age-related change in hearing.
2 Presbycusis, or loss of high-frequency tones, is the characteristic hearing loss of normal aging.
3 Generalized loss of hearing in all frequencies is not an age-related change in hearing.
4 Loss of high and low-frequency tones is not an age-related change in hearing.

 

 

PTS:   1                    CON:  Nursing | Sensory Perception

 

  1. ANS:  2

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Special senses

Chapter page reference: 33

Heading: Special Sense Organs

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing; Sensory Perception

Difficulty: Easy

  Feedback
1 Speaking loudly raises the frequency to a level that the older patient may not be able to hear.
2 Older adults can hear a normally pitched, clearly articulated voice.
3 Increasing the pitch moves the voice into the high-frequency range that is difficult for an older adult to hear.
4 Mouthing words so the patient reads lips is an inappropriate strategy.

 

 

PTS:   1                    CON:  Nursing | Sensory Perception

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Special senses

Chapter page reference: 33

Heading: Special Sense Organs

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Sensory Perception

Difficulty: Easy

  Feedback
1 Older adults have difficulty seeing the color green because of yellowing of the eye lens.
2 Older adults have difficulty seeing the colors blue and green because of yellowing of the eye lens.
3 Because of yellowing of the lens of the eye with normal aging, older adults have difficulty seeing and differentiating low tone colors, such as blue, green, purple, and brown. Yellow and red are the colors of choice for signs and safety markings.
4 Older adults have difficulty seeing the color blue because of yellowing of the eye lens.

 

 

PTS:   1                    CON:  Nursing | Sensory Perception

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Special senses

Chapter page reference: 33

Heading: Special Sense Organs

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Sensory Perception

Difficulty: Easy

  Feedback
1 Decreased tearing does not increase the risk of falling in an older adult.
2 Yellowing of the lens does not increase the risk of falling in an older adult.
3 Increased sensitivity to glare does not increase the risk of falling in an older adult.
4 The change in accommodation to light and dark takes longer and increases the incidence of falls for older adults.

 

 

PTS:   1                    CON:  Nursing | Sensory Perception

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Special senses

Chapter page reference: 33

Heading: Special Sense Organs

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Sensory Perception

Difficulty: Easy

  Feedback
1 The increased keratin in the cerumen makes it drier and increases the likelihood of it impacting in the ear canal.
2 There is no documentation of an increased cerumen production with aging.
3 Bathing and washing the external canal does not affect the production of cerumen or prevent the development of cerumen impaction.
4 Older adults frequently use cotton-tipped applicators. This practice is not advisable because there is a tendency to push impacted cerumen deeper into the ear canal.

 

 

PTS:   1                    CON:  Nursing | Sensory Perception

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Neurological

Chapter page reference: 32

Heading: Nervous System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Neurological Regulation

Difficulty: Moderate

  Feedback
1 The diet does not reduce reaction time while driving or create dizziness when getting out of a car.
2 Senile dementia does not reduce reaction time while driving or create dizziness when getting out of a car.
3 As motor neurons work less efficiently, reaction time and the ability to respond to stimuli decrease. Older adults frequently have the potential for hypotensive episodes, with position change secondary to decreased blood volume.
4 Decreased mental capabilities do not reduce reaction time while driving or create dizziness when getting out of a car.

 

 

PTS:   1                    CON:  Nursing | Neurological Regulation

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Neurological

Chapter page reference: 29

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Mobility

Difficulty: Easy

  Feedback
1 Eating is a basic personal need included in ADLs.
2 Moving is a basic personal need included in ADLs.
3 Cooking requires a greater level of independence.
4 Dressing is a basic personal need included in ADLs.

 

 

PTS:   1                    CON:  Nursing | Mobility

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Neurological

Chapter page reference: 29

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Mobility

Difficulty: Easy

  Feedback
1 Toileting is a basic task.
2 IADLs are the ability to live independently in the community. Cleaning requires a greater level of independence.
3 IADLs are the ability to live independently in the community. Managing finances requires a greater level of independence.
4 IADLs are the ability to live independently in the community. Taking medication requires a greater level of independence.

 

 

PTS:   1                    CON:  Nursing | Mobility

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 25

Heading: Physiological Theories of Aging

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension {Understanding]

Concept: Nursing; Mobility

Difficulty: Easy

  Feedback
1 As part of the normal aging process, the body shows signs of use—wear and tear. Among these signs is slower movement.
2 As part of the normal aging process, the body shows signs of use—wear and tear. Among these signs is decreased cartilage, causing the need for knee replacement.
3 As part of the normal aging process, the body shows signs of use—wear and tear. Among these signs is possible use of a walker because of decreased bone mass and reduced muscle strength.
4 Many older people do not have chronic diseases and chronic diseases are not inevitable with age.

 

 

PTS:   1                    CON:  Nursing | Mobility

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 25

Heading: Physiological Theories of Aging

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Assessment; Nursing

Difficulty: Easy

  Feedback
1 The nutritional status of the person can play a role in the development of certain diseases and in life span.
2 Family history can play a role in the development of certain diseases and in life span
3 The presence of any chronic diseases can play a role in the development of certain diseases and in life span.
4 The number of friends may or may not play a role in the development of certain diseases and life span.

 

 

PTS:   1                    CON:  Assessment | Nursing

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Integumentary

Chapter page reference: 30

Heading: Integumentary System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Thermo-Regulation

Difficulty: Easy

  Feedback
1 Increased body fluid does not cause an older person to feel colder or have decreased diaphoresis with an elevated body temperature.
2 Alterations in appetite do not cause an older person to feel colder or have decreased diaphoresis with an elevated body temperature.
3 A normal age-related change is a reduction in subcutaneous fat, often leading an older adult to feel cold and ask for sweaters. This reduction in subcutaneous fat and decreased sweat production may also cause an older adult not to exhibit diaphoresis even with a fever.
4 Difficulty with bowel elimination does not cause an older person to feel colder or have decreased diaphoresis with an elevated body temperature.

 

 

PTS:   1                    CON:  Nursing | Thermo-regulation

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Integumentary

Chapter page reference: 30

Heading: Integumentary System

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Reduction of Risk Potential

Cognitive level: Analysis [Analyzing]

Concept: Nursing; Skin Integrity

Difficulty: Moderate

  Feedback
1 Clustering of melanocytes contributes to the development of age spots.
2 Decreased sweat production causes an older person to not experience diaphoresis with a fever.
3 A decrease in subcutaneous fat causes an older person to feel cold.
4 Age-related skin dryness and decreased elasticity increase the risk of skin breakdown and skin tears, leading to increased potential for injury and infection.

 

 

PTS:   1                    CON:  Nursing | Skin Integrity

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems. Cardiovascular

Chapter page reference: 28

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Knowledge [Remembering]

Concept: Perfusion; Nursing

Difficulty: Easy

  Feedback
1 Reduced blood volume would cause a drop in blood pressure.
2 Increased rigidity of heart valves contributes to changes in cardiac output and the development of heart murmurs.
3 During the aging process, the walls of the blood vessels thicken and become less elastic, often leading to increases in blood pressure.
4 Decreased strength of cardiac muscle contributes to changes in cardiac output.

 

 

PTS:   1                    CON:  Perfusion | Nursing

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems. Cardiovascular

Chapter page reference: 28

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Knowledge [Remembering]

Concept: Perfusion; Nursing

Difficulty: Easy

  Feedback
1 Decreased blood volume with aging is not caused by decreased physical activity.
2 Decreased blood volume with aging is not caused by increased daily urine output.
3 Decreased blood volume with aging is not caused by reduced oral intake of fluids.
4 Blood volume is decreased in an older adult because of decreased total body water.

 

 

PTS:   1                    CON:  Perfusion | Nursing

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems. Cardiovascular

Chapter page reference: 28

Heading: Normal Physiological Changes According to Body Systems

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Application [Applying]

Concept: Perfusion; Nursing

Difficulty: Moderate

  Feedback
1 Decreased hemoglobin and hematocrit levels in an older person are not because of increased oral fluid intake.
2 Decreased hemoglobin and hematocrit levels in an older person are not because of decreased rigidity of heart valves.
3 Decreased hemoglobin and hematocrit levels in an older person are not because of increased rigidity of blood vessels.
4 Red blood cells (RBCs) carrying hemoglobin are produced in the bone marrow; a decrease in bone marrow production frequently leads to a decrease in levels of RBCs, hemoglobin, and hematocrit.

 

 

PTS:   1                    CON:  Perfusion | Nursing

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Respiratory

Chapter page reference: 29

Heading: Respiratory System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Nursing; Oxygenation

Difficulty: Moderate

  Feedback
1 The degree of changes within both systems cannot be predicted.
2 Changes appear slower in the respiratory system than the cardiovascular system.
3 The age-related changes affecting the respiratory system are so gradual that most older adults compensate well.
4 Changes in the cardiovascular system are more sudden than those appearing in the respiratory system.

 

 

PTS:   1                    CON:  Nursing | Oxygenation

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Respiratory

Chapter page reference: 29

Heading: Respiratory System

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Oxygenation

Difficulty: Moderate

  Feedback
1 Osteoporosis will not improve the patient’s cough reflex.
2 Osteoporosis will not improve the patient’s lung capacity.
3 Osteoporosis often causes compression of the vertebral column, leading to a bent-over or stooped posture. This posture allows less space for lung expansion and air flow.
4 Osteoporosis leads to a stooped posture, which reduces lung space for expansion and air flow.

 

 

PTS:   1                    CON:  Nursing | Oxygenation

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 25

Heading: Physiological Theories of Aging

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Stress; Nursing

Difficulty: Moderate

  Feedback
1 Good nutrition, exercise, and stress control will not cause an early death.
2 There is no way to predict the number of years that can be added to a person’s life if good nutrition, exercise, and stress control are practiced.
3 Although it is believed that good nutrition, exercise, and stress control can impact chronic illnesses, there is no way of knowing if these approaches will reduce the risk factors for chronic disease.
4 Although the genetic theory of aging claims that humans are born with a genetic program that predetermines their life span, a healthy diet, exercise, and stress control support a higher quality of life, if not adding to longevity.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 1. Define the term ageism.

Chapter page reference: 24

Heading: Ageism

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Nursing

Difficulty: Easy

  Feedback
1 Hospice care is provided to a person with a terminal illness with 6 months or less time to live.
2 Palliative care is given to a person to ensure comfort while managing a chronic illness.
3 Custodial care is given to maintain a person’s life without impacting chronic illnesses or improving the health status.
4 Today’s nursing home is characterized by a concept of rehabilitative, not custodial, care. Rehabilitative care supports the highest possible level of independence despite physical and cognitive limitations.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 1. Define the term ageism.

Chapter page reference: 24

Heading: Ageism

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Diversity; Nursing

Difficulty: Moderate

  Feedback
1 Addressing the older patient with respect honors the uniqueness of the older individual.
2 Calling an older patient “baby doll” is demeaning and fosters dependence.
3 Calling an older patient “hon” is demeaning.
4 Calling an older patient “sweetie” is demeaning.

 

 

PTS:   1                    CON:  Diversity | Nursing

 

  1. ANS:  3

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 25

Heading: Wear and Tear

Integrated Processes: Nursing Process: Evaluation

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Analysis [Analyzing]

Concept: Nursing

Difficulty: Moderate

  Feedback
1 Reviewing the intake of calcium is focusing on the nutrient theory of aging.
2 Asking about the death of parents focuses on the genetic theory of aging.
3 By stopping and resting for a few seconds while ambulating an older patient the nurse understands that the patient’s body parts might be worn out. With lung disease, the need to rest while walking would be necessary.
4 Suggesting that the patient use a wheelchair to reduce the time to get somewhere is not taking the wear and tear theory of aging into consideration.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  1

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 26

Heading: Psychological Theories

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Comprehension [Understanding]

Concept: Self; Nursing

Difficulty: Easy

  Feedback
1 The continuity theory states that as people change, their basic personalities and behavioral patterns do not change. Because the older patient was unable to teach, writing was the other avenue used to continue to instruct others.
2 According to the subculture theory older people have their own cultural norms and standards. This does not explain the patient’s actions.
3 The wear and tear theory explains the effect of living on the human body parts and organs.
4 Developmental task theory states that older people have the task to achieve integrity vs. despair in old age. This does not explain the actions of this older patient.

 

 

PTS:   1                    CON:  Self | Nursing

 

  1. ANS:  4

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes to the body systems.

Chapter page reference: 28

Heading: Normal Aging Process

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Health Promotion

Difficulty: Easy

 

  Feedback
1 Expecting to enjoy perfect health until death would be everyone’s wish, but is not being realistic.
2 Realizing that everyone dies is a negative view of health for an older adult.
3 Understanding that the body wears out and that nothing can be done about it is a negative view of health.
4 Health for older adults might be defined as the ability to function at an individual’s highest potential despite the presence of age-related changes and risk factors.

 

 

PTS:   1                    CON:  Nursing | Health Promotion

 

MULTIPLE RESPONSE

 

  1. ANS:  1, 2, 4
  Feedback
1. The task for old age, according to Erikson, is integrity vs. despair. If older people can find meaning in the life lived, then they will have the ego integrity to adjust and manage the process of aging. If they do not have integrity, they will be angry.
2. The task for old age, according to Erikson, is integrity vs. despair. If older people can find meaning in the life lived, then they will have the ego integrity to adjust and manage the process of aging. If they do not have integrity, they will be depressed.
3. Reading the newspaper does not indicate that the older patient is having difficulty with the developmental task of integrity vs. despair.
4. The task for old age, according to Erikson, is integrity vs. despair. If older people can find meaning in the life lived, then they will have the ego integrity to adjust and manage the process of aging. If they do not have integrity, they will feel despair.
5. Laughing with grandchildren indicates ego integrity to adjust to aging.

 

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 2. Discuss six common theories of aging.

Chapter page reference: 26

Heading: Psychological Theories

Integrated Processes: Nursing Process: Evaluation

Client Need: Psychosocial Integrity

Cognitive level: Analysis [Analyzing]

Concept: Nursing; Development

Difficulty: Moderate

 

PTS:   1                    CON:  Nursing | Development

 

  1. ANS:  1, 2, 5
  Feedback
1. Normal aging includes gains and losses and does not indicate decline.
2. As individuals age they become more diverse and not alike.
3. Age-related changes develop in each individual in a unique way.
4. Normal aging and disease are separate entities.
5. Successful adaptation to the aging process is accomplished by most older adults.

 

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes to the body systems.

Chapter page reference: 28

Heading: Normal Aging Process

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Nursing; Health Promotion

Difficulty: Easy

 

PTS:   1                    CON:  Nursing | Health Promotion

 

  1. ANS:  1, 2, 4, 5
  Feedback
1. Lung elastic recoil is progressively lost with advancing age.
2. Alveoli enlarge and become thin with aging.
3. The surface area for gas exchange is reduced.
4. The alveolus-capillary membrane thickens.
5. The number of functioning alveoli decreases overall.

 

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Respiratory

Chapter page reference: 29

Heading: Respiratory System

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Oxygenation; Nursing

Difficulty: Moderate

 

PTS:   1                    CON:  Oxygenation | Nursing

 

  1. ANS:  1, 2, 4, 5
  Feedback
1. An age-related change in the oral cavity is loose teeth.
2. Delayed gastric emptying time can reduce the appetite.
3. Feelings of thirst are not age-related changes of the gastrointestinal system.
4. A weak gag reflex is an age-related change in the older person’s esophagus.
5. Feeling full is caused by delayed gastric emptying.

 

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Gastrointestinal

Chapter page reference: 31

Heading: Gastrointestinal System

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Analysis [Analyzing]

Concept: Digestion; Nursing

Difficulty: Moderate

 

PTS:   1                    CON:  Digestion | Nursing

 

  1. ANS:  1, 2, 3, 5
  Feedback
1. Functional impairments caused by decreased bladder capacity can lead to nocturia.
2. Functional impairments caused by decreased bladder capacity can lead to frequency.
3. Functional impairments caused by decreased bladder capacity can lead to incontinence.
4. Renal calculi is not identified as being caused by functional impairments in bladder capacity.
5. Functional impairments caused by decreased bladder capacity can lead to urinary retention.

 

Chapter number and title: Chapter 2 The Aging Experience

Chapter/learning objective: 3. Identify age-related changes in the following body systems: Genitourinary

Chapter page reference: 31

Heading: Genitourinary System

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive level: Application [Applying]

Concept: Urinary Elimination; Nursing

Difficulty: Moderate

 

PTS:   1                    CON:  Urinary Elimination | Nursing

 

Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Which statement defines the nursing process?

1) A problem-solving approach
2) A standardized care-planning method
3) An intuitive approach to planning nursing care
4) A structured and inflexible way to approach problems

 

 

____    2.   Which phrase LEAST describes the nursing process?

1) Planned care
2) Patient-centered
3) Adaptable to change
4) Organized according to medical diagnosis

 

 

____    3.   Which is NOT a step in the nursing process?

1) Planning
2) Assessment
3) Physician orders
4) Nursing diagnosis

 

 

____    4.   In which step of the nursing process does the nurse complete the minimum data set (MDS)?

1) Planning
2) Diagnosis
3) Assessment
4) Physician orders

 

 

____    5.   Which is an example of assessment data?

1) Altered nutrition
2) Monitoring the resident’s oral intake
3) Resident will walk 100 feet each afternoon
4) Resident is complaining of difficulty swallowing

 

 

____    6.   Which statement best explains the MDS?

1) Refers care providers to standardized plans of care
2) Focuses on care required for specific medical diagnoses
3) Dictates the nursing care that should be provided to every nursing home resident
4) Refers care providers to problem areas that must be addressed in the plan of care

 

 

____    7.   Which is a nursing diagnosis?

1) Osteoporosis related to menopause
2) Congestive heart failure related to history of hypertension
3) Non–insulin-dependent diabetes mellitus related to obesity
4) Alteration in thought process related to Alzheimer’s disease

 

 

____    8.   What does the development of a nursing diagnosis depend on?

1) Medical diagnoses
2) Chronic disease processes
3) Goals for the resident’s care
4) Data collected in the comprehensive assessment

 

 

____    9.   Which statement describes the process of identifying a nursing diagnosis?

1) Setting goals for nursing care
2) Identifying the patient’s strengths and weaknesses
3) Reviewing medical-surgical nursing texts for patterns of disease processes
4) Selecting a nursing diagnosis from a list approved by the North American Nursing Diagnosis Association (NANDA)

 

 

____  10.   How frequently are goals in long-term care measured?

1) Yearly
2) Weekly
3) Bimonthly
4) Every 30 or 90 days

 

 

____  11.   Which best describes goals?

1) Resident-focused
2) Nurses providing ordered care
3) Priorities of the nursing facility
4) Priorities set by the physician’s orders

 

 

____  12.   Which is a measurable goal for an older person?

1) The resident will feel better.
2) The resident will feel less nauseated.
3) The resident’s appetite will improve.
4) The resident will eat more than 80% of each meal for the next week.

 

 

____  13.   An 80-year-old patient has the nursing diagnosis of impaired skin integrity related to stasis ulcer on the left ankle. Which would be a goal for this nursing diagnosis?

1) The resident will not have any more leg ulcers.
2) The nurse will change the wound dressing b.i.d. until healed.
3) The nurse will chart any wound drainage and report it to the physician.
4) Stasis ulcer will have decreased redness and granulation tissue evident in 2 weeks.

 

 

____  14.   A 68-year-old resident has an elevated blood pressure. What would be a goal for this resident’s care?

1) The resident’s blood pressure will be normal.
2) The resident’s blood pressure will not be elevated.
3) The resident’s blood pressure will be monitored t.i.d. for 1 week.
4) The resident’s blood pressure will be less than 160/90 mm Hg in 1 week.

 

 

____  15.   Which is an appropriate goal for a resident who has a history of falling?

1) The resident will have no falls in the next 90 days.
2) The resident will be toileted q2h for the next week to prevent falls.
3) The resident will be walked by the physical therapy assistant two times a day.
4) The resident will be assessed for complaints of dizziness or unsteadiness for the next 90 days.

 

 

____  16.   Which health-care provider implements the resident care plan?

1) The entire nursing team
2) The registered nurse (RN)
3) The licensed practical nurse (LPN) and the certified nursing assistant (CNA)
4) The RN and the CNA

 

 

____  17.   What is NOT a part of assessment documentation?

1) Blood pressure
2) What the resident said
3) The nurse’s observation
4) Phone calls to the physician

 

 

____  18.   After the care plan is completed on a new admission what must be done?

1) Notify the physician so that he or she may make changes.
2) File it in the drawer; it is not a useful tool for the ongoing care of the patient.
3) Re-evaluate and update the plan of care continually based on the patient’s needs.
4) Inform the family that the plan of care is complete for the duration of the patient’s stay.

 

 

____  19.   Based on Maslow’s hierarchy of needs, which represents the most appropriate list of priorities?

1) Nutrition less than body requirements; constipation; self-care deficit; confusion
2) Constipation; self-care deficit; confusion; nutrition less than body requirements
3) Nutrition less than body requirements; self-care deficit; confusion, constipation
4) Self-care deficit; confusion; constipation; nutrition less than body requirements

 

 

____  20.   Which care provider performs nursing interventions?

1) RN
2) LPN
3) CNA
4) All members

 

 

____  21.   Which statement best describes the nursing process?

1) A step-by-step linear plan
2) A step-by-step circular plan
3) A standardized plan of care for specific diseases or disorders
4) A plan of care designed by the physician according to the medical diagnosis

 

 

____  22.   How does a nursing diagnosis differ from a medical diagnosis?

1) It is identified by a physician.
2) It identifies specific signs and symptoms.
3) It identifies a specific disease process affecting a specific body system.
4) It describes the impact a specific disease has on a patient’s day-to-day activities.

 

 

____  23.   How should the nurse explain the minimum data set (MDS) to a new nursing student?

1) Highlights the major issues for each resident
2) Lists specific issues according to each resident
3) Outlines the specific care needed for every resident
4) Identifies standardized information for every resident

 

 

____  24.   When should the MDS be completed?

1) On the day of admission
2) Within the first month of admission
3) Within the first 7 days of admission
4) Prior to discharge from the facility

 

 

____  25.   What is embedded within the MDS responses?

1) Care area triggers
2) Care area assessment
3) Resident assessment protocols
4) Resident assessment instrument

 

 

____  26.   What is missing from the goal “the resident will walk down the hall every day?”

1) Specificity
2) Timeliness
3) Attainability
4) Measurability

 

 

____  27.   Why is it important for all disciplines to participate in the planning of a resident’s care?

1) Reduces duplication of effort
2) Ensures that everyone is working
3) Speeds up the process of providing care
4) Ensures enough time to document at the end of the shift

 

 

____  28.   Why should CNAs help in the development of nursing interventions for a resident’s plan of care?

1) They are nicer to the resident.
2) They spend the most time with the resident.
3) They have the most theory-based knowledge.
4) They are better received by the family members.

 

 

____  29.   What should be done with the plan of care for a resident who is discharged back home?

1) Discard it.
2) Provide a copy to the family.
3) Keep it with the medical record.
4) Send it to the resident’s physician.

 

 

____  30.   The nurse provides a resident with medication to aid with constipation. What should be included when documenting this intervention?

1) Resident’s response
2) Number of pills remaining
3) Number of residents needing the medication
4) Resident’s location when the medication was given

 

 

____  31.   What should the nurse consult when documenting care provided to a resident in a nursing facility?

1) Physician’s progress note
2) Medical-surgical textbook
3) CNAs’ flow sheet information
4) Medication administration record

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  32.   The nurse is reviewing information received from an acute care facility for a patient being transferred to the nursing home. What information should the nurse expect regarding the patient’s functional ability? Select all that apply.

1) Need for oxygen
2) Integrity of the skin
3) How the patient bathes
4) Assistance needed to eat
5) How the patient transfers

 

 

____  33.   What is included in an admission assessment? Select all that apply.

1) Nursing history
2) Physical examination
3) Interview with the resident
4) Review of laboratory values
5) Previous facility nurse’s notes

 

 

____  34.   What is included in the resident assessment instrument (RAI)? Select all that apply.

1) Minimum data set (MDS)
2) Care area assessment (CAA)
3) Medication reconciliation form
4) Medicare and Medicaid conditions of participation
5) RAI utilization guidelines

 

 

____  35.   Which are care area triggers? Select all that apply.

1) Falls
2) Delirium
3) Activities
4) Dental care
5) Arrhythmia

 

 

____  36.   What is included in the planning phase of the nursing process? Select all that apply.

1) Setting priorities
2) Identifying goals
3) Designing interventions
4) Evaluating outcomes of care
5) Identifying outcomes of care

 

 

____  37.   Why is a written plan of care created for all residents of a nursing facility? Select all that apply.

1) Required by federal regulations
2) Required by states for nursing licensure
3) Required by standards of nursing practice
4) Required by the nursing home administrator
5) Required by continuing education organizations

 

 

____  38.   What is included in the nursing plan of care? Select all that apply.

1) Problems
2) Goals to be achieved
3) Time the action is to occur
4) Actions to address problems
5) Person to address the actions

 

 

____  39.   Which actions facilitate that a resident’s plan of care will be followed by CNAs? Select all that apply.

1) Assigning CNAs to pass linen
2) Giving the CNAs written assignments
3) Scheduling CNAs to do the same tasks
4) Discussing the plan of care with the CNAs
5) Using primary CNAs with steady assignments

 

 

____  40.   What is the purpose of the evaluation phase of the nursing process? Select all that apply.

1) Determine if goals are met.
2) Assess the outcomes of care.
3) Make the next day’s assignments.
4) Ensure the resident is charged for all care.
5) Validate information to bill the insurance company.

 

Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 62

Heading: Nursing Process

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 The nursing process is a problem-solving approach that describes what nurses do.
2 The nursing process is changeable.
3 The nursing process is individualized for each person and provides a planned framework for providing care.
4 The nursing process is flexible.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 62

Heading: Nursing Process

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 The nursing process is based on planned care.
2 The nursing process is patient-centered.
3 The nursing process is individualized for each person and provides a planned framework for providing care.
4 The nursing process is not organized according to medical diagnoses.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  3

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 63

Heading: Nursing Process

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 After problems are identified, the plan is developed.
2 The nursing process starts with assessment.
3 Physician orders are considered in the plan of care but are not a step in the nursing process.
4 During assessment, the information regarding the patient is collected and then organized according to patient-centered problems and nursing diagnoses.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  3

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 63

Heading: Assessment

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 The MDS is not done during the planning step of the nursing process.
2 The MDS is not part of the diagnosis step of the nursing process.
3 The MDS is part of the assessment step in the nursing process.
4 Physician orders are not a part of the nursing process.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 63

Heading: Assessment

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Assessment; Critical Thinking

Difficulty: Moderate

  Feedback
1 Altered nutrition is a nursing diagnosis.
2 Monitoring the resident’s oral intake is a nursing intervention.
3 Resident will walk 100 feet each afternoon is a patient goal.
4 Resident complaining of difficulty swallowing is assessment data.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 64

Heading: Minimum Data Set (MDS)

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Assessment; Critical Thinking

Difficulty: Easy

  Feedback
1 The MDS is not based on standardized care plans.
2 The MDS is not based on medical diagnoses.
3 The MDS and resident assessment protocols provide guidelines designed to individualize the patient’s plan of care.
4 The MDS is part of the comprehensive assessment and has accompanying resident assessment protocols that provide the nurse with guidelines for care planning.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 65

Heading: Nursing Diagnosis and Medical Diagnosis

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Assessment; Critical Thinking

Difficulty: Easy

  Feedback
1 This is a medical diagnosis.
2 Naming a medical problem is not a nursing diagnosis.
3 Combining medical problems is not a nursing diagnosis.
4 This describes a patient problem that nursing care can address.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 64

Heading: Nursing Diagnosis

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Assessment; Critical Thinking

Difficulty: Easy

  Feedback
1 Medical diagnoses are part of the comprehensive assessment but are not what nursing diagnoses are based on.
2 Chronic disease processes are part of the comprehensive assessment but are not what nursing diagnoses are based on.
3 Goals for the resident’s care will depend on the nursing diagnosis.
4 The nursing diagnosis results from the organization of assessment data into problem areas.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  2

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 64

Heading: Nursing Diagnosis

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Assessment; Critical Thinking

Difficulty: Easy

  Feedback
1 Setting goals follows identification of the nursing diagnosis.
2 The process of identifying a nursing diagnosis starts with evaluating a patient’s strengths and weaknesses.
3 Reviewing medical-surgical texts assists the nurse in understanding responses to disease and assists in designing care plans but does not identify nursing diagnoses.
4 The NANDA-approved list provides diagnostic labels for the patient’s strengths and weaknesses.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 68

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 Goals can be reviewed yearly, however, are not used because of the lack of framework for reviews at this interval.
2 Goals can be reviewed weekly, however, are not used because of the lack of framework for reviews at this interval.
3 Goals can be reviewed bimonthly, however, are not used because of the lack of framework for reviews at this interval.
4 Omnibus Reconciliation Act (OBRA) guidelines mandate a 30-day review after recent admission and a quarterly (90-day) interdisciplinary team review. These time frames provide measurable time markers for goals.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 68

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 Goals are resident-focused and based on priorities identified for the resident.
2 Goals are not nurses providing ordered care because this is not resident-focused.
3 Goals are not priorities of the nursing facility because these would not be resident-focused.
4 Goals are not priorities set by the physician’s orders because they may not be resident-focused.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 68

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 This is not a measurable goal.
2 This may be difficult to measure.
3 This may be difficult to measure objectively.
4 Goals are measurable, realistic, specific, time-related, and attainable.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 68

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Diagnosis

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 Even though this is a goal, it is not specific or timely.
2 This is a nursing intervention.
3 This is a nursing action.
4 This is a measurable, realistic, specific, time-related, and attainable goal.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 68

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 This goal is not measurable.
2 This goal is not specific.
3 This is a nursing intervention.
4 This is a measurable, timely, patient-specific, realistic, and attainable goal.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 68

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 This goal is measurable, realistic, specific, time-related, and attainable.
2 This is a nursing intervention.
3 This is a physical therapy intervention.
4 This is a nursing action.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 70

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 The entire nursing team is responsible for implementing the plan of care.
2 The RN is identified as head of the nursing team.
3 The LPN manages the care given by the CNA and passes medications, does dressings, and provides other care within the LPN domain of practice.
4 The CNA often gives the personal care to the resident under the supervision of the LPN.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 71

Heading: Implementation

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking; Communication

Difficulty: Easy

  Feedback
1 Objective measurements are part of assessment documentation.
2 What the resident said is part of assessment documentation.
3 The nurse’s observation is part of assessment documentation.
4 Phoning the physician is part of the plan when documenting using the Assessment-Action-Plan approach.

 

 

PTS:   1                    CON:  Critical Thinking | Communication

 

  1. ANS:  3

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 71

Heading: Evaluation

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 The physician may have input into the care plan but does not have the right to make changes unilaterally, unless by virtue of changed orders.
2 The care plan is a valuable communication, planning, and evaluation tool and should not be stored in a drawer.
3 Care planning and the nursing process are ongoing processes that are never completed as long as the patient is in the health-care environment.
4 The care plan is reviewed and revised in interdisciplinary team meetings and at other times deemed necessary by changes in patient status.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 67

Heading: Setting Priorities

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 Maslow places life-sustaining needs highest (nutrition, constipation), followed by safety and security (self-care deficit), love and belonging, self-esteem (confusion), and self-actualization.
2 Nutrition would be a priority with constipation in this list.
3 Constipation should appear after nutrition in this list.
4 Nutrition and constipation should begin this list, followed by self-care deficit and confusion.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 70

Heading: Implementation

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 The RN, in addition to all team members, performs nursing interventions.
2 The LPN, in addition to all team members, performs nursing interventions.
3 The CNA, in addition to all team members, performs nursing interventions.
4 All team members perform nursing interventions.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  2

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 63

Heading: Nursing Process

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 The nursing process is not a linear approach to care.
2 The nursing process includes the steps of assessment, nursing diagnosis, planning, intervention, and evaluation. It is an ongoing process that takes into account changes in the patient’s condition and responses to interventions, which lead to a need for reassessment—or a return to the first step, as in a circular path.
3 The nursing process is not a standardized plan of care for specific diseases or disorders.
4 The nursing process is not a plan of care designed by the physician according to the medical diagnosis.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 66

Heading: Nursing Diagnosis and Medical Diagnosis

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 A medical diagnosis is identified by a physician.
2 A medical diagnosis identifies signs and symptoms.
3 A medical diagnosis identifies a disease process affecting a body system.
4 A nursing diagnosis is specific to the patient’s nursing care needs and relates to the areas in which the individual has difficulty functioning.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 64

Heading: Minimum Data Set (MDS)

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Assessment, Critical Thinking

Difficulty: Moderate

  Feedback
1 The MDS does not highlight the major issues for each resident.
2 The MDS does not list specific issues according to each resident.
3 The MDS does not outline the specific care needed for every resident.
4 The MDS is standardized so the same information is collected on every resident.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  3

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 64

Heading: Minimum Data Set (MDS)

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Assessment, Critical Thinking

Difficulty: Easy

  Feedback
1 The MDS does not need to be completed on the day of admission.
2 The MDS must be completed within the first 7 days of admission.
3 The MDS must be completed within the first 7 days of admission.
4 The MDS must be completed within the first 7 days of admission.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 64

Heading: Care Area Assessment (CAA)

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Assessment, Critical Thinking

Difficulty: Easy

  Feedback
1 Embedded within the MDS responses are care area triggers (CATs), which indicate the need for further assessment.
2 When the MDS is completed, it provides a comprehensive assessment as well as indicators of risk for the resident. This is called the care area assessment (CAA).
3 CAAs have replaced resident assessment protocols.
4 The resident assessment instrument includes the MDS, the CAA, and the resident assessment instrument utilization guidelines.

 

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  4

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 68

Heading: Goal Setting or Identifying Outcomes

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 The goal identifies the action of walking.
2 The goal identifies that something is to be done every day.
3 The goal is written as attainable.
4 The goal cannot be measured. How far is the resident supposed to walk every day? How many feet? How many times?

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 68

Heading: Designing and Documenting the Plan of Care

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking

Difficulty: Easy

  Feedback
1 A coordinated approach among all disciplines enhances the effectiveness of the care given to the resident and minimizes duplication of efforts.
2 A coordinated approach among all disciplines is not done to ensure that everyone is working.
3 A coordinated approach among all disciplines is not done to speed up the process of providing care.
4 A coordinated approach among all disciplines is not done to ensure that there is enough time at the end of the shift to document.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  2

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 69

Heading: Designing and Documenting the Plan of Care

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 CNAs are not necessarily nicer to the residents.
2 Nursing interventions must be developed with input from CNAs because they spend more time with residents in nursing facilities than any other member of the interdisciplinary team.
3 CNAs do not have the most theory-based knowledge. The RN and LPN will have this knowledge.
4 CNAs are not necessarily better received by the family members.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  3

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 70

Heading: Designing and Documenting the Plan of Care

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 The plan of care should not be discarded.
2 The plan of care does not need to be provided to the family.
3 The plan of care is a permanent part of the resident’s medical record.
4 The plan of care does not need to be sent to the physician.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 71

Heading: Implementation

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 Documentation of interventions includes the resident’s response to the intervention.
2 The number of pills is not documented.
3 The number of residents needing the medication is not documented.
4 The resident’s location when the medication was given is not documented.

 

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  3

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 71

Heading: Implementation

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Moderate

  Feedback
1 Physician’s progress notes do not need to be consulted when documenting care.
2 Medical-surgical textbooks do not need to be consulted when documenting care.
3 Results and trends from the flow sheets can be incorporated into the LPN’s regular progress charting.
4 The medication administration record does not need to be consulted when documenting care.

 

 

PTS:   1                    CON:  Critical Thinking

 

MULTIPLE RESPONSE

 

  1. ANS:  3, 4, 5
  Feedback
1. The need for oxygen would be identified under equipment needs.
2. Skin integrity would be included under special needs.
3. Bathing would be provided under functional ability.
4. Feeding would be included under functional ability.
5 Transferring would be included under functional ability.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 63

Heading: Assessment

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Assessment; Critical Thinking

Difficulty: Moderate

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  1, 2, 3, 4
  Feedback
1. The admission assessment includes a nursing history.
2. The admission assessment includes a physical examination.
3. The admission assessment includes an interview with the older adult.
4. The admission assessment includes a review of laboratory values.
5 The previous facility’s nurse’s notes are not part of the admission assessment.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 63

Heading: Assessment

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Assessment; Critical Thinking

Difficulty: Easy

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  1, 2, 5
  Feedback
1. The RAI includes the MDS.
2. The RAI includes the CAA.
3. The RAI does not include medication reconciliation forms.
4. The RAI does not include Medicare and Medicaid conditions of participation.
5 The RAI includes the RAI utilization guidelines.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 64

Heading: Resident Assessment Instrument (RAI)

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Assessment; Critical Thinking

Difficulty: Easy

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  1, 2, 3, 4
  Feedback
1. Falls are identified as a problem area from the MDS.
2. Delirium is identified as a problem area from the MDS.
3. Activities are identified as a problem area from the MDS.
4. Dental care is identified as a problem area from the MDS.
5 Arrhythmias are not identified as a problem area from the MDS.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 2. Identify the use of the nursing process minimum data set (MDS) and care area assessments (CAAs) in developing nursing care plans for residents in nursing facilities.

Chapter page reference: 65

Heading: Problem Areas Identified From the Minimum Data Set

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Assessment; Critical Thinking

Difficulty: Easy

 

PTS:   1                    CON:  Assessment | Critical Thinking

 

  1. ANS:  1, 2, 3, 5
  Feedback
1. The planning portion of the nursing process includes setting priorities.
2. The planning portion of the nursing process includes identifying goals.
3. The planning portion of the nursing process includes designing interventions.
4. The evaluation phase of the nursing process includes evaluating outcomes of care.
5 The planning portion of the nursing process includes identifying outcomes of care.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 67

Heading: Planning

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1, 3
  Feedback
1. Federal regulations require that each resident have a written, comprehensive, and interdisciplinary plan of care.
2. A written plan of care is not required by states for nursing licensure.
3. Standards of nursing practice require that each resident have a written, comprehensive, and interdisciplinary plan of care.
4. A written plan of care is not required by the nursing home administrator.
5 A written plan of care is not required by continuing education organizations.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 68

Heading: Designing and Documenting the Plan of Care

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1, 2, 4, 5
  Feedback
1. The plan of care includes the problem or potential problem to be identified.
2. The plan of care includes the goals to be achieved.
3. The plan of care does not include the time the action is to occur.
4. The plan of care includes the actions or interventions to be taken to address the problem.
5 The plan of care includes the person or discipline responsible for each action.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 68

Heading: Designing and Documenting the Plan of Care

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Critical Thinking

Difficulty: Easy

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  2, 4, 5
  Feedback
1. Assigning CNAs to pass linen will not ensure that a plan of care will be followed.
2. Giving each CNA written assignments with information on the plan of care ensures the implementation of the plan of care.
3. Scheduling CNAs to perform the same tasks will not ensure that a plan of care will be followed.
4. Meeting regularly with CNAs to discuss the plan of care ensures the implementation of the plan of care.
5 Using primary CNAs who care for the same residents each day ensures the implementation of the plan of care.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 70

Heading: Implementation

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Critical Thinking

Difficulty: Medium

 

PTS:   1                    CON:  Critical Thinking

 

  1. ANS:  1, 2
  Feedback
1. The main purpose of evaluation is to decide if the resident has met the identified goals.
2. The main purpose of evaluation is to assess the outcomes of the nursing care provided.
3. The main purpose of evaluation is not to make the next day’s assignments.
4. The main purpose of evaluation is not to ensure that the resident is charged for all care.
5 The main purpose of evaluation is not to validate information to bill the insurance company.

 

Chapter number and title: Chapter 4: The Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults

Chapter/learning objective: 1. Describe the nursing process as a problem-solving technique in the context of assessment of the older adult, plan of care, nursing interventions, and nursing documentation.

Chapter page reference: 71

Heading: Evaluation

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Critical Thinking

Difficulty: Easy

 

PTS:   1                    CON:  Critical Thinking

 

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