DIAGNOSTICS EXAM NCMB 314

1. A nurse is caring for an older adult client. The nurse
should recognize the client is at risk for which of the
following physiological changes? (select all that
apply)
a. decreased gastric motility
b. decreased skin elasticity
c. increased pain threshold
d. increased metabolic rate
e. increased cardiac output
most older people should be involved in care decisions
most older people have strengths we should focus on
most older people have dependent functioning
6. Nurse suspects an older-adult patient is experiencing
caregiver neglect. Which assessment findings are
consistent with nurse's suspicions?
Group of answer choices

2. A nurse is teaching a class of older adults about the cuts and bruises
expected physiologic changes of aging. Which of the
following changes should the nurse include in the left at a grocery store
discussion? (select all that apply)
refuses to take a bath
a. more difficulty seeing due to a greater sensitivity
to glare
b. decreased cough reflex flea bites and lice infestation
7. A nurse is teaching a group of older-adult patients.
c. decreased bladder capacity
Which teaching strategy is best for the nurse to use?
d. decreased systolic blood pressure
e. dehydration of interveterbal discs Group of answer choices
3. A nurse is obtaining a history on an older adult.
Which finding will the nurse most typically find?
provide several topics of discussion at once to promote
lives alone
independence and making choices

speak in a high pitch to help patients hear better

lives with a spouse
ask patients to recall past experiences that correspond with
lives in a nursing home their interests

lives divorced avoid uncomfortable silences after questions by helping

4. A nurse is developing a plan of care for an older
adult. Which information will the nurse consider?
Group of answer choices
Should be standardized because more geriatric patients have
the same needs
needs to be individualized to the patient's unique needs
must be based on chronological age alone
focuses on the disabilities that all aging persons face
5. Which information from a co-worker on a
gerontological unit will cause the nurse to intervene?
Group of answer choices
patients complete their statements
8. An older patient has fallen and suffered a hip
fracture. As a consequence, the patient's family is
concerned about the patient's ability to care for self,
especially during this convalescence. What should
the nurse do?
Group of answer choices
stress that older patients usually ask for help when needed
provide information and answer questions as family members
make choices among care options
inform the family that placement in a nursing center is a
permanent solution

tell the family to enroll the patient in a ceramics class to

most older people should be encouraged to have
maintain quality of life
independence
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9. A nurse is caring for an older adult. Which goal is
priority?
Group of answer choices
adjusting to career
adjusting to divorce
adjusting to retirement
adjusting to grandchildren
10. A nurse is observing skin integrity of an older adult.
Which finding will the nurse document as a normal
finding?
Group of answer choices
oily skin
increased facial hair in men
decreased elasticity
faster nail growth
11. The nurse hears a client calling out for help, hurries
down the hallway to the client's room, and finds the
client lying on the floor. The nurse performs an
assessment, assists the client back to bed, notifies
the health care provider of the incident, and
completes an incident report. Which statement
should the nurse document on the incident report?
Group of answer choices
The client climbed over the side rails
The client fell out of bed
The client was found lying on the floor
12. The client became restless and tried to get out of
bed.
A client is brought to the emergency department by
emergency medical services (EMS) after being hit by a car.
The name of the client is unknown, and the client has
sustained a severe head injury and multiple fractures and is
unconscious. An emergency craniotomy is required.
Regarding informed consent for the surgical procedure, which
is the best action?
Group of answer choices
Transport the victim to the operating room for surgery
Obtain a court order for the surgical procedure
Call the police to identify the client and locate the family.
13. Ask the EMS team to sign the informed consent
The nurse has just assisted a client back to bed after a fall.
The nurse and health care provider have assessed the client
and have determined that the client is not injured. After
completing the incident report, the nurse should implement
which action net?
Group of answer choices
Document in the nurse's notes that an incident report was
completed.
Reassess the client
Conduct a staff meeting to describe the fall
14. Contact the nursing supervisor to update
information regarding the fall
A hospitalized client tells the nurse that a living will is being
prepared and that the lawyer will be bringing the will to the
hospital today for witness signatures. The client asks the
nurse for assistance obtaining a witness to the will. Which is
the most appropriate response to the client?
Group of answer choices
"You will need to find a witness on your own.'
"I will call the nursing supervisor to seek assistance regarding
your request."
"Whoever is available at the time will sign as a witness for
you."
"I will sign as a witness to your signature."
15. The nurse has made an error in a narrative
documentation of an assessment finding on a client
and obtains the client's record to correct the error.
The nurse should take which action to correct the
error?
Group of answer choices
Using whiteout to delete the error to write in the correct data
Trying to erase the error for space to write in the correct data
 19. Which statement is true regarding falls in the
elderly?
Documenting a late entry into the client's record
Group of answer choices
Drawing one line through the error, initialing and dating, and
then documenting the correct information. Fall risk decreases with addition of medications.
16. Which identifies accurate nursing documentation
notations? Select all that apply
Hip fractures resulting from falls are a leading cause of
a. The client slept through the night
placement in long-term care facilities.
b. Abdominal wound dressing is dry and intact
without drainage
c. The client seemed angry when awakened for vital Most falls occur in the garage.
sign measurement
d. The client appears to become anxious when it is Sedatives reduce the risk of falls.
time for respiratory treatments 20. Appropriate nursing care for a patient with urinary
e. The client's left lower medial leg wound is 3 cm in incontinence is to:
length without redness, drainage, or edema
Group of answer choices
17. A nursing instructor delivers a lecture to nursing
students regarding the issue of client's rights and
asks a nursing student to identify a situation that recommend herbal approaches to reduce incontinence.
represents an example of invasion of client privacy.
Which situation, if identified by the student, order oxybutynin chloride (Ditropan).
indicates an understanding of a violation of this
client right?
encourage fluids to decrease the urine concentration so it is
less irritating.
Group of answer choices

insert an indwelling Foley catheter.

Observing care provided to the client 21. A nursing intervention for a patient with constipation
without the client's permission is to:

Group of answer choices

Performing a procedure without consent

encourage bran cereal or whole-grain breads.

Telling the client that he or she cannot leave
the hospital
limit fluid intake.
Threatening to give a client a medication
18. Nursing staff members are sitting in the lounge avoid the urge to defecate.
taking their morning break. An unlicensed assistive
personnel (UAP) tells the group that she thinks that give prune juice with a noncarbonated drink.
the unit secretary has acquired immunodeficiency 22. A patient with dysphagia is:
syndrome (AIDS) and proceeds to tell the nursing
staff that the secretary probably contracted the Group of answer choices
disease from her husband, who is supposedly a drug
addict. Which legal tort has the UAP violated?
able to drink thin liquids.
Group of answer choices
fed only for pleasure.
Negligence
at a higher risk for pneumonia
Assault
at low risk for nutritional deficits.
Libel 23. Age-related eye changes may include:

Slander Group of answer choices


non-preventable blindness as a result of glaucoma.
increased visual accommodation.
decreased ability of pupil to respond to light changes.
macular degeneration.
24. Nurses' knowledge of sexuality in the older adult
population should include:
Group of answer choices
Ability to achieve orgasm declines.
Sexual response time is unchanged.
Dryness of the vaginal walls is associated with pelvic
inflammatory disease.
Chronic illness may affect the ability to participate in sexual
activity.
25. What is the initial nursing intervention in preventing
polypharmacy?
Group of answer choices
Consult a pharmacist to review all medications.
Refer the patient to a geriatric practitioner.
Discontinue all herbal preparations.
Obtain a thorough medication history.
26. What should the nurse include in the teaching plan
for self-medication practices of older adults?
Group of answer choices
Eliminate unnecessary medications.
Pharmacy shop for the cheapest medications.
Develop a drug reminder system and schedule.
Substitute herbal preparations for certain prescribed
medications.
27. Which age-related changes predispose the elderly
patient to drug toxicity and extended duration of
action of drugs? (Select all that apply.)
A. Decreased body water
B. Increased ratio of muscle to fat
C. Low serum albumin
D. Reduced blood flow to liver
28. The nurse is setting up an education session with an
85-year-old patient who will be going home on
anticoagulant therapy. Which strategy would reflect
consideration of aging changes that may exist with
this patient?
Group of answer choices
Develop large-print handouts that reflect the verbal
information presented.
Give the patient pamphlets about the medications to
read at home.
Show a colorful video about anticoagulation therapy.
Present all the information in one session just before
discharge.
29. Which information obtained by the home health
nurse when making a visit to an 88-year-old with
mild forgetfulness is of the most concern?
Group of answer choices
The patient is cared for by a daughter during the day and
stays with a son at night.
The patient has lost 10 pounds (4.5 kg) during the last month.
The patient tells the nurse that a close friend recently died.
30. The patient's son uses a marked pillbox to set up the
patient's medications weekly.
In reviewing changes in the older adult, the nurse recognizes
that which of the following statements related to cognitive
functioning in the older client is true?
Group of answer choices
Cognitive deterioration is an inevitable outcome of the
human aging process.
Therapeutic drug intoxication is a common cause of senile
dementia.
Delirium is usually easily distinguished from irreversible
dementia.
Reversible systemic disorders are often implicated as a cause
of delirium.
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31. Which of the following statements accurately
reflects data that the nurse should use in planning
care to meet the needs of the older adult?
Group of answer choices
50% of older adults have two chronic health problems.
Cancer is the most common cause of death among older
adults.
Nutritional needs for both younger and older adults are
essentially the same.
Adults older than 65 years of age are the greatest users of
prescription medications.
32. A long-term care facility sponsors a discussion group
on the administration of medications. The
participants have a number of questions concerning
their medications. The nurse responds most
appropriately by saying:
Group of answer choices
"Feel free to ask your physician why you are receiving the
medications that are prescribed for you."
"Unless you have severe side affects, don't worry about the
minor changes in the way you feel."
"Don't worry about the medication's name if you can identify
it by its color and shape."
"Remember that the hepatic system is primarily responsible
for the pharmacotherapeutics of your medications."
33. In performing a physical assessment for an older
adult, the nurse anticipates finding which of the
following normal physiological changes of aging?
Group of answer choices
Increased perspiration
Increased pitch discrimination
Increased airway resistance
Increased salivary secretions
34. There are factors that influence the musculoskeletal
system associated with aging. The nurse recognizes
that with age:
Group of answer choices
Muscle strength does not diminish as much as muscle mass
Weight-bearing exercise reduces the loss of bone mass
Muscle fibers increase in size and become tighter
Men have the greatest incidence of osteoporosis
35. Which of the following responses by an older-adult
client is most reflective of a need for further
education by the nurse regarding the physiological
changes associated with the older adult?
Group of answer choices
"I really enjoy eating good vanilla ice cream, but I have cut
way down." 0%
"I can't help worrying about becoming forgetful."
"I call a cab if I want to go out after dark."
"I have my eyes checked regularly. Can't afford to fall."
36. Which of the following statements made by a family
member of a client recently diagnosed with early
stages of Alzheimer's disease is most reflective of an
understanding of this disease process?
Group of answer choices
"Good thing we found out about this early so we can prevent
this from getting worse."
"We have a made arrangements to discuss nursing home
placement for dad."
"We have an appointment with his care provider to see about
medication therapy."
"Dad has always been a fighter; he'll fight this too. He won't
give up."
37. The nurse is planning client education for an older
adult being prepared for discharge home after
hospitalization for a cardiac problem. Which nursing
action addresses the most commonly determined
need for this age-group?
Group of answer choices
Encourage the client to use a compartmentalized pill storage
container for his daily medications.

Arrange for the client to receive meals delivered to his home

daily.

Suggest that he purchase an emergency in-home alert

system.

Provide only written document describing the medications

the client is currently prescribed.
38. Older adult is characterized by the following except?

Group of answer choices

All of the above

Old-old

Young Adult

Elderly
39. Healthy adults often experience decreased strength
and endurance in performing activities as they age.
This can be attributed to:     

Group of answer choices

A decreased in taste

A decrease in social contact to other people

A decrease in smell

A decrease in lean muscle mass

40. The following appropriately describes Gerontology
except:

Group of answer choices

It includes biologic, sociologic, psychologic, and economic

aspects

It is the scientific study of the process of aging and problems

of aged persons

AOTA –all of the above

It came from a Greek word geron meaning “old age”