COA CFU

SAS 1
1. Which of the following improves attitudes toward aging and older adults?
a. Staying away from older adults
b. Education about older adults
c. Traveling to older communities
d. Watching the portrayals of older adults in movies and on TV

Ans: B

2. What best describes nurses as a care provider?

a. Determine client's need
b. Provide direct nursing care
c. Help client recognize and cope with stressful psychological situation
d. Works in combined effort with all those involved in patient's care

Ans: B

3. As a student nurse, you understand that it is important to study Gerontological Nursing

because:
a. it is fixed and unchanging.
b. it provides a way to understand the aging process and provide quality care to older adults
c. it can help predict the responses that the body can do in during aging.
d. it gives positive outlook to older adults.

Ans: B

4. Nurse Beth told Mr. Dela Cruz about ways to decrease the risk of heart disease. What role of
a gerontologic nurse did Nurse Beth portray?
a. Manager
 b. Advocate
c Teacher
d. Provider of Care

Ans: C

5. Nurse Beth explains medical and nursing procedures to Mr. Dela Cruz's family members.
What role did Nurse Beth play in this situation?
a. Manager
b. Advocate
c. Teacher
d. Provider of Care

Ans: B

6. What role involves gerontological nurses being aware of current research literature,
continuing to read practice the results of reliable and valid studies?
a. Research Consumer
b. Advocate
c. Teacher
d. Provider of Care

Ans: A

7. As a nurse manager, Nurse Beth knows that she needs to develop the following skilis except,
a. Time management
b. Assertiveness
c. Staff insubordination
d. Communication
Ans: C

8. A primary care provider's order indicates that a consent form needs to be signed. Since the
nurse was not present when the primary care provider discussed the procedure, which
statement best illustrates the nurse fulfilled the client advocate role?
a. "The doctor has asked that you sign this consent form."
b. "Do you have any questions about the procedure?"
c. "What were you told about the procedure you are going to have?"
d. "Remember that you can change your mind and cancel the procedure."

Ans: C

9.A nurse who reads research articles and incorporates research findings into nursing practice
would demonstrate which of the following roles?
a. Collaborator
b. Primary Investigator
c. Producer
d. Consumer

Ans: D

10. The nurse clarifies to a group of clients that the field of nursing interest that specializes in
disease prevention, increasing autonomy and self-care, and maintenance of function for older
adults is
a. gerontology
b. geriatrics.
c. developmental psychology.
d. public health.

Ans: A
SAS 2
1. An 80-year-old patient, who lives at home with a spouse, is instructed to follow a 2 g sodium
diet. The patient states, "I've always eaten the same way all my life, and I'm not going to change
now." To promote optimal dietary adherence, the gerontological nurse's initial approach is to:
a. informs the patient about the need to follow the diet.
b. Inquiries about the patient's current food preferences and eating habits.
c. list the variety of foods that are allowed on the diet.
d. provides dietary instruction to the patient's spouse, who prepares the meals.

Ans: B

2. Which best describes what guides the appropriate nursing care of an aging adult?
a. Evidence-based practice developed with ongoing research into the needs and outcomes of
older adults
b. General nursing care previously practices.
c. Facility policies and procedures
d. Physician orders for patient complaints

Ans: A

3. When teaching an independent older adult patient how to self-administer insulin, the most
productive approach is to
a. facilitate involvement in a small group where the skill is being taught.
b. gathers information about the patient's family health history.
c. provides frequent, competitive skills testing to enhance learning.
d. uses repeated return demonstrations to promote the patient's retention of the involved tasks.

Ans: D
4. A 90-year-old patient comes to the clinic with a family member. During the health history, the
patient is unable to respond to questions in a logical manner. The gerontological nurse's action
is to:
a. asks the family member to answer the questions.
b. asks the same questions in a louder and lower voice.
c. determines if the patient knows the name of the current president.
d rephrases the questions slightly, and slowly repeat them in a lower voice.

Ans: D

5. The American Nurses Association's Gerontological Nursing: Scope and Standards of Practice
emphasizes:
a. Those abnormal responses to the aging process determine the appropriate nursing
diagnoses.
b. that the health status data of older adult patients be documented in a retrievable form.
c. the role of the older adult patient as the sole decision maker in planning his or her care.
d. the unchanging nature of the goals and plans of care for older adult patients

Ans: B

6. The nurse is aware that the majority of older adults:

a. Live alone:
b. Live in institutional settings
c. Are unable to care for themselves
d. Are actively involved in their community

Ans: D

7. Which choice best explains the practice setting for the gerontological nurse?
a. In the home of the client
 b. Only in acute care settings
c. Clinics and long-term care facilities
d. Home of the client, acute care facilities health care and health education

Ans: D

8. A 70-year-old presents to the clinic stating that his family thinks he is losing his mind and they
want to put him in a home. What would be the initial role of the gerontological nurse?
a. Begin the process of finding a qualified nursing home
b. Do a complete history, physical, and assessment
c. Speak with the family about their concerns
d. Make light of the subject until the nurse can evaluate the situation

Ans: B

9. An 87-year-old man, who has been living independently, is entering a nursing home. To help
him adjust; the most effective action is to:
a. involves him in as many activities as possible so he can meet other residents.
b. moves him as quickly as possible so that he does not have time to think.
c. restricts family visits for the first two weeks to give him time to adjust.
d. suggest that he bring his favorite things from home to make his room seem familiar.

Ans: D

10. Members of a family are caring for their father at home. Which statement by a family
member indicates a need for teaching and caregiver instruction?
a. "Dad has gotten lazy about his bathroom habits. He blames his arthritis medication for his
toileting accidents."
b. "Dad's room is close to the bathroom and we keep a light on for him at night."
c. "It's inconvenient, but we stop other activities to remind Dad to go to the bathroom on a
regular schedule."
 d. "We try to avoid coffee and tea at night, but Dad really likes a cup of coffee for breakfast."

Ans: A

SAS 3
1. Nurse Bianca is aware that the theory of aging most likely to explain why the older population
is at risk for autoimmune disorder is known as:
a. cross-link theory.
b. free radical theory.
c. error theory.
d. autoimmune theory.

Ans: D

2. The family member of a patient asks if vitamin C will prevent aging. In formulating an
appropriate response, the nurse considers what theory?
a. free radical theory.
b. autoimmune theory.
C. wear-and-tear theory.
d. continuity theory.

Ans: A

3. Nurse Maria implements the concepts of the activity theory of aging when instructing the
older client with osteoarthritis to:
a. continues her daily walking routine.
b. curtail further increases in physical activity.
c. document preferred end-of-life interventions
d. avoids exposing herself to crowds.
Ans: A

4. The 45-year-old patient reports to the nurse he feels he is going through a "mid-life crisis. The
nurse recognizes phenomenon refers to the theory developed by which psychologist?
a. Jung
b. Erikson
c. Newman
d. Havighurst

Ans: A

5. The patient in the clinic tells the nurse she can "feel her biologic clock ticking. The nurse
knows the patient based on which theory?
a. Gene theory
b. Programmed theory
c. Rate of living theory
d. Somatic mutation theory

Ans: B

6. An 80-year-old female who enjoys good health explains to her primary provider that she
attributed her health status to her regular intake of berries, fruit, green tea, which she states
"Help cleanse the damaging molecules out of my body. "Which of the following theories of aging
underlies the client's health behaviors?
a. Free radical theory
b. Biogerontology
c. Disposable soma theory

Ans: A
7. The nurse would recognize successful aging according to Jung's theory when a long-term
care facility resident demonstrates which of the following behaviors?
a. The resident takes special care to dress for dinner in a manner that pleases his tablemates
b. The resident asks permission to sit on the patio with other residents.
c. The resident asks persons in his hall if his television is bothering them.
d. The resident wears a large cowboy hat at all times because he likes it.

Ans: D

8. The nurse in the long-term care facility who cares for primarily order adults knows these
adults are in which stage of Erikson's developmental tasks?
a. Trust vs mistrust
b. Integrity vs Despair
c. Industry vs Inferiority
d. Generativity vs stagnation

Ans: B

9. Which theory suggests that older people who have low levels of social activity have a high
degree of life satisfaction?
a. Activity
b. Age stratification
c. Disengagement
d. Exchange

Ans: B

10. Based on the free theory of aging, what would be an appropriate behavior that might
increase one's life expectancy?
a. Exercise for 45 minutes at least three times a week.
 b. Eat food rich in antioxidants.
c. Eat a low-calorie, high protein diet
d. Do nothing. Life expectancy is determined through genetic programming.

Ans: B

SAS 4
1. Which is the best example of polypharmacy?
a. Your patient is filling her medications at more than 1 drugstore.
b. Your patient is taking more than 2 medications.
c. Your patient is taking more than 9 medications.
d. Your patient is taking a potentially inappropriate combination of medicines.

Ans: C

2. Which is the most effective method of managing polypharmacy?

a. Review of medications at each office visit, to ensure an accurate med list.
b. Limit your patients' medication list to no more than 4 medicines.
c. Regularly assess patient adherence to the medication regimen.
d. (a) and (c)

Ans: D

3. Oral drugs may be absorbed less quickly in older people because:

a. Of increased number of receptors in the heart
b. Of increased liver metabolism
c. Of increased kidney function
d. Of decreased gastrointestinal motility

Ans: D
4. Enteric coated tablets are designed to avoid being dissolved in the highly acidic stomach.
Instead, they dissolve in the intestines. Knowing this and what you know about gastrointestinal
changes associated with age, what can you conclude about enteric coated tablets and older
patients?
a. The tablets will need to be given intravenously instead
b. These tablets will probably dissolve more slowly
c. The enteric coated tablets are unaffected by changes associated with age
d. These tablets may dissolve more quickly

Ans: B

5. In an older population we can expect that drugs will be:

a. Absorbed more quickly
b. Metabolized more quickly
c. Excreted more rapidly by the kidneys
d. Excreted less readily

Ans: D

6. Which of the following is an age-related physiologic change that may affect the absorption of
drugs?
a. Xerostomia
b Faster stomach emptying
c. Altered pH of the stomach contents
d. Increased gastrointestinal tract motility

Ans: C

7. The nurse is caring for a group of older adult patients who are all receiving multiple
medications the nurse understands that it is essential to Individualize each patient's therapy.
Which is the best rationale for this practice?
A. The percentage of drug absorbed often is decreased in older adults.
B. Most older adults have decreased body fat and increased lean mass.
C. Hepatic metabolism tends to increase in older adults, resulting in decreased drug levels.
D. Renal function declines with age, leading to decreased drug excretion.

Ans: D

8. When assessing for drug effects in the older adult, which phase of pharmacokinetics is the
greatest concern?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion

Ans: D

9. All of the following are impacts of polypharmacy EXCEPT:

a. Increased communication between care teams
b. Adverse drug events
c. Increased healthcare costs
d. Medication non-adherence

Ans: A

10. The single most important thing we can do as healthcare providers to prevent polypharmacy
Is:
a. Encourage our patients to carry a list of home medications in their wallet
b. Tell our patient to appoint a lead doctor
 c. Educate our patients on each of their new medications
d. Tell our patients to Google all of their medications

Ans: C

SAS 5
1. You are caring for a client at the end of life. The client tells you that they are grateful for
having considered and decided upon some end-of-life decisions and the appointments of those
who they wish to make decisions for them when they are no longer able to do so. During this
discussion with the client and the client's wife, the client states that "my wife and I are legally
married so I am so glad that she can automatically make all health care decisions on my behalf
without a legal durable power of attorney when I am no longer able to do so myself and the wife
responds to this statement with, that is not completely true. I can only make decisions for you
and on your behalf when these decisions are not already documented on your advance
directive. How should you, as the nurse, respond to and address this conversation between the
husband and wife and the end of life?
a. You should respond to the couple by stating that only unanticipated treatments and
procedures that are not included in the advance directive can be made by the legally appointed
durable power of attorney for healthcare decisions.
b. You should be aware of the fact that the wife of the client has a knowledge deficit relating to
advance directives and durable powers of attorney for healthcare decisions and plan an
educational activity to meet this learning need.
c. You should be aware of the fact that the client has a knowledge deficit relating to advance
directives and durable powers of attorney for healthcare decisions and plan an educational
activity to meet this learning need.
d. You should reinforce the wife's belief that legally married spouses automatically serve for the
other spouse's durable power of attorney for health care decisions and that other than the
spouse cannot be legally appointed while people are married

Ans: A

2. Your client is in the special care area of your hospital with multiple traumas and severe bodily
burns. This 75-year-old male client has an advance directive that states that the client wants all
life saving measures including cardiopulmonary resuscitation and advanced cardiac life support,
including mechanical ventilation. As you are caring for the client, the client has a complete
cardiac and respiratory arrest. This client has little or no chance for survival and they are facing
imminent death according to your professional judgment, knowledge of pathophysiology and
your critical thinking. You believe that all life saving measures for this client would be futile. What
is the first thing that you, as the nurse, should do?
A. Call the doctor and advise them that the client's physical status has significantly changed and
that they have just had a
B. Begin cardiopulmonary resuscitation other emergency life saving measures.
C. Notify the family of the client's condition and ask them what they should be done for the
client.
D. Ensure that the client is without any distressing signs and symptoms at the end of life.

Ans: B

3. You are asked by your supervisor to take photographs of the residents and their family
members who are attending a holiday dinner and celebration at your long-term care facility.
What should you do?
A. Take the photographs because these photographs are part of the holiday tradition at this
facility
B. Take the photographs because all of the residents are properly attired and in a dignified
condition
C. Refuse to take the photographs unless you have the consent of all to do so
D. Refuse to take the photographs because this is not part of the nurse's roles

Ans: C

4. Which is most closely aligned with ethics?

A. Morals
B. Laws
C. Statutes
 D. Client rights

Ans: A

5. What ethical principle below is accurately paired with a way that ethical principle is applied
into nursing practice
A. Justice: Equally dividing time and other resources among a group of clients
B Beneficence: Doing no harm during the course of nursing care.
C. Veracity: Fully answering the client's questions without any withholding of Information
D. Fidelity: Upholding the American Nurses Association's Code of Ethics

Ans: C

6. One of the roles of the registered nurse in terms of informed consent is to:
A. Serve as the witness to the client's signature on an informed consent.
B. Get and witness the client's signature on an informed consent.
C. Get and witness the durable power of attorney for health care decisions' signature on an
informed consent.
D. None of the above

Ans: A

7. Which of the following is most closely aligned with the principles and concepts of informed
consent?
A. Justice
B. Fidelity
C. Self determination
D. Non-maleficence

Ans: C
8. The student understands the ANA Code of Ethics for Nurses when she identifies which
statement as incorrect? The Code of Ethics for Nurses:
a. provides a framework for ethical decision-making.
b. is non-negotiable.
c. is not applicable to most practice settings.
d. helps with professional self-regulation.

Ans: C

9. The RN student has been studying ethics in health care. Based on what she has learned,
how would she explain the
a. It states that the physician knows what is best for the patient.
b. It does not apply to informed consent.
c. It refers to patient self-determination.
d. It states that every patient has a right to health care.

Ans: C

10. For the RN to practice ethical decision-making, it is most important for him or her to:
a. base decision-making on whether an action is right or wrong.
b. base decision-making on possible consequences.
c. accurately assesses a situation.
d. seeks the assistance of an ethics committee.

Ans: C

SAS 6
1. Which of the following is NOT a priority for patients with a life-limiting illness receiving
palliative care?
 A Relieving burden
B. Prolonging life at all costs
C. Obtaining a sense of control
D. Strengthening relationships with loved ones

Ans: B

2. The family of a client with a terminal illness hesitates to agree to palliative care because of
not wanting to give up on a possible cure. How should the nurse respond while also including a
principle of palliative care?
a. "Most people don't realize that palliative care means there is no cure,"
b. "There will not be another opportunity if palliative care is refused now
c. The client can continue to receive treatment intended to cure the disease
d. "Palliative care and curative treatments cannot be provided at the same time,"

Ans: C

3. The family of a client receiving palliative care for a terminal illness hesitate to call for the
nurse since all staff seem to be too busy to address the client's needs. Which action should the
nurse take to improve the connection with the family?
a. Vary the number and type of caregivers who respond to the client's needs
b. Enter the room and stand or sit at the bedside to talk with the client and family
c. Provide the family with reading material that explains the role of palliative care
d. Attend to infusions and environmental issues while talking with the client and family

Ans: B

4. Which of the following is NOT a barrier to the optimum use of palliative care at the end of life?
A Reimbursement policies
B. Easily determined prognoses
 C. Lack of well-trained healthcare professionals
D. Attitudes of patients, families, and clinicians

Ans: B

5. An 80-year-old patient is receiving palliative care for heart failure. What is the primary
purposes of her receiving palliative care (select all that apply)?
A. Improve her quality of life.
B. Assess her coping ability with disease.
C. Have time to teach patient and family about disease
D. Focus on reducing the severity of disease symptoms
E. Provide care that the family is unwilling or unable to give.

Ans: A,D

6. The home health nurse visits a 40-year-old breast cancer patient with metastatic breast
cancer who is receiving palliative care. The patient is experiencing pain at a level of 7 (on a
10-point scale). In prioritizing activities for the visit. you would do which of the following first?
A. Auscultate for breath sounds.
B. Administer prn pain medication
C Check pressure points for skin breakdown.
D. Ask family members about patient's dietary intake.

Ans: B

7. You are visiting with the wife of a patient who is having difficulty making the transition to
palliative care for her dying husband. What is the most desirable outcome for the couple?
A. They express hope for a cure.
B. They comply with treatment options
C. They set additional goals for the future.
 D. They acknowledge the symptoms and prognosis

Ans: D

8. 67-year-old woman was recently diagnosed with inoperable pancreatic cancer. Before the
diagnosis, she was very active in her neighborhood association. Her husband is concerned
because his wife is staying at home and missing her usual community activities. Which common
end-of-life (EOL) psychological manifestation is she most likely demonstrating?
A. Peacefulness
B. Decreased socialization
C. Decreased decision-making
D. Anxiety about unfinished business

Ans: B

9. The caregiver children of an elderly patient whose death is imminent have not left the bedside
for the past 36 hours. In your assessment of the family, which of the following findings indicates
the potential for an abnormal grief reaction by family members (select all that apply)?
A. Family members cannot express their feelings to one another.
B. The dying patient is becoming more restless and agitated.
C. A family member is going through a difficult divorce.
D. The family talks with and reassures the patient at frequent intervals.
E. Siblings who were estranged from each other have now reunited.

Ans: A, C

10. Which statement made by the graduate nurse working in the hospice unit with a patient near
the end of life requires intervention by the preceptor nurse?
A. "The patient has eaten only small amounts the past 48 hours; will the physician consider
placing a feeding tube?"
 B. "The family seems comfortable with the long periods of silence."
C. "The physician ordered an increase in the dosage of morphine; I will administer the new dose
right away."
D. "The blood pressure is lower this afternoon than it was this morning; I will communicate the
changes to the family"

Ans: A

SAS 7
1.The word spirituality derives from the Latin word spiritus, which refers to breath or wind.
Today, spirituality is
a. Awareness of one's inner self and a sense of connection to a higher being
b. Loss important than coping with the patient's illness
c. Patient centered and has no bearing on the nurse's belief patterns.
d. Equated to formal religious practice and has a minor effect on health care.

Ans: A

2. The nurse is caring for a patient who claims that he does not believe in God, nor does he
believe in an ultimate reality." The nurse realizes that this patient
a. is devoid of spirituality.
b. is an atheist/agnostic
c. Finds no meaning through relationships with others.
d. Believes that what he does is meaningless.

Ans: B

3. The nurse is caring for a patient who is terminally ill with very little time left to live. The patient
states, " always believed that there was life after death. Now, I'm not so sure. Do you think there
is? The nurse states. "I believe there is the nurse has attempted to
a. Strengthen the patient’s religion.
 b. Provide hope.
c. Support the patient's agnostic beliefs.
d. Support the horizontal dimension of spintual well-being

Ans: B

4. The nurse is admitting a patient to the hospital. The patient states that he is a very spiritual
person but does not practice any specific religion. The nurse understands that these statements
a. Are contradictory
b. Indicate a strong religious affiliation
c Indicate a lack of faith.
d. Are reasonable.

Ans: D

5. Which of the following statement about religion and spirituality is true?

a. Religion is a unifying theme in people's lives.
b. Spiritually is unique to the individual.
c. Spirituality encompasses religion.
d. Religion and spirituality are synonymous.

Ans: B

6. The nurse creates a referral to pastoral care when he/she realizes that the patient is in need
of
a. Psychiatric care
b. Rotum to religious affiliation.
c. Spiritual care
d. Transfer to the psychiatric unit.
Ans: C

7. When caring for a terminally ill, 90 yr old patient, the nurse should focus on the fact that the
least important nursing intervention.
a Spiritual care is possibly the least important nursing intervention
b. Spiritual needs often need to be sacrificed for physical care priorities.
c. The nurse's relationship with the patient allows for an understanding of patient priorities.
d. Members of the church or synagogue play no part in the patient's plan of care.

Ans: C

8. The nurse is caring for an elderly patient who is in the final stages of his terminal disease.
The patient is very weak but refuses to use a bedpan, and wants to get up to use the bedside
commode. What should the nurse do?
a. Explain to the patient that he is too weak and needs to use the bedpan.
b. Insert a rectal tube so that the patient no longer needs to actively defecate.
c Enlist assistance from family members if possible and assist the patient to get up.
d. Put the patient on a bedpan and stay with him until he is finished.

Ans: C

9.When evaluating a patient's risk for spiritual crises, which of the following are part of the
evaluation process? (Select all that apply)
a. Review the patient's self-perception regarding spiritual health.
b. Review the patient's view of his/her purpose in life.
c. Discuss with family and associates the patient's connectedness
d Ask whether the patient's expectations are being met.
e Impress on the patient that spiritual health is permanent once obtained.

Ans: A,B,C,D
10. The nurse is caring for a patient who has been diagnosed with a terminal illness. The patient
states, "I just don't feel like going to work. I have no energy, and I can't eat or sleep." The patient
shows no interest in taking part in his care. The nurse should
a. Not be concerned about self-harm because the patient has not indicated any desire toward
suicide.
b. Ignore individual patient goals until the current crisis is over.
c. Encourage the patient to purchase over-the-counter sleep aids to help him sleep.
d. Assess the potential for suicide and make appropriate referrals.

Ans: D

SAS 8
1. A hospice nurse is visiting with a dying patient. During the interaction, the patient is silent for
some time. What is the best response?
A. Recognize the patient's need for silence and sit quietly at the bedside.
B. Try distraction with the patient.
C. Change the subject and try to stimulate conversation.
D. Leave the patient alone for a period.

Ans: A

2. 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?
A. The patient's son uses a marked pillbox to set up the patient's medications weekly.
B. The patient has lost 10 pounds (4.5 kg) during the last month.
C. The patient is cared for by a daughter during the day and stays with a son at night
D. The patient tells the nurse that a close friend recently died.

Ans: B
3. Which of the following statements accurately reflects data that the nurse should use in
planning care to meet the needs of the older adult?
A. 50% of older adults have two chronic health problems.
B. Cancer is the most common cause of death among older adults,
C. Nutritional needs for both younger and older adults are essentially the same.
D. Adults older than 65 years of age are the greatest users of prescription medications.

Ans: D

4. A long-term care facility sponsors a discussion group on the administration of medications.

The participants have several questions concerning their medications. The nurse responds most
appropriately by saying:
A "Don't worry about the medication's name if you can identify it by its color and shape."
B. "Unless you have severe side effects, don't worry about the minor changes in the way you
feel."
C. "Feel free to ask your physician why you are receiving the medications that are prescribed for
you."
D. "Remember that the hepatic system la primarily responsible for the pharmacotherapeutics of
your medications."

Ans: C

5. Which of the following statements, made by the daughter of an older adult client concerning
bringing her mother home to live with her family, presents the greatest concern for the nurse?
A. "If this doesn't work out, she can always go to live with my sister.
B. "I don't think she will react very well to me making decisions for her."
C. I'm afraid that mom will be depressed and miss her home."
D. "My children will just have to adjust to having their grandmother with us."
Ans: B

6. An assisted living facility has provided its clients with an educational program on safe
administration of prescribed medications?
A. "I don't seem to have problems with side effects, but I'll let my doctor know if something
happens."
B. "I'm lucky since my daughter is really good about keeping up with my medications."
C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand something."
D. "It shouldn't be too hard to keep it straight since I don't have any really serious health issues."

Ans: C

7. Of the following options, which is the greatest barrier to providing quality health care to the
older-adult client?
A. Poor client compliance resulting from generalized diminished capacity
B. Inadequate health Insurance coverage for the group as a whole
C. Insufficient research to provide a basis for effective geriatric health care,
D. Preconceived assumptions regarding the lifestyles and attitudes of this group

Ans: D

8. A home health aide is dressing a client. Which of the following is not true regarding this care?
A. Encourage the client to choose his or her own clothes
B. Overextend the extremities, if necessary, when undressing and dressing
C. Assist the client to don pants, shirt with sleeves, and socks,
D. Never the force the extremities when undressing and dressing

Ans: B

9. A home health nurse is assisting a client to transfer from the bed to a wheelchair. Which of
the following is not true regarding this process?
A. Stand in front of the client as he or she stands up to go to the wheelchair
B If needed, when the client stands to go to the wheelchair, grasp the gait belt from underneath
at each side
C. Take large steps to a position so that the client's kneecaps are touching the front of the
wheelchair
D. On the count of three, assist the client to stand up to walk to the wheelchair

Ans: D

10. A client wants to wear a pair of sunglasses in the facility at nighttime. Which of the following
is the appropriate action of the home health nurse?
A. None of the other options
B. Allow the client to wear the sunglasses since it is his or her right to do so
C. Let the client wear the sunglasses in the hopes that he or she will run into something due to
impaired vision
D. The sunglasses will impair the vision; so the home health aide should not allow the client to
wear the sunglasses

Ans: B

SAS 9
1. 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 change that may exist with
this patient?
A. Show a colorful video about anticoagulation therapy.
B. Present all the information in one session just before discharge.
C. Give the patient pamphlets about the medications to read at home.
D. Develop large-print handouts that reflect the verbal information presented.

Ans: D
2. The nurse asks a newly admitted client. "What can we do to help you?" What is the purpose of this
therapeutic communication technique?
A.To reframe the client's thoughts about mental health treatment
B. To put the client at ease
C.To explore a subject, idea, experience, or relationship
D. To communicate that the nurse is listening to the conversation

Ans: C

3. A student nurse is learning about the appropriate use of touch when communicating with clients
diagnosed with psychiatric disorders. Which statement by the instructor best provide information about
this aspect of therapeutic communication?
A. Touch carries a different meaning for different individuals
B. Touch is often used when descalating volatile client situations
C.Touch is used to convey interest and warmth."
D. Touch is best combined with empathy when dealing with anxious clients"

Ans: A

4. Which nursing statement is a good example of the therapeutic communication technique of

focusing?
A "Describe one of the best things that happened to you this week"
B. "I'm having a difficult time understanding what you mean"
C. "Your counseling session is in 50 minutes. I'll stay with you until then"
D. "You mentioned your relationship with your father. Let's discuss that further"

Ans: D

5 After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been
canceled. The client swears at the nurse and states, "You are incompetent!" Which is the
nurse's best response?
A. "Do you believe that I was the cause of your blood test being canceled?"
B. “I see that you are upset, but I feel uncomfortable when you swear at me”
C. "Have you ever thought about ways to express anger appropriately?"
D. "I'll give you some space. Let me know if you need anything.

Ans: B

6. During a nurse-client interaction, which nursing statement may belittle the client's feelings and
concerns?
A. "Don't worry. Everything will be alright."
B. "You appear uptight."
C. "I notice you have bitten your nails to the quick
D. "You are jumping to conclusions."

Ans: A

7. A client states, "You won't believe what my husband said to me during visiting hours. He has
no right treating me that way. Which nursing response would best assess the situation that
occurred?
A. "Does your husband treat you like this very often?"
B. "What do you think is your role in this relationship?"
C. "Why do you think he behaved like that?"
D. "Describe what happened during your time with your husband."

Ans: D

8. When interviewing a client, which nonverbal behavior should a nurse employ?

A. Maintaining indirect eye contact with the client
B. Providing space by leaning back away from the client
C. Sitting squarely, facing the client
D. Maintaining open posture with arms and legs crossed
Ans: C

9. When working with an older adult who is hearing-impaired, the use of which techniques would
improve communication? (Select all that apply.)
A. Check for needed adaptive equipment.
B. Exaggerate lip movements to help the patient lip read.
C. Give the patient time to respond to questions
D. Keep communication short and to the point
E. Communicate only through written information.

Ans: A,C,D

10. A new nurse complains to her preceptor that she has no time for therapeutic communication
with her patients. Which of the following is the best strategy to help the nurse find more time for
this communication?
A. Include communication while performing tasks such as changing dressings and
checking vital signs
B. Ask the patient if you can talk during the last few minutes of visiting hours.
C. Ask Pastoral care to come back a little later in the day.
D. Remind the nurse to complete all her tasks and then set up remaining time for
Communication

Ans: A

SAS 10
1. Why is it important for the nurse to be cautious when using medical jargon with an older adult
patient?
A) It could become an opportunity to instruct the patient.
B) It could become an effective abbreviated communication shortcut
C) It could become an indicator of formal communication.
D) It could become a communication barrier.

Ans: D

2. The nurse is engaging the patient in social conversation. What is the benefit of social
conversation in the health care setting?
A) It lets the patient know that he or she is considered to be a person, not just a patient.
B) It encourages sharing of intimate details.
C) It establishes the nurse's role as a health care provider
D) It blocks more meaningful therapeutic communication.

Ans: A

3. Mr. Gonzales, 72 years old, is admitted to the emergency room with a diagnosis of acute
myocardial Infarction. The client tells the nurse, I'm scared I think I'm going to die. Which of the
following responses by the nurse would be MOST appropriate?
A) "Everything is going to be fine. We'll take good care of you
B) "I know what you mean. I thought I was having a heart attack once."
C) I'll call your doctor so you can discuss it with him."
D) "It's normal to feel frightened. We're doing everything we can for you?

Ans: D

4. When using an interpreter to speak with an 84-year-old Chinese patient, on what should the
nurse focus?
A) The patient, not the interpreter
B) Encouraging the interpreter to paraphrase
C) Limiting questions from the patient
D) Listening to the words, not emotional tone

Ans: A
5. What are the two parts to communication?
A) There only needs to be one part, when someone says something
B) When someone says something, and the other person has understood
C) When someone says something, and the other person has replied
D) When someone says something while using non-verbal communication

Ans: B

6. Nurse Clara asked Mrs. Ramirez about how her day went. Mrs. Ramirez crossed her arms
and rolled not say anything. Nurse Clara nodded her head up and left the room. Have they
communicated?
A) No, at this stage it is one-way communication
B) No, when they answer you they will have communicated back, completing two-way
communication
C) No, but they are being rude
D) Yes, they have used non-verbal communication

Ans: D

7. An unhelpful approach to communication with an older person may involve:

a) Always speaking slowly
b) Assessing them as an individual
c) Adapting to their individual needs
d) Seeing them as partners in their care

Ans: B

8. An example of an environmental barrier to effective communication is:

a) Inflexible appointment systems
b) medical jargon
c) Staff shortages
d) Noisy clinical settings

Ans: D

9. Person-centered communication strategies with older people might involve:

a) Avoiding assumptions about their capacity to communicate effectively
b) Giving too much information at once c
c) Speaking too quickly c
d) Prioritizing staff safety, comfort and well-being

Ans: A

10. Which of the following can be a barrier to communication?

A) A nurse talking while the patient is talking
B) A nurse using slang
C) A hot room
D) All of the above

Ans: D

SAS 11

1. What is the leading cause of catastrophic out-of-pocket costs for families and involves
substantial government spending, primarily through Medicaid and Medicare?
a. Palliative-care
b. Long-term care
c Hospice Care
d. Home Care

Ans: B
2. Problems that the potential burden on aging society contribute on the care-giving systern and
public finances are the following except.
a. Challenge of assuring sufficient resources
b. Effectivity of service system
c. Quality of Long-term care
d. More health care workers

Ans: D

3. Which of the following is not a solution to add funding for future care services?
a. Efforts to promote private long-term care insurance
b. Medicaid and Medicare expansions
c. Retaining long-term care workers
d. More attention from policymakers

Ans: C

4. The following are the different disability projection scenarios except

a. High disability scenario.
b. Low disability scenario
c. Middle disability scenario.
d. Intermediate disability projection

Ans: C

5. This provides the best guess of the future size of the frail older population/ does not assume
any particular and in disability rates.
a. High disability scenario
b. Low disability scenario
c. Middle disability scenario
d. Intermediate disability projection

Ans: D

6. What is the most appropriate nursing diagnosis for an older adult who is bedridden because
of progressed Parkinson disease?
a. Risk for Impaired skin integrity related to immobility
b. Immobility related to Parkinson disease.
c. Impaired skin integrity related to incontinence
d. ischemia related to disuse syndrome

Ans: A

7. An older patient asks why a wound is taking so long to heal. What explanation should the
nurse provide to this patient?
a. There is less protein in the skin with aging"
b. The tissue between the skin cells is weaker."
c. "The amount of blood flow to the skin is slower with aging"
d. "The number of immune cells in the skin reduces with aging"

Ans: D

8. The nurse noted that an older patient complains of always feeling cold. Which age-related
change to the side could be
causing this in the patient?
a. Power protein stores
b. Decreased subcutaneous tissue
c. Reduced levels of immune cells
d. Slower blood flow to the skin layers

Ans: B
9. The primary reason an older adult client is more likely to develop a pressure ulcer on the
elbow as compared to a middle-aged adult is:
a. A reduced skin elasticity is common in the older adult
b. The attachment between the epidermis and dermis is weaker
c. The older client has less subcutaneous padding on the elbows
d. older adults have a poor diet that increases risk for pressure ulcers

Ans: C

10. While bathing an elderly client who has limited abilities for self-care, the nurse notices
several patches of dry skin on the client's heels, elbows, and coccyx. The nurse cleans and
dries all the areas well and applies a moisturizing lotion. The most appropriate immediate
follow-up by the nurse to ensure appropriate nursing care for this client's skin is to:
a.Revise the client's care plan to show the need for the application of moisturizing lotion
b. Assume personal responsibility to apply the moisturizing lotion daily to the client's skin
c. Encourage the client to tell whoever bathes her to apply the moisturizing lotion to her areas of
dry skin
d. Inform the staff that the client's skin is showing signs of breakdown and moisturizing lotion
needs to be applied dally

Ans: A

SAS 12
1. The nurse is performing an assessment on an older client who is having difficulty breathing
during morning exercise. What is the best advice the nurse can give to the client?
a. "Go on, you can do it."
b. "Give yourself time to rest between exercise routines."
c. "You need to finish the exercise routines to facilitate lung expansion."
d. "You are not allowed to exercise with your condition."
Ans: B

2. In performing a physical assessment for an older adult, the nurse anticipates finding which of
the following normal physiological changes of aging?
a. Increased perspiration
b. increased airway resistance
c. Increased salivary secretions
d. Increased pitch discrimination

Ans: B

3. The patient assigned to you has pneumonia. You are reviewing the age-related changed
involved with the older adult Select all age-related changes of the respiratory system that apply.
a. Decreased in residual lung volume
b. Decreased gas exchange
c. Decreased cough efficiency
d. Increased gas exchange

Ans: B,C

4 What is the most significant change in vital organs in the aging client?
a.No change in organ tissue is noted
b.The outer appearance of an organ changes, but the functional component
c. Organs show signs of decrease in function during the aging process
d. The aging process speeds up the functional capacity of major organs

Ans: C

5. Factors that may further decrease lung function besides aging include all but
a. Smoking
b. Obesity
c. Immobility
d. Exercise

Ans: D

6. The nurse is evaluating a 64-year-old male for coronary artery disease (CAD) Understanding
that cause of mortality, which risk factor would not be related to CAD?
a. Hypertension
b. Dyslipidemia
c. Diabetes
d. Sexual orientation

Ans: D

7. What is the single most cost-effective discovery made in the past 30 years that has influenced
the prevention and treatment of cardiovascular events?
a. The development of oral hypoglycemic drugs
b. Recognizing the need to lower blood pressure in older adults
c. Anti Smoking campaigns
d. Zero tolerance for drug and alcohol abuse in older adults

Ans: B

8. The nurse is examining a 76-year-old female with the complaints of fatigue, ankle swelling,
and mild shortness of breath over a three-week period. An appropriate nursing diagnosis might
include:
a. Decreased cardiac output related to altered contractility and elasticity of cardiac
muscle
b. Activity tolerances due to compensation of oxygen supply
c. Increased cardiac output related to an aging heart muscle
d. Decreased urinary output due to poor kidney perfusion
Ans: A

9. A client is experiencing tachycardia. The nurse's understanding of the physiological basis for
this symptom is explained by which of the following statements?
a. The demand for oxygen is decreased because of pleural involvement
b. The inflammatory process causes the body to demand more oxygen to meet its needs.
c. The heart has to pump faster to meet the demand for oxygen when there is lowered
arterial oxygen tension.
d. Respirations are labored.

Ans: C

10. According to the best available evidence, which one of the following lifestyle interventions
for reducing primary hypertension is not likely to be effective?
a. Dietary salt restriction
b. Fish oil supplementation
c. Magnesium supplementation
d. Physical activity and Weight loss

Ans: A

SAS 13
1. 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?
A."I call a cab if I want to go out after dark."
B. "I can't help worrying about becoming forgetful."
C"I have my eyes checked regularly. Can't afford to fall."
D. "I really enjoy eating good vanilla ice cream, but I have cut way down."
Ans: B

2. When caring for an older adult patient, the nurse uses the following interventions to
accommodate decreased touch sensation except
a. Lower the water heater temperature to no higher than 120°F (49°C)
b. Treat seen injuries even if it is not painful
c. Check the thermometer to decide how and what to dress.
d. Give patients' hot beverages

Ans: D

3. When caring for an older adult patient, the nurse uses the following interventions to
accommodate visual changes with age
A. Eyeglasses in the bedside table.
B. Adequate lighting and uncluttered walkways.
C. Draw drapes in room to prevent glare.
D. Keep bedside rails down.

Ans: B

4. Which statement would be most appropriate to ask when assessing an aging adult for
cognitive function?
a) What is today's date?
b) Can you count to 10 for me?
c) Have you noticed anything different about your memory or thinking in the past few
months?
d) Who is the president of the Philippines?

Ans: C

5. Which statement demonstrates normal cognitive function for an aging adult?

a) Occasional memory lapses
b) Unable to recall the names of their children or siblings
c) Unable to recall current address or phone number
d) Unable to count to 10 or repeat a series of consecutive numbers

Ans: A

6. Which item would not be a focus of a cognitive-perceptual pattern assessment for the older
client
a. Cognition-Have you experienced any changes in your memory?
b. Communication-Have you had any difficulty speaking or forming ideas?
c. Financial-Have you had any financial hardships over the past several months?
d. Orientation-Do you know what day, month, and year it is?

Ans: C

7. For an individual with age-related hearing loss, which sound is most difficult to hear:
a. A recording of a march played softly
b. A young child talking in a cafeteria line
c. Hammering during construction of a house next door
d. The voice of a man speaking in an elevator

Ans: B

8. An 80-year-old resident of a retirement center states that something is wrong with the
lighting in the room because colored rings appear around the light bulbs. The resident
most likely has:
a. cataracts.
b. delusions.
c. glaucoma.
d. Increased intracranial pressure.
Ans: C

9. The nurse recognizes that involuntary movements may appear in the elderly patient and be
normal. These normal involuntary movements may present as which of the following?
a. Seizures
b. Tongue protrusions
c. Resting tremors
d. Eye twitches and spasms

Ans: C

10. The nurse recognizes the most common eye-related disease affecting the older adult is!
a. glaucoma
b. cataracts
c. near-sighted visual disturbances
d. far-sighted visual disturbances

Ans: B

SAS 14
1. Mr. Domingo, a 72-year-old, verbalizes his feelings of pain in his fingers. When a client
complains of pain, your initial response is:
a. Record the description of pain
b. Verbally acknowledge the pain
c. Refer the complaint to the doctor
d. Change to a more comfortable position

Ans: A

2. Decrease bone density is one of the effects of aging in the musculoskeletal system. What
independent nursing intervention should the nurse do to address this?
a. Promote safe and sensible exercise programs
b. Prepare diet rich in calcium and vitamin D
c. Prescribe multivitamins
d. Avoid sun exposure

Ans: B

3. Which of the following interventions should be taken to help an older client to prevent
osteoporosis?
A. Decrease dietary calcium intake.
B. Increase sedentary lifestyles
C. Increase dietary protein intake..
D. Encourage regular exercise..

Ans: D

4. There are factors that influence the musculoskeletal system associated with aging. The nurse
recognizes that with age:
a. Men have the greatest incidence of osteoporosis
b. Muscle fibers increase in size and become lighter
c.Weight-bearing exercise reduces the loss of bone mass
d. Muscle strength does not diminish as much as muscle mass

Ans: C

5. The most common cause of chronic pain in older adults is

a. Arthritis.
b. Fractures.
c. Headaches.
d. Neuropathy.
Ans: A

6. A 76-year-old patient with osteoarthritis complains of pain, stiffness, and deformities of the
fingers. The gerontological nurse recommends:
a. cold packs.
b. exercise.
c. meditation therapy.
d. vitamin therapy.

Ans: B

7. Changes in bone and muscle in the aging population have the greatest effect on?
a. Stature, posture, and function
b. Appearance
c. Immunity
d. Pain tolerance

Ans: A

8. The nurse caring for the elderly population understands that movement slows with aging. This
is most likely due to
a. Cognitive function:
b. Changes in musculoskeletal and nervous systems
c. Laziness and a fooling that life is over.
d. A recent change in medical condition

Ans: B

9. A 69-year-old female presents with knee pain. The nurse hears a dry crackling or grating
sound and the client feels the same sensation on exam. The nurse recognizes this ast
a. Nothing abnormal for the age of the client
b. Crepitation, the sound of osteoarthritis in the knee joint
c. Osteoporosis and a softening of the knee joint
d. Fluid-filled spaces in the knee joint

Ans: B

10. The nurse may recommend which of the following for the older client with mild arthritis?
a. Complete bedrest
b. Rest and ice for the joints affected
c. A mild exercise program including walking
d. No exercise will improve arthritis

Ans: C

SAS 15
1. The nurse would instruct the client to eat which of the following foods to obtain the best
supply of vitamin B12?
A. Whole grains
B. Green leafy vegetables
C. Meats and dairy products
D. Broccoli and Brussels sprouts

Ans: C

2. A vegetarian client was referred to a dietitian for nutritional counseling for anemia. Which
client outcome indicates that the client does not understand nutritional counseling? The client:
A. Adds dried fruit to cereal and baked goods
B. Cooks tomato-based foods in iron pots
C. Drinks coffee or tea with meals
D. Adds vitamin C to all meals
Ans: C

3. Mr. Santos, 79-years-old, was admitted with iron deficiency anemia. Which question is most
appropriate for the nurse to ask in determining the extent of the client's activity intolerance?
A. "What activities were you able to do 6 months ago compared to the present?
B. "How long have you had this problem?
C "Have you been able to keep up with all your usual activities?"
D. "Are you more tired now than you used to be?"

Ans: A

4. The nurse is assessing a client's activity Intolerance by having the client walk on a treadmill
for 5 minutes. Which of the following indicates an abnormal response?)
A. Pulse rate increased by 20 bpm immediately after the activity
B. Respiratory rate decreased by 5 breaths/minute
C.Diastolic blood pressure increased by 7 mm Hg
D. Pulse rate within 6 bpm of resting phase after 3 minutes of rest.

Ans: B

5. A client with microcytic anemia is having trouble selecting food items from the hospital menu.
Which food is best for the nurse to suggest for satisfying the client's nutritional needs and
personal preferences?
A. Egg yolks
B. Brown rice
C. Vegetables
D. Tea

Ans: A
6. Which of the following blood components is decreased in anemia?
A. Erythrocytes
B. Granulocytes
C. Leukocytes
D. Platelets

Ans: A

7. Laboratory studies are performed for an elderly suspected of having Iron deficiency anemia.
The nurse reviews the laboratory results, knowing that which of the following results would
indicate this type of anemia?
A. An elevated hemoglobin level
B. A decreased reticulocyte count
C. An elevated RBC count
D. Red blood cells that are microcytic and hypochromic

Ans: D

8. Changes in the immune system that accompany aging include:

A.T cells becoming less responsive to antigens.
B. more cytotoxic T cells responding to infections.
C. increased numbers of T helper cells.
D. higher levels of antibodies after initial exposure to antigens

Ans: A

9. With advancing age, the immune system

A. becomes more effective at combating disease.
B. remains the same and is not affected by the aging process.
C. becomes less effective at combating disease.
D. becomes more responsive to antigens.
Ans: C

10. The increased incidence of cancer in the elderly reflects the fact that
A. immune surveillance increases.
B. their diets do not meet nutritional standards.
C. everyone is prone to disease.
D. Immune surveillance declines with age.

Ans: D

SAS 16
1. A 67-year-old male client has been complaining of sleeping more, Increased urination,
anorexia, weakness, imitability.
depression, and bone pain that interferes with her going outdoors. Based on these assessment
findings, nurse Richard would suspect which of the following disorders?
A. Diabetes mellitus
B. Diabetes insipidus
C. Hypoparathyroidism
D. Hyperparathyroidism

Ans: D

2 Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control
hypoglycemic episodes, the nurse should recommend:
A. Increasing saturated fat intake and fasting in the afternoon..
B. Increasing intake of vitamins B and D and taking iron supplements.
C. Eating a candy bar if lightheadedness occurs.
D. Consuming a low-carbohydrate, high protein diet and avoiding fasting.

Ans: DD
3. What factors can cause premature menopause?
A. Smoking
B. Autoimmune disorders
C. A woman's mother had early menopause
D. All of the above

Ans: D

4. What is the serious adverse effect of menopause? SATA

A. Hot flashes
B. Osteoporosis
C. Heart disease
D. B and C

Ans: D

5. Hormone therapy cases some of the negative effects of menopause. Which of these
hormones is used?
A. Estrogen
B. Estrogen and progesterone
C. Testosterone
D. Prostaglandin

Ans: B

6. The nurse recognizes that a client is experiencing insomnia when the client reports (select all
that apply):
A Extended time to fall asleep
B. Falling asleep at inappropriate times
C. Difficulty staying asleep
D. Feeling tired after a night's sleep

Ans: A,C,D

7. A nursing measure to promote sleep in older adults is to

A. Make sure the room is dark and quint
B. Encourage evening exercise
C. Encourage television watching
D. Encourage quiet activities prior to bedtime.

Ans: D

8. A female client verbalizes that she has been having trouble sleeping and feels wide awake as
soon as getting into bed. The nurse recognizes that there are many interventions the promote
sleep. Check all that apply.
A. Eat a heavy snack before bedtime
B. Read in bed before shutting out the light
C. Leave the bedroom if you are unable to sleep
D. Drink a cup of warm tea with milk at bedtime
E. Exercise in the afternoon rather than the evening
F. Count backwards from 100 to 0 when your mind is racing

Ans: C,E,F

9. Which of the following substances is a natural hormone produced by the pineal gland that
induces sleep?
A Amphetamine
B. Melatonin
C. Methylphenidate
D. Pemoline
Ans: B

10. Which of the following symptoms would a patient exhibit with hyperthyroidism?
A. Intolerance to cold
B. Decreased bowel movements
C. Slow heart rate above
D. None of the

Ans: A

SAS 16
1. A 67-year-old male client has been complaining of sleeping more, increased urination,
anorexia, weakness, iritability. depression, and bone pain that interferes with her going
outdoors. Based on these assessment findings, nurse Richard would suspect which of the
following disorders?
A. Diabetes mellitus
B. Diabetes insipidus
C Hypoparathyroidism
D Hyperparathyroidism

Ans: D

2. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control
hypoglycemic episodes, the nurse should recommend
A. Increasing saturated fat intake and fasting in the afternoon
B. Increasing intake of vitamins B and D and taking iron supplements.
C Eating a candy bar if lightheadedness occurs.
D. Consuming a low-carbohydrate, high protein diet and avoiding fasting.

Ans: D
D. Consuming a low-carbohydrate, high protein diet and avoiding fasting

Ans:

3. What factors can cause premature menopause?

A. Smoking
B. Autoimmune disorders
C. A woman's mother had early menopause
D. All of the above

Ans: D

4. What is the serious adverse effect of menopause? SATA

A. Hot flashes
B. Osteoporosis
C. Heart disease
D. B and C

Ans: D

5. Hormone therapy causes some of the negative effects of menopause. Which of these
hormones is used?
A. Estrogen
B Estrogen and progesterone
C. Testosterone
D. Prostaglandin

Ans: B
6 The nurse recognizes that a client is experiencing insomnia when the client reports (select all
that apply)
A Extended time to fall asleep
B. Falling asleep at inappropriate times
C. Difficulty staying asleep.
D. Feeling tired after a night's sleep

Ans: A,C,D

7 A nursing measure to promote sleep in older adults is to

A. Make sure the room is dark and quiet
B Encourage evening exercise
C Encourage television watching
D. Encourage quiet activities prior to bedtime

Ans: D

8. A female client verbalizes that she has been having trouble sleeping and feels wide awake as
soon as getting into bed. The nurse recognizes that there are many interventions the promote
sleep. Check all that apply
A Eat a heavy snack before bedtime
B Read in bed before shutting out the light
C. Leave the bedroom if you are unable to sleep
D. Drink a cup of warm tea with milk at bedtime
E Exercise in the afternoon rather than the evening
F Count backwards from 100 to 0 when your mind is racing.

Ans: C,E,F

9 Which of the following substances is a natural hormone produced by the pineal gland that
induces sleep?
A Amphetamine
B. Melatonin
C. Methylphenidate
D Pemoline

Ans: B

10. Which of the following symptoms would a patient exhibit with hyperthyroidism?
A Intolerance to cold
B. Decreased bowl movements
C Slow heart rate
D. None of the above

Ans: A

SAS 17
1. A female client with dysphagia is being prepared for discharge. Which outcome indicates that
the client is ready for discharge?
A. The client doesn't exhibit rectal tenesmus.
B. The client is free from esophagitis and achalasia.
C. The client reports diminished duodenal inflammation.
D. The client has normal gastric structures.

Ans: B

2. What laboratory finding is the primary diagnostic indicator for pancreatitis?

A. Elevated blood urea nitrogen (BUN)
B. Elevated serum lipase
C. Elevated aspartate aminotransferase (AST)
D. Increased lactate dehydrogenase (LD)

Ans: B

3.Nurse Liza is teaching a group of old-aged men about peptic ulcers. When discussing risk
factors for peptic ulcers, the nurse should mention:
A a sedentary lifestyle and smoking.
B. A history of hemonholds and smoking.
C.alcohol abuse and a history of acute renal failure.
D alcohol abuse and smoking

Ans: D

4. When teaching an elderly client how to prevent constipation, which of the following
instructions should the nurse Include?
A "Drink 6 glasses of fluid each day
B. "Avoid grain products and nuts
C.”Add at least 4 grams of bran to your cereal each morning"
D. "Be sure to get regular exercise."

Ans: D

5. In a client with diarrhea, which outcome indicates that fluid resuscitation is successful?
A The client passes formed stools at regular intervals
B. The client reports a decrease in stool frequency and liquidity
C. The client exhibits firm skin turgor
D. The client no longer experiences perianal burning.

Ans: C
6 The nurse is caring for an older adult patient who reports continued problems with
constipation. What intervention can be implemented to promote timely bowel movements?
A Increase fiber intake.
B Limit fluid intake to 1500 mL daily
C Administration of an oil retention enema weekly.
D. Take a mild over-the-counter laxative each evening.

Ans: A

7. An elderly patient reports a loss of interest in eating. When providing information to the
patient, which action by the nurse is likely to be most helpful in increasing the patient's intake?
A Having the patient keep a food diary
B. Giving the patient a list of high-calorie foods
C. Reminding the patient of the importance of eating.
D. Suggesting to the patient's family members that someone join the patient for meals

Ans: D

9. The specific cause of dysphagia can be determined more easily when the nurse obtains
which information about the patient?
A Patient's vital signs, especially rate and depth
B. Level of physical activity tolerated by the patient
C Patient's bowel habits and whether taxatives are taken habitually
D.Observing conditions under which the patient experiences difficulty swallowing

Ans: D

10. When planning care for the patient with acute pancreatitis, the nurse knows which
intervention is a priority of care?
A Pain control
B. Nutritional supplementation
C Observation for mental changes
D Observation for intestinal obstruction

Ans: A

SAS 18
1. You have a patient that might have a urinary tract infection (UTI). Which statement by the
patient suggests that a UTI is likely?
A "I pee a lot"
B. "It burns when I pee."
C. "I go hours without the urge to pee."
D. "My pee smells sweet."

Ans: B

2. Which patient is at greatest risk for developing a urinary tract infection (UTI)?
A. A 35 y.o. woman with a fractured wrist
B. A 20 y.o. woman with asthma
C. A 50 y.o. postmenopausal woman
D. A 28 y.o. with angina

Ans: C

3. Nurse Gil is aware that the following statements describing urinary incontinence in the elderly
is true?
A. Urinary Incontinence is a normal part of aging.
B. Urinary Incontinence isn't a disease.
C. Urinary Incontinence in the elderly can't be treated.
D. Urinary Incontinence is a disease.
Ans: B

4.When developing a plan of care for the stress incontinence is best defined as the involuntary
loss of urine associated with
A. A strong urge to urinals
B. Overdistention of the bladder
C. Activities that increase abdominal pressure
D. Obstruction of the urethra

Ans: C

5. The nurse is developing a teaching plan for a client with stress incontinence. Which of the
following instructions should be included?
A. Avoid activities that are stressful and upsetting
B Avoid caffeine and alcohol
C. Do not wear a girdle
D. Limit physical exertion

Ans: B

6.A client has urge incontinence Which of the following signs and symptoms would the nurse
expect to find in this client?
A Inability to empty the bladder
B. Loss of urine when coughing
C. Involuntary urination with minimal warning
D. Frequent dribbling of urine.

Ans: C
7. When assessing the patient who has a lower urinary tract infection (UTI), the nurse will
initially ask about
a. Flank pain
b. Pain with urination.
c. Poor urine output.
d. Nausea.

Ans: B

8. After her bath, a 62-year-old patient asks the nurse for a perineal pad, saying that she uses
them because sometimes she leaks urine when she laughs or coughs. Which intervention is
most appropriate to include in the care plan for the patient?
A Teach the patient how to perform Kegel exercises
B.Demonstrate how to perform Credé's maneuver
C. Place commode at the patient's bedside.
D. Assist the patient to the bathroom q3hr

Ans: A

9. A 78-year-old patient is admitted to the hospital with dehydration and electrolyte imbalance.
The patient is confused and incontinent of urine on admission. In developing a plan of care for
the patient, an appropriate nursing intervention for the patient's Incontinence is to
a. Insert an indwelling catheter.
b. Apply absorbent incontinent pads.
c. Assist the patient to the bathroom q2hr.
d. Restrict fluids after the evening meal.

Ans: D

10. A patient in the hospital has a history of urinary incontinence. Which nursing action will be
included in the plan of care?
a. Place a bedside commode near the patient's bed.
b. Use an ultrasound scanner to check urine residual after the patient voids.
c. Demonstrate the use of the Credé maneuver to the patient.
d. Teach the use of Kegel exercises to strengthen the pelvic floor.

Ans: A

SAS 19
1. The nurse is counseling a postmenopausal woman about her new stress incontinence. Which
statement by the nurse is most important?
a. "You can try a variety of briefs and undergarments"
b. "It will be important to keep that area clean and dry."
c. "I can refer you to a good incontinence clinic."
d. "Unfortunately, incontinence is common in women your age."

Ans: B

2. An older woman is asking the nurse about her husband's sexual functioning. Which statement
by the nurse is most accurate?
a. "Men his age tend to have a rapid decline in sexual abilities."
b. "His testosterone levels will decrease only slightly until he is quite old."
c. "Changes in testosterone levels do not affect sexual performance."
d. "You are lucky your husband is healthy enough for sexual activity"

Ans: B

3. The nurse is conducting a reproductive assessment of a postmenopausal woman. Which

assessment finding reported by the client requires Immediate intervention by the nurse?
a. Urinary incontinence
b. Vaginal dryness
c. Painful intercourse
d. Returning periods

Ans: D

4. A postmenopausal client says that she is experiencing difficulty with vaginal dryness during
intercourse and wonders what might be causing this Which is the nurse's best response?
a. "The less frequently you have intercourse, the drier the vaginal tissues become"
b. "Estrogen deficiency causes the vaginal tissues to become drier and thinner”
c. "Drinking at least 3 liters of water each day will make all your tissues less dry
d. "Try using a water-soluble lubricant during intercourse."

Ans: B

5. The nurse is teaching a postmenopausal woman about nutrition Which statement by the
nurse is most appropriate?
a."Be sure to eat cereal fortified with folic acid and B vitamins."
b. "Make sure you take a calcium supplement every day"
c."Vitamin C is important for the postmenopausal woman"
d. "You can get all the iron you need in two daily meat servings."

Ans: B

6. When performing an assessment of the external genitalia of an older man, the nurse
observes the scrotum to have smooth skin and to be very pendulous. Which action by the nurse
is most appropriate?
a. Suggest to the client that he should wear an athletic supporter while awake.
b. Ask the client if he has been treated for a sexually transmitted disease
c. Document the observation and continue the assessment
d. Notify the health care provider and facilitate a scrotal ultrasound

Ans: C

7. The nurse counsels the 70-year-old female who has remained on hormone replacement
therapy (HRT) that she needs to have a
a semiweekly douche to wash out cervical debris
b. liver function assessment annually
c.mammogram biannually.
d. Pap smear annually.

Ans: D

8. The nurse evaluates a need for further instruction to reduce the symptoms of vaginal dryness
when the 70-year-old patient says:
a."Vaseline was good enough for my mother. It's good enough for me."
b."I use a water-soluble lubricant to aid intercourse"
c."I'm trying an estrogen cream to see if it works"
d "Til let you know how wild yams work for vaginal dryness."

Ans: A

9. The nurse identifies the person most likely to experience erectile dysfunction as the
65-year-old who has been sexually active in earlier years.
a. diabetes and was very
b. irritable bowel syndrome and was minimally
c. chronic pancreatitis and was very
d. osteoarthritis and was moderately
Ans: A

10. The nurse lists the age-related changes in the female reproductive system that affect sexual
intercourse, which are (Select all that apply.)
a. pruritus vulvae
b. atrophic vaginitis
c. frequent yeast infections
d. dyspareunia
e. decreased response time

Ans: A,B,C,D

SAS 20
1. As we get older, we should limit our physical activities because they can be too taxing on our
bodies.
A. True
B. False

Ans: B

2. Exercising during the day will keep you up at night.

A. True
B. False

Ans: B

3. Many exercises can be done from a wheelchair.

A. True
B. False
Ans: A

4. An older person's exercise program should include activities that develop flexibility, balance,
strength training, and endurance
A True
B. False

Ans: A

5. Older people don't need to drink as much fluid during exercise as younger people.
A True
B. False

Ans: B

6. During the morning change-of-shift report at the long-term care facility, the nurse leams that
the patient with dementia has had sundowning. Which nursing action should the nurse take
while caring for the patient?
A Provide hourly orientation to time of day.
B. Move the patient to a quieter room at night.
C. Keep blinds open during the daytime hours.
D. Have the patient take a brief mid-morning nap

Ans: C

7. A long-term care patient with moderate dementia develops increased restlessness and
agitation. The nurse's initial action should be to
A.reorient the patient to lime, place, and person.
B.administer the PRN dose of lorazepam (Alivan)
C.assess for factors that might be causing discomfort.
D. have a nursing assistant stay with the patient to ensure safety

Ans: C

8 Which statement(s) accurately describe(s) mild cognitive impairment (select all that apply)?
A. Always progresses to AD
B. Caused by variety of factors and may progress to AD
C. Should be aggressively treated with acetylcholinesterase drugs
D. Caused by vascular infarcts that, if treated, will delay progression to AD
E.Patient is usually not aware that there is a problem with his or her memory

Ans: B

9. Which patient is most at risk for developing dellnum?

A.A 50-year-old woman with cholecystitis
B. A 19-year-old man with a fractured femur
C. A 42-year-old woman having an elective hysterectomy
D. A 78-year-old man admitted to the medical unit with complications related to heart failure

Ans: D

10. 82-year-old Mr. Robeson together with his daughter arrived at the medical-surgical unit for
diagnostic confirmation and management of probable delirium. Which statement by the client's
daughter best supports the diagnosis?
A. "Maybe it's just caused by aging. This usually happens by age 82."
B. "The changes in his behavior came on so quickly! I wasn't sure what was happening"
C. "Dad just didn't seem to know what he was doing. He would forget what he had for
breakfast."
D. "Dad has always been so independent. He's lived alone for years since mom died."
Ans: B

SAS 21
1. What are the benefits of telehealth? (Select all that apply)
A Continuity of care
B. Centralized health records
C. Collaboration among healthcare professionals
D. low quality of care

Ans: A,B,D

2. After instituting a new system for recording patient data, a nurse evaluates the "usability of
the system. Which actions by the nurse BEST reflect this goal? Select all that apply
A. The nurse checks that the screens are formatted to allow for ease of data entry
B. The nurse reorders the screen sequencing to maximize effective use of the system
C. The nurse ensures that the computers can be used by specified users effectively.
D. The nurse checks that the system is intuitive, and supportive of nurses.
E The nurse improves end-user skills and satisfaction with the new system.
F. The nurse ensures patient data is able to be shared across health care systems

Ans: A,C,D

3. Mr. Sanchez is using telehealth services. He can talk with this physician via videocall about
his condition What type of telehealth applications in he using?
A Synchronous
B. Store-and-Forward
C. Remote Patient Monitoring
D. Mobile Health

Ans: A
4. Mrs. Quezon noticed a rash on her face. She immediately took a picture and send it to her
dermatologist. What type of telehealth applications is she using?
A Synchronous
B. Store-and-Forward
C. Remote Patient Monitoring
D. Mobile Health

Ans: B

5. Telehealth differs from telemedicine in that

A Telemedicine is a broader term than telehealth and emphasizes the provision of Information to
healthcare providers and consumers
B.Telemedicine uses the Internet to provide professionals with Information while telehealth does
not
C. Telehealth encompasses telemedicine, but is a broader term that emphasizes the provision
of information to health care providers and consumers
D.Telehealth is a narrow term referring only to wellness behaviors

Ans: C

6. A 79-year-old patient recently fractured her hip and had a Hemiarthroplasty bipolar hip repair
Her daughter works during the day but provides care in the evening. Which service agency is
most appropriate to provide for this patients daily care?
A Private duty agency
B. Home health agency
C Nursing home facility
D. Outpatient rehabilitation agency

Ans: B
7 A student nurse asks her nurse educator why there is an increased demand for home health
care. Which response is the MOST accurate for the nurse educator?
A. Most family members want to care for their ill members at home.
B. There is a shortage of nurses who want to work in acute hospital care settings
C. There is an increase in the number of older patients with chronic illnesses
D. There is increased technology in hospitals which provokes anxiety to many patients

Ans: C

8. Nurse Abbie is assigned to home health care for an 83-year-old patient with a stroke who has
right-sided hemiplegia, the home care nurse provide? difficulty swallowing, and speech
impairment. He is receiving care in his home from his wife and daughter What should
A Strict regimen and care plan
B. Holistic, nonjudgmental philosophy
C.Teaching plan for all family members
D. Means of transporting the patient to his physician

Ans: B

9. A 68-year-old patient is recovering from an abdominoperineal Resection with a permanent

Colostomy Her physician has ordered home health care nursing on her discharge What is the
primary patient goal?
A. The patient will be able to return to previous lifestyle.
B. The patient will avoid dependency on medication therapy.
C. The patient will establish self-care and independence.
D. The patient will maintain a friendly relationship with family members.

Ans: C
10. The home health nurse has been assigned to provide care for a patient with cultural values
that differ from the nurse's What is the BEST action for the nurse to take? (Select all that apply)
A. Ask for an assignment change to allow a colleague who has cultural values more in line with
those of the patient to be assigned.
B. Take time to consider the differences between the values held and those of the assigned
patient
C. Research the culture of the assigned patient
D. Accept the assignment and provide the patient with information on the values of the nurse to
facilitate communication

Ans: B,C