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2024 GERO EXAM 1 WITH CORRECT ANSWERS
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2024 GERO EXAM 1 WITH CORRECT ANSWERS
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2024 GERO EXAM 1 WITHCORRECT ANSWERS
1. A nurse is responsible for assessing an older adult in an acute care setting.
Which of the following statements most accurately captures the complexity
involved in assessing the older adult?
A) Older adults manifest fewer symptoms of illness than do younger clients.
B) Signs and symptoms of illness are often obscure and less predictable
among older adults.
C) Care must be taken to avoid assessing normal, age-related changes.
D) Older adults experience fewer acute health problems but more chronic
illnesses than do younger clients. - CORRECT-ANSWERSAns: B
Feedback:
The manifestations of illness in older adults can be less clear and less
predictable than among younger clients. Older adults often show different,
but not necessarily fewer, symptoms than do younger clients. Age-related
changes must be recognized and acknowledged, not excluded from the
assessment process. Older adults do not experience fewer acute health
problems than do younger adults but rather different manifestations of
health problems.
2. An 82-year-old client is getting advice from a family member on how to
drive safely. What piece of advice should the older adult follow?
A) "Avoid modifying your vehicle with devices that were not supplied by the
manufacturer."
B) "Realize that normal, age-related changes should not affect your ability to
drive safely."
C) "You can consider timing your medications to avoid their interfering with
safe driving."
D) "You should transition from driving to using public transportation as soon
as possible." - CORRECT-ANSWERSAns: C
Feedback:
Older adults can be taught how to safely time their medications to avoid
effects such as drowsiness that can affect driving safely. Modification of
vehicles with assistive devices can be a useful tool in promoting safe driving.
Age-related changes such as decreased visual acuity are significant factors
in driving safely. With compensation and education, many older adults can
safely drive and do not necessarily need to give up their licenses early.
3. A nurse conducts a functional assessment of a client who has moved to
the assisted living facility. Which of the following statements best describes
this functional assessment?
,A) Information on the client's medical diagnoses and health problems.
B) Client's ability to perform self-care tasks with a focus on rehabilitation.
C) Assessment of the client's activities of daily living (ADLs).
D) Prioritization of the client's ability to perform roles in relationships and in
society. - CORRECT-ANSWERSAns: B
Feedback:
Functional assessment is a way of determining an individual's ability to fulfill
responsibilities and perform self-care. While it is distinct from a medical
diagnosis approach, it does not discount or ignore information on an older
adult's diagnoses and health problems. It includes data on ADLs and is not a
counterpoint to ADL assessment. The focus is on the fulfillment of
responsibilities and self-care more than on performing social and relationship
roles.
4. As part of a functional assessment, a nurse is assessing an older adult's
ADLs and instrumental activities of daily living (IADLs). What piece of
assessment data would most likely be considered an IADL rather than an
ADL?
A) The older adult is able to ambulate to and from the bathroom at home.
B) The older adult can feed herself independently.
C) The older adult can dress in the morning without assistance.
D) The older adult is able to clean and maintain her own apartment. -
CORRECT-ANSWERSAns: D
Feedback:
IADLs refer to tasks higher in complexity than basic ADLs. IADLs include
housekeeping and shopping. Toileting, feeding, and dressing are all
considered basic ADLs.
5. A nurse in a Medicare- and Medicaid-funded nursing home performs
assessments and develops care plans. Which of these statements is true of
the functional assessments the nurse is likely to perform?
A) The nurse will address core ADLs but not more complex IADLs.
B) The nurse will identify changes in the older adult's function over time.
C) The nurse will utilize various functional assessment models.
D) The main goal of functional assessments will be to ensure older adult
safety. - CORRECT-ANSWERSAns: B
Feedback:
Functional assessments consider an older adult's functional status and
changes in this status over time. They include both core ADLs and more
complex IADLs. The nurse is likely to use the Minimum Data Set for Resident
Assessment and Care Screening, as mandated for Medicare- and Medicaid-
funded facilities. While safety is a consideration in functional assessment,
the main goal is determining the older adult's need for assistance and for
planning care.
,6. A nurse completes the admission assessment of an 84-year-old client to
the long-term care facility. Which assessment finding would direct the nurse
to document a deficit in the client's ADLs?
A) The client experiences chronic pain as a result of rheumatoid arthritis.
B) The client is able to ambulate with a wheeled walker for 60 ft but then
requires a rest break.
C) The client is able to wash self but requires assistance entering and leaving
the bathtub.
D) The client is unable to explain the rationale for each of the prescribed
medications. - CORRECT-ANSWERSAns: C
Feedback:
ADLs include activities such as bathing, dressing, mouth care, hair care,
dietary intake, transfer mobility, ambulation, bed mobility, and bladder and
bowel elimination. Ambulation using an assistive device does not normally
constitute a deficit in mobility. Chronic pain and unfamiliarity with one's
medication regimen are significant assessment findings, but neither
constitutes an ADL deficit.
7. A 79-year-old client has been admitted to a long-term care facility because
of the progression of Alzheimer disease from mild to the moderate stage.
How should the nurse proceed with functional assessment?
A) Document the fact that it is not possible to accurately gauge the woman's
ADLs.
B) Obtain assessment data from the woman's family members and friends.
C) Perform assessment passively by observing and recording the woman's
behavior and actions over the next several days.
D) Use an assessment tool that is specifically designed for use with
cognitively impaired clients. - CORRECT-ANSWERSAns: D
Feedback:
The presence of cognitive deficits presents a challenge to the assessment of
a client's ADLs. However, there are assessment instruments that are
designed for this explicit purpose and these should be utilized. The nurse
should not forgo functional assessment. Observation and input from family
should be included in assessment, but these do not replace a formal,
functional assessment.
8. A nurse working in an acute care for elders unit observes that a client on
the unit frequently stumbles when ambulating with a walker. Which action by
the nurse is best?
A) Provide a wheelchair for the client to use for the duration of the hospital
stay.
B) Ask the client to remain in bed as much as possible and teach the client
about falls risks.
C) Place a chair in the hallway so the client can take a rest break when
feeling unsteady.
, D) Ensure that the woman's mobility is assessed and the appropriate
assistive device is provided. - CORRECT-ANSWERSAns: D
Feedback:
Nurses should be aware of problems with assistive devices and follow up
these problems with the appropriate therapists. It would be inappropriate to
confine the client to bed or to independently replace her walker with a
wheelchair. Providing a chair for rest breaks does not address the central
problem that she may be using the wrong device.
9. A nurse discusses driving with an older adult who continues to drive, but is
probably unsafe on the road. Which statement made by the nurse is most
appropriate?
A) I am calling your child to take your keys.
B) I am concerned about your safety, as well as the safety of others.
C) We just don't want you to crash when you drive across the state.
D) You shouldn't drive anymore. - CORRECT-ANSWERSAns: B
Feedback:
Nurses can sensitively address issues about driving by expressing
compassionate concern not only for the individual older adult but also for the
safety of others.
10. Assessment of an older adult's ADLs addresses parameters such as
mobility, dressing, and elimination. In addition to these, which of the
following categories should the functional assessment also include?
A) Pain
B) Mental status
C) Previous medical history
D) Integumentary assessment - CORRECT-ANSWERSAns: B
Feedback:
A brief mental status assessment is included on the ADL form. Including
mental status in the functional assessment rather than using a separate
mental status assessment tool reinforces the fact that cognitive function is
an integral component of ADLs. In addition, it helps to determine whether
ADL impairments are attributable, at least in part, to cognitive impairments,
rather than primarily to physical limitations. Pain, medical history, and
integument are all relevant assessment parameters, but none is explicitly
included in a functional assessment.
11. A nurse assesses a 91-year-old client in long-term care healing from
bilateral broken legs caused in a fall. Today, the client developed new onset
confusion and combativeness. Which of the factors must the nurse
investigate as a source of this mental status state? (Select all that apply.)
A) Social separation
B) Hyponatremia
C) Medication interactions
D) Positional pain
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