Eliopoulos, C. (2024-2025).
Gerontological Nursing Chapters 8, 9,
15, 20, 24, 31 Exam
1. A nurse caring for older adult patients shows an understanding of the implementation
of
standards of care when:
a. dialing the telephone when the patient wants to call his daughter.
b. requesting the patients favorite dessert on his birthday.
c. closing the patients door when he is praying.
d. reminding the patient to call for assistance before getting out of bed. - Answers -D
A standard of care is a guideline for nursing practice and establishes an expectation for
the nurse
to provide safe and appropriate care, such as reminding the patient to call for
assistance before
getting out of bed. Standards of care may be established on national or regional levels.
Dialing
the phone for the patient, closing the patients door, and requesting a special dessert are
not
actions that conform to standards of care.
DIF: Applying (Application) REF: N/A OBJ: 3-1
TOP: Nursing Process: Implementation
Safe and Effective Care Environment
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2. A nurse new to geriatric nursing asks the nurse manager to clarify how to handle a
patients
claim that she has been physically abused. The nurse manager responds most
appropriately when
stating:
a. Ill show you where you can find this states reporting requirements.
b. As a nurse you are considered a mandated reporter of elder abuse.
c. As long as you are reasonably sure abuse has occurred, report it.
d. You need to report any such claims directly to me. - Answers -A
To be responsive to the legal obligation to report reasonably suspicious acts of abuse
and
because there is great variation among the states, nurses should determine the specific
reporting
requirements of their jurisdictions, including where reports and complaints are received
and in
,what form they must be made. The statements that the nurse is a mandatory reporter
and that
abuse should be reported if suspected are true, but they do not help the nurse learn to
handle the
complaint. The manager may want to know about claims of abuse and it may be facility
policy to
report up the chain of command, but the nurse is responsible for filing the formal
complaint.
DIF: Applying (Application) REF: N/A OBJ: 3-8
TOP: Nursing Process: Implementation
Safe and Effective Care Environment
3. The nurse recognizes that a nursing aide likely to abuse an older patient is one who
has:
a. ineffective verbal communication skills.
b. little experience working with the older population.
c. poor stress management skills.
d. been a victim of abuse. - Answers -C
It has been shown that the primary abusers of nursing facility residents are nurse aides
and
orderlies who have never received training in stress management.
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Safe and Effective Care Environment
4. An older adult resident of a long-term care nursing facility frequently attempts to get
out of
bed and is at risk of sustaining an injury. The nurses planned intervention to minimize
the
patients risk for injury is guided by:
a. the patients right to self-determination and to be free to get out of bed.
b. an understanding that nondrug interventions must be tried before medications.
c. the knowledge that application of a vest restraint requires a physicians order.
d. the patients cognitive ability to understand and follow directions. - Answers -B
The drug use guidelines are based on the principles that certain problems can be
handled with
nondrug interventions and that such forms of treatment must be ruled out before drug
therapy is
initiated. The patient does have the right to self-determination, but the staff must ensure
the
patients safety. Vest restraints do require an order, but environmental measures must
be tried
before chemical or physical restraints. The patients cognitive abilities do not allow for
unjustified
,physical or chemical restraints.
DIF: Remembering (Knowledge) REF: Page 35-6 OBJ: 3-7
TOP: Nursing Process: Implementation
Safe and Effective Care Environment
5. During the state inspection of a skilled nursing facility, a surveyor notes suspicion that
a
particular nurse may not be providing the proper standard of care. The nurse manager
informs
the nurse to expect:
a. a review of the situation by the state board of nursing.
b. termination of employment from the facility.
c. mandatory remediation related to the suspect care issues.
d. unannounced reevaluation of performance within the next 3 months.
www.mynursingtestprep.com - Answers -A
In such cases, the surveyor may forward the record showing the relevant findings to the
appropriate state agency or board for review of the nurses practice, requesting a
determination of
whether the nurse may have violated the states nurse practice act. Regulations do not
specify that
the nurse be terminated, have remediation, or have an unannounced reevaluation.
DIF: Understanding (Comprehension) REF: Page 37 OBJ: 3-1
TOP: Communication and Documentation
Safe and Effective Care Environment
6. An 87-year-old patient is unsure of the purpose of a living will. The nurse describes
its
purpose best when stating:
a. Its a legal document that Social Services can help you create.
b. It designates a family member to make decisions if you become incompetent.
c. It provides a written description of your wishes in the event you become
terminally ill.
d. It assures you wont be subjected to treatments you dont want. - Answers -C
Living wills are intended to provide written expressions of a patients wishes regarding
the use of
medical treatments in the event of a terminal illness or condition.
DIF: Understanding (Comprehension) REF: Page 39 OBJ: 3-10
TOP: Teaching-Learning
Safe and Effective Care Environment
7. The nurse is caring for an unresponsive patient who has terminal cancer with a Do
Not
Resuscitate order in effect. A family member tells the nurse, Ill sue you and every other
nurse
here if you dont do everything possible to keep her alive. The nurse understands that
protection
, from legal prosecution in this situation is provided by:
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a. legal immunity granted when acting according to the patients expressed wishes.
b. the legal view that the duty to put into effect the patients wishes falls to the
physician.
c. knowledge of and compliance with facility policies and procedures regarding
end-of-life care.
d. implementing interventions that preserve the patients right to self-determination. -
Answers -C
In this case, immunity applies only to the physician and not to the nurse because the
physician is
given the legal duty to put into effect the patients wishes. Consequently, the nurse must
rely on
effective communication with the physician, patient, and family, and on the quality of the
facilitys policies and procedures, to be sure that his or her actions are consistent with
the legally
required steps.
DIF: Understanding (Comprehension) REF: Page 42 OBJ: 3-10
TOP: Nursing Process: Implementation
Safe and Effective Care Environment
8. The nurse is caring for a terminally ill older patient who has a living will that excludes
pulmonary and cardiac resuscitation. The family expresses a concern that the patient
may change
her mind. The nurse best reassures the family by stating:
a. The nursing staff will watch her very closely for any indication she has changed
her mind.
b. We will discuss her wishes with her regularly.
c. She can change her mind about any provision in the document at any time.
d. Your mother was very clear about her wishes when she signed the document. -
Answers -A
AMD provisions appropriately provide that people can change their minds at any time
and by
any means. Nurses need to be alert to any indications from a patient. Based on the
persons
medical condition, subtle signs such as a gesture or a nod of the head may be easily
overlooked.
The patient may or may not be able to discuss her condition. Stating that the mother
was very
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clear in her wishes does not take into account the fact that patients can change their
minds any
time.
DIF: Applying (Application) REF: N/A OBJ: 3-7
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