This document contains a compilation of practice test for the NURSING board exam. This prep exam questions will improve your knowledge and understanding on NURSING topics.
TEST BANK FOR GERONTOLOGICAL
NURSING EXAM 2 PREP QUESTIONS WITH
ANSWERS
In the US, most older adults die:
A. At home
B. In the hospital
C. In the nursing home
D. Other - *B. In the hospital*
What percent of Medicare spending is spent on 5% of older adults during the last year of life? - 25% of
Medicare spending
Informed consent - The process by which competent individuals are provided with information that
enables them to make a reasonable decision about any treatment or intervention that is to be
performed on them
-Applies to the decision-making capability of those that are competent to make a decision
What does the right to self determination include? - *Covers all decisions about one's care and
treatment, including:*
-Removal of life support or life-sustaining treatments
-Life-prolonging or lifesaving measures
Right to self determination: Competence - Refers to the ability to understand proposed treatments/
procedures enough to be able to make an informed decision
Advance Medical Directives (AMDs) - Documents that permit people to set forth in writing their wishes
and preferences regarding health care
-States wishes and preferences for future care that healthcare professionals can follow
-Can appoint a surrogate decision maker
When are advance medical directives active? - Not operational until the person is *no longer able to
speak for themselves*
T/F: If you are under the age of 25, your surrogate decision maker (DPOA-HC) is automatically your
parents if you are unable to speak for yourself - FALSE
,Durable Power of Attorney for Health Care (AKA Medical Power of Attorney) - Legal document that
designates an individual (health care agent or proxy) to make medical decisions for you in the event that
you are unable to do so
*Different from a power of attorney authorizing someone to make financial transactions for you*
Living will - Legal document
*Has vague terminology* ("terminal illness", "pervasive vegetative state")
-References future events
Do not require involvement of appointed surrogate decision maker-POA-HC
*Not available at time of healthcare crisis*
T/F if a patient has a DNR order on file, that means they do no want any further treatment - FALSE
DNR orders - Do not resuscitate *does NOT mean do not treat*
-Facility specific
-Does not advise on how to treat a patient that has a pulse and is breathing
*Out of hospital DNR*- not honored by EMS
*Limited for pediatric patients*
Dignified death - -A good death
-Dying well
-Natural part of life
-Opportunity for growth
-A profoundly personal experience
-Different for every individual
Aspects of Quality of Life - Physical
Social
Psychological
Spiritual
Physical aspects of Quality of Life - Functional Ability
Strength/Fatigue
Sleep & rest
Nausea
Appetite
Constipation
Pain
Psychological aspects of Quality of Life - Anxiety
Depression
Enjoyment/Leisure
Pain distress
Happiness
Fear
Cognition/ attention
Social aspects of Quality of Life - Financial burden
, Caregiver burden
Roles and relationships
Affection/ Sexual function
Appearance
Spiritual aspects of Quality of Life - Hope
Suffering
Meaning of pain
Religiosity
Transcendance
POLST - *Physician Orders for Life-Sustaining Treatment*
-Started in Oregon in 1991
-Turns health care preferences into medical orders
-Is more *comprehensive* than a DNR/CPR order*
Advance Care Planning - *Focus on conversation, not document*
-Verifies that discussion done well in advance of a healthcare crisis
-Ongoing conversations with changes in health- *ACP is a process, not a one-time decision*
-Include patient, POA, family, and friends
-Based on patients' values, beliefs, and culture
-Active listening helps identify themes of living well
IPOST- mission - *Iowa Physician Orders for Scope of Treatment*
-To create a system to honor the healthcare treatment choices of individuals through improved
communication across the healthcare continuum and to promote community engagement in advanced
care planning
Terms of IPOST - -Mandate standardized training and form
-Respecting Choices evidenced-based curriculum for facilitator and instructor training (training the
trainer)
-Forms must be ordered from IDPH
-Can be signed by physician (MD/DO), NP, PA
-*Honored across all care settings* (and POLST forms from other states)- IPOST belongs to patient
-Compliments advanced directive (converts wishes into medical orders)
Who can have an IPOST - -Frail and elderly, chronic conditions in frequent contact with a healthcare
provider, life-limiting terminal illnesses
-*No age-limits*- includes pediatric population
Think: "Would I be surprised if this patient were to die in the next year?"
T/F: An IPOST is a medical order - TRUE
Advance Directives - *For all adults with decision-making capacity*
-Future care
-Person completes form (*healthcare proxy cannot complete*)
-Person is responsible for updating and giving document to health care providers
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