Chapter 11: The Older Patient

Linton: Introduction to Medical-Surgical Nursing, 6th Edition

MULTIPLE CHOICE

1.How is the term old age or aged best defined?

a. Person’s state of mind

b. Person older than 65 years of age

c. Process of growing older

d. Person of advanced age

ANS: D

Aged or old age is defined as advanced in years.

DIF: Cognitive Level: Comprehension REF: p. 137 OBJ: 2

TOP: Definitions of Old Age KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

2.How is aging recognized by gerontologists as a developmental process?

a. Measured in chronologic years

b. Directly related to heredity

c. Related to behavioral characteristics

d. Begins at the time of birth

ANS: D

Geriatrics is the science of old age and the application of knowledge related to the biologic, biomedical, behavioral, and social aspects of aging.

DIF: Cognitive Level: Knowledge REF: p. 137 OBJ: 2

TOP: Definitions of Old Age KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

3.What understanding is a prerequisite for a nurse working with the geriatric patient?

a. Specialized knowledge is needed.

b. Geriatric patients are physically impaired.

c. Most geriatric patients will develop dementia.

d. Geriatric patients need to be closely supervised.

ANS: A

Knowledge, understanding, and caring are prerequisites for working effectively with older adults. Although specialized formal education programs at the graduate level are available for gerontologic nurses, many nurses gain specials skills through on-the-job experiences.

DIF: Cognitive Level: Comprehension REF: p. 138 OBJ: 1

TOP: Roles of the Gerontologic Nurse KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

4.A 78-year-old resident of a long-term care facility insists on wearing high heels and miniskirts to the dining room for meals and will not leave her room without first applying glamorous makeup. What should the gerontologic nurse assess as the reason for this behavior?

a. Insecurity about her appearance

b. Trying to cope with the changes of aging

c. Denial concerning her advancing age

d. Her fashion consciousness

ANS: C

Some older people confront aging, but others deny it by acting in a younger manner.

DIF: Cognitive Level: Analysis REF: p. 138-139 OBJ: 2

TOP: Ageism: Myths and Stereotypes KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

5.What does Butler, a well-known gerontologist, relay regarding ageism?

a. It dehumanizes older individuals.

b. It is based on the biologic theory of aging.

c. It is based on natural and purposeful occurrences.

d. It continues to change as the population ages.

ANS: A

Ageism is the stereotyping of and discrimination against people because of their age.

DIF: Cognitive Level: Comprehension REF: p. 138-139 OBJ: 2

TOP: Ageism: Myths and Stereotypes KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

6.What are the effects of aging on the nervous system?

a. Accelerated loss of neurons in the brain

b. Gradually declining loss of intellectual capability

c. Decreased conduction speed of neurons

d. Loss of long-term memory

ANS: C

Age-related effects on body systems are integral parts of the basis of nursing care for older adults. The aging nervous system is characterized by decreased conduction speed of neurons.

DIF: Cognitive Level: Comprehension REF: p. 140-141 OBJ: 3

TOP: Physiologic Change KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Physiological Adaptation

7.A nurse is caring for older adult patients with mild cognitive impairment (MCI). What are these patients more likely to develop?

a. Dementia, non-Alzheimer type

b. Alzheimer dementia

c. Parkinson disease

d. Psychotic disorders

ANS: B

Approximately 40% of people with MCI develop Alzheimer dementia within 3 years.

DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: 3

TOP: Physiologic Change KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

8.What is the most appropriate nursing action when planning activities to improve short-term memory for an older adult patient experiencing memory deficits?

a. Maintain the same daily schedule.

b. Rehearse memory training.

c. Provide a varied and stimulating daily schedule.

d. Conduct deep-breathing exercises.

ANS: B

Using mnemonics and memory rehearsal may improve memory performance in some older individuals.

DIF: Cognitive Level: Application REF: p. 140-141 OBJ: 3

TOP: Physiologic Change KEY: Nursing Process Step: Planning

MSC:NCLEX: Physiological Integrity: Physiological Adaptation

9.What is the best example of normal memory change or lapse of memory?

a. Relying on another person to remember names or important events

b. Occasional forgetfulness or inability to recall names or facts

c. Difficulty in recalling recent events

d. Difficulty in recalling past events

ANS: B

Memory lapses such as forgetting a name or misplacing an item are common, normal memory changes.

DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: 3

TOP: Physiologic Change KEY: Nursing Process Step: Implementation

MSC:NCLEX: Psychosocial Integrity: Psychosocial Adaptation

10.Which facts are generally accepted for most older adults?

a. Intellectual capabilities are impaired.

b. Functional brain activities decrease.

c. Functional intellectual capability is maintained.

d. Creativity and judgment are severely impaired.

ANS: C

Functional ability may not be significantly affected because reserve cells are able to compensate.

DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: 3

TOP: Physiologic Change KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A