Geriatric Health Assessment
Midterm Exam
Course Introduction
Geriatric Health Assessment focuses on the comprehensive evaluation of health status in older adults, emphasizing the physiological, psychological, and social changes associated with aging. The course covers methods for assessing functional ability, cognitive function, nutritional status, mental health, and common geriatric syndromes. Students will learn to perform age-appropriate physical examinations, utilize geriatric assessment tools, and interpret findings in order to create tailored care plans. Ethical considerations and effective communication with elderly patients and their families are also addressed, preparing students to deliver holistic and culturally competent care in diverse healthcare settings.
Recommended Textbook
Ebersole and Hess Gerontological Nursing and Healthy Aging in Canada 2nd Edition by Theris A.
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26 Chapters
314 Verified Questions
314 Flashcards
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2
Chapter 1: Introduction to Healthy Aging
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) Which of the following nursing interventions represent a holistic approach to caring for an older person?
A)Performs glucose testing during the weekly worship service
B)Wheels ambulatory adults to exercise when running late
C)Assigns female nurses to older female persons who are Muslim
D)Allows older persons in a nursing home to eat meals alone
Answer: C
Q2) An older-person male who resides in a nursing home has very high cholesterol levels.Which nursing intervention is most likely to assist this man in achieving his highest level of wellness?
A)Instruct him about increasing dietary fibre.
B)Ask the health care provider for a low-fat diet.
C)Schedule a consultation for him with the dietitian.
D)Review a menu with him to choose suitable foods.
Answer: D
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3
Chapter 2: Gerontological Nursing History, Education, and Roles
10 Flashcards
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Sample Questions
Q1) The gerontological nurse collaborates with the wound care team about an older person who has an ulcer.How is this nurse demonstrating leadership in the care of an older person?
A)The nurse is screening and assessing older persons effectively.
B)The nurse is facilitating access to older person care programs.
C)The nurse is coordinating members of the health care team.
D)The nurse is empowering older persons to manage chronic illness.
Answer: C
Q2) A male older person is transferred to a hospice facility with end-stage disease.Which of the following is a suitable nursing intervention for this older person and his family, according to the Canadian Gerontological Nursing Association's Standards of Practice?
A)Decrease the analgesic dose to prevent sedation.
B)Provide a basin and towels for morning self-care.
C)Inform family members about strict visiting hours.
D)Facilitate family rituals related to death and dying.
Answer: D
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Chapter 3: Communicating With Older Persons
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Which of the following is a good strategy to use for teaching older-person learners?
A)Use printed materials in soft colours.
B)Provide extra time for the learner to respond.
C)Use a pleasant soprano voice in audio materials.
D)Cover a diverse range of topics in each session.
Answer: B
Q2) Which of the following statements is true about forming a group with older persons?
A)Leaders must be prepared for members to fail to show up as a result of illness, death, or other reasons.
B)Groups should include persons with diverse levels of cognitive ability.
C)A group leader who is prone to depression will be better able to empathize with the depression and losses suffered by group members.
D)The evening is a good time for a group to meet.
Answer: A
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Chapter 4: Culture, Ethnicity, and Aging
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) The phenomenon known as "healthy migrant effect" states that recent immigrants tend to have better health than long-term immigrants or nonimmigrants, because of:
A)Better access to education.
B)More economic supports/resources.
C)Healthier childhoods.
D)Canadian immigration policies.
Q2) The nurse prepares a female older person, who is Polish, for discharge through an interpreter and notes that the older person becomes tense during the instructions about elimination.Which of the following interventions should the nurse implement?
A)Move on to the discussion about medication.
B)Ask the older person how she feels about this topic.
C)Instruct the interpreter to repeat the instructions.
D)Have the older person repeat the instructions for clarity.
Q3) Which health belief system uses treatments to repair a body part?
A)Holistic
B)Biomedical
C)Personalistic
D)Magicoreligious
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Chapter 5: Nursing Documentation
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Which of the following is a true statement about documentation?
A)Nurses should keep records of patients' wishes.
B)Patients do not have access to their own medical records.
C)The DARE approach is a complete record of the health status of a patient.
D)The nurse is responsible for completing all of the Minimum Data Set (MDS).
Q2) The nurse must inform an older person whose first language is French and who does not speak any English about patient rights.The nurse also has to have the older person sign the document about information access.Which intervention should the nurse use to maintain the confidentiality of this older person?
A)The nurse should present the older person with a French version of the information access document.
B)The nurse should have an English-speaking family member explain the document to the older person.
C)The nurse should explain the document to the older person using an interpreter to ensure understanding.
D)The nurse should instruct an interpreter to read the information access document to the older person privately.
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Chapter 6: Biological Theories and Physical Changes of Aging
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Which change in the skin is abnormal in an older person?
A)Thinner and more fragile skin
B)A tear in the skin after being assisted with transferring from the bed
C)Mottled pigmentation and greater number of freckles
D)Loss of hair on the extremities
Q2) An older-person male who spray-paints houses for a living has had a myocardial infarction (MI).Which intervention should the nurse implement to prevent adverse health effects from his occupational history?
A)Provide low-cholesterol diet meals.
B)Avoid substances that are hepatotoxic.
C)Promote coughing and deep breathing.
D)Analyze the electrocardiogram's rhythm.
Q3) An older person who recently had surgery complains of pain at a level of 3 out of 10 and constipation during the postoperative primary care visit.Which intervention should the nurse implement to first facilitate elimination in this older person?
A)Encourage use of a laxative.
B)Review medication list.
C)Promote fibre in the diet.
D)Suggest added fluid intake.
Page 8
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Chapter 7: Social, Psychological, Spiritual, and Cognitive Aspects of Aging
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) An older male adult with severe knee pain tells the nurse how he lost his job and his home after starting a new business when he was 48 years old.Now he lives alone and relies on welfare.Using Jung's theory, what in this individual's life is the most pivotal in his personality development?
A)Living alone
B)Meagre income
C)Severe knee pain
D)Job loss and home loss
Q2) Which physiological change in the brain is the reason the nurse allows more time for older persons to answer questions?
A)Increased secretion of acetylcholine
B)Decreased secretion of neurotransmitters such as dopamine
C)Loss of brainstem neurons
D)Atrophy of dendrites in the cerebral cortex
Q3) Crystallized intelligence consists of:
A)Memories created more than 20 years ago.
B)Knowledge and abilities that the person acquires through education and life.
C)Skills that are biologically determined.
D)Education acquired through post-secondary education.
Page 9
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Chapter 8: Nutritional Needs
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The nurse instructs the health care aide to feed an older person.If the nurse is unable to observe feeding directly, which action should the nurse use to assess the older person's risk for aspiration immediately following feeding?
A)Note the food volume eaten by the older person.
B)Observe the older person's skin colour.
C)Inspect for pocketing.
D)Monitor the older person for bradypnea.
Q2) When providing health teaching to an older person, which of the following nutrition information guidelines should be recommended for the older person's daily diet?
A)A daily fibre intake of 15 g
B)No more than 1500 mg/day sodium intake
C)Five servings of meat per day
D)Vitamin D intake of 600 to 800 IU/daily
Q3) Which of the following is a true statement about dental health in older persons?
A)Most people can expect to lose most of their teeth by old age.
B)Excessive saliva production is a common problem among older persons.
C)Functional and cognitive limitations may contribute to poor oral hygiene.
D)A little blood on the toothbrush is normal.
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Chapter 9: Hydration and Continence
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) The nurse wants to begin helping an older person who is overweight and has urinary incontinence, with healthy bladder behaviour skills.Which intervention should the nurse implement?
A)Begin low-calorie diet for weight management.
B)Schedule voiding at two- to four-hour intervals.
C)Instruct the older person to practise abdominal exercises.
D)Reduce the time between an urge to void and voiding.
Q2) Which of the following statements is true about fluid intake for older persons?
A)An older person's daily total volume should be 1000 to 1500 mL.
B)Coffee is a suitable beverage for maintaining hydration.
C)Sports drinks should not be consumed, because they contain too much sugar.
D)The amount of fluid offered with medication administration should be standardized (at least 100 mL) for an older person.
Q3) Which one of the following signs and symptoms is characteristic of a urinary tract infection (UTI) in an older person?
A)Fever
B)Dysuria
C)Anorexia
D)Flank pain
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Page 11
Chapter 10: Rest, Sleep, and Activity
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) Which of the following are benefits of exercise for nonambulatory older persons?
A)Muscle weakness and atrophy may be reversed.
B)Incontinence problems will be resolved.
C)Memory issues may improve.
D)Ambulation will develop.
Q2) The nurse at an assisted-living facility uses the Exercise and Screening for You (EASY) tool to plan an exercise program for an older-person resident who is in good health except that her height has decreased 1.5 cm.Which exercise safety tip from EASY calls for the nurse to assess the resident before planning care?
A)Do not exercise a red, warm, or swollen joint.
B)Avoid stretches that cause you to bend at the waist.
C)Evaluate your surroundings for outdoor exercising.
D)Begin by warming up with low to moderate exercises.
Q3) Which factor contributes to sleep problems in older persons?
A)Excessive napping
B)Daily exercise
C)Lethargy
D)Rapid eye movement (REM)
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12
Chapter 11: Promoting Healthy Skin and Feet
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Which of the following statements is true about impaired skin integrity?
A)A stage III pressure ulcer can regress to stage II as the subcutaneous tissues regenerate.
B)Stasis ulcer is another term for pressure ulcer.
C)An unstageable wound presents with redness and blistering.
D)Anemia and poor nutritional status correlate with poor healing of pressure ulcers.
Q2) Which of the following is an important consideration regarding the skin of an older person?
A)Generous amounts of soap should be used for cleansing.
B)Sweat glands increase in activity.
C)The skin becomes more vulnerable to damage.
D)The skin becomes darker in unexposed areas.
Q3) The nurse cares for an older male adult who has a malignant melanoma.Which intervention should the nurse implement for this man, to prevent a recurrence or advancement of this condition in the future?
A)Place posters about sunscreen in the halls of his apartment building.
B)Promote application of sunscreen at his neighbourhood health fair.
C)Tell him to schedule all outdoor activities after 1600 hours daily.
D)Instruct him to wear sun-protective clothing and a hat at all times.
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Page 13
Chapter 12: Maintaining Mobility and Environmental Safety
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13 Flashcards
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Sample Questions
Q1) The overall temperature in your gerontological unit is 17°C (62°F) during the evening shift.In documenting this concern to administration, which factor is the most important for the health and well-being of older persons?
A)It is not fair for older persons to have to deal with an uncomfortable environment.
B)Some of the residents are wearing blankets around their shoulders to keep warm.
C)An ambient temperature of 17°C (62° F) is unsuitable for older people because they have impaired thermoregulation.
D)It feels much warmer in the administration wing than out in the patient care areas.
Q2) The nurse is discharging an older female adult who is using a walker from rehabilitative care.Which observation does the nurse use to determine that this patient is prepared for discharge?
A)The patient holds the front of the walker.
B)The patient has a walker with four wheels.
C)The patient takes four steps into the walker.
D)The patient takes the walker to the elevator.
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14
Chapter 13: Assessment Tools in Gerontological Nursing
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13 Flashcards
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Sample Questions
Q1) Which of the following should the nurse include in the psychosocial assessment of an older patient?
A)Comorbid diseases
B)Joint pain
C)Genetics
D)Family relationships
Q2) Which functional assessment tool asks about the mechanical and psychological factors affecting an older person's ability to maintain an adequate diet?
A)Katz Index
B)FANCAPES
C)Functional Independence Measure
D)Older Americans Resources and Services
Q3) Which one of the following categories is not found in the Fulmer SPICES assessment tool?
A)Pain
B)Confusion
C)Falling
D)Incontinence
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Chapter 14: Safe Medication Use for Older Persons
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Polypharmacy may include which one of the following definitions?
A)10 or more prescribed medications
B)Adverse drug reactions
C)More than 3 prescribers of medications for one client
D)Use of medications that are duplicated or unnecessary
Q2) The nurse provides instruction about medication safety to older persons.Which of the following instructions should the nurse provide?
A)Nausea and vomiting are common, harmless medication side effects.
B)Keep a supply of medications at the bedside for convenience.
C)Ask the health care provider to describe the purpose of the medication therapy.
D)Take your daily medications on an empty stomach with water.
Q3) Which of the following processes is not increased in the early morning?
A)Fibrinolytic activity
B)Osteoarthritis pain
C)Asthma symptoms
D)Rheumatoid arthritis pain
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16
Chapter 15: Living With Chronic Illness
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Sample Questions
Q1) Which one of the following describes the nurse's role for an older patient with a chronic illness?
A)Implement an individualized therapeutic regimen that brings about a cure.
B)Focus on potential rather than on limitations.
C)Suggest that the patient accept eventual death to reduce burdens on the patient's family.
D)Encourage the patient to minimize the utilization of services to control costs.
Q2) Which of the following qualities does the nurse need to provide caring?
A)Sensitivity to the needs of other nurses
B)Longing to help others live a healthy life
C)Desire to have a stable career and income
D)Ability to create a trusting environment
Q3) Which one of the following descriptors represents a phase of the chronic illness trajectory (CIT)?
A)Caring
B)Stable
C)Bargaining
D)Rehabilitation
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Chapter 16: Pain and Comfort
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Sample Questions
Q1) An older female adult had surgery one day ago, and the nurse thinks that the woman also has dementia.While assessing the patient, what indication would the nurse use to determine that the older person is experiencing pain?
A)The patient holds her abdomen tightly.
B)The patient has stable vital signs.
C)The patient is not verbalizing.
D)The patient moves during sleep.
Q2) An older male adult who had a gastric resection states that he wants to ambulate, but the osteoarthritis (OA) in his knees causes too much pain.Which intervention should the nurse implement to increase the amount of walking he can perform?
A)Encourage pain medication around the clock.
B)Instruct him to rest until the pain disappears.
C)Suggest taking pain medication before walking.
D)Collaborate with the health care provider to get him a walker.
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18
Chapter 17: Diabetes Mellitus
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Sample Questions
Q1) The nurse assists an older male adult with type 2 diabetes mellitus to improve his glucose control.What does the nurse instruct this individual to do when he plans to walk more than usual in one day?
A)Omit antidiabetic medication.
B)Wear sturdy open-toed shoes.
C)Supplement his caloric intake.
D)Prepare to administer insulin.
Q2) An older male adult with diabetes mellitus complains to the nurse that his feet feel like they are burning.What should the nurse recommend to this older person to improve his discomfort?
A)Well-fitting leather shoes
B)Knee-high nylon stockings
C)Soaking feet in warm water
D)Antifungal powder on feet
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19
Chapter 18: Bone and Joint Health
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Sample Questions
Q1) An older male adult who has hyperuricemia complains of severe pain in the right ankle.Which instruction should the nurse include in patient teaching to enhance the action of medication the patient takes for his condition?
A)Avoid dehydration by drinking water.
B)Take aspirin when joints are red and hot.
C)Comply with antihypertensive diuretic regimen.
D)Avoid beef kidneys, asparagus, and alcohol.
Q2) An osteoporosis-related fall necessitated hip-replacement surgery for an older female adult who is entering a rehabilitation facility.Which of the following goals is the nurse's priority during this woman's rehabilitation?
A)Tell the patient to eat whole grains, fruits, and vegetables.
B)Recapture the patient's preoperative mobility status.
C)Keep the patient's surgical wound clean and dry.
D)Tell the patient to take two steps into the walker.
Q3) Which of the following statements about osteoporosis is true?
A)Osteoporosis is indicative of an underlying health problem.
B)The most common site for osteoporosis fractures is in the long bones.
C)Women who are of African descent have the highest risk for osteoporosis.
D)A high risk of death follows an osteoporosis-related hip fracture.
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Page 20
Chapter 19: Visual and Auditory Changes
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Sample Questions
Q1) According to the Canadian National Institute for the Blind (CNIB), age-related macular degeneration (AMD) is the leading cause of severe vision loss in older persons in Canada.The CNIB suggests that older persons can change several modifiable risk factors to reduce or prevent AMD.Which of the following demonstrates modification of a risk factor for AMD?
A)Consume few or no alcoholic beverages.
B)Stop smoking.
C)Avoid direct sunlight.
D)Consume foods high in vitamin C.
Q2) The most detrimental illness or condition that an older person with prelingual deafness can experience is which one of the following?
A)Aphasia
B)Cataracts
C)Glaucoma
D)Osteoarthritis
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21
Chapter 20: Cardio-Vascular and Respiratory Disorders
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Sample Questions
Q1) The nurse notices that an older female nursing home resident is not eating and that her heart rate is faster than usual at 110-120 beats per minute.What should the nurse do to eliminate pneumonia as a potential cause of the change in this resident's status?
A)Obtain a specimen for aerobic blood cultures.
B)Send the resident for a chest X-ray exam promptly.
C)Analyze sputum for colour, texture, and volume.
D)Compare tympanic temperature to the baseline.
Q2) An older female adult who has chronic obstructive pulmonary disease (COPD) wants to perform self-care activities.Which instruction should the nurse include in patient teaching to help this older person achieve this goal?
A)Bathe and eat slowly, with periodic rest.
B)Walk short distances without oxygen.
C)Perform all activities of daily living (ADLs) together, and then rest.
D)Bathe right after eating and then rest.
Q3) Which of the following statements about heart disease in older persons is true?
A)More women than men die from myocardial infarctions.
B)Cardiac care for men and women is equally aggressive.
C)Cardiac medications have been tested on men and women equally.
D)Women generally receive less aggressive treatment than men do.
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Page 22
Chapter 21: Cognitive Impairment and Neurological Disorders
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Sample Questions
Q1) At 2200 hours, an older male resident is attempting to climb over the bedrails.Which intervention should the nurse implement first?
A)Gently question the resident about his behaviour.
B)Call the physician and ask for sedation.
C)Apply a vest restraint to the resident.
D)Get a companion to keep the older person in the bed.
Q2) An older female adult is recovering in the intensive care unit from a bowel resection, but remains intubated and on a mechanical ventilator.Using the Hospital Elder Life Program (HELP), what should the nurse implement to help prevent delirium in this older person?
A)Assess cognition with Mini-Mental State Exam.
B)Provide uninterrupted periods of rest and sleep.
C)Maintain adequate sedation and pain management.
D)Cover her eyes with protective ophthalmic ointment.
Q3) An older person who has had a TIA should be assessed for which of the following?
A)Age, race, gender, income
B)Vital signs, speech, gender, race
C)Age, income, coordination, sensation
D)Vital signs, speech, coordination, sensation
Page 23
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Chapter 22: Economic and Legal Issues
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Q1) Under the Canada Health Act, "medically necessary" services are publicly insured, including primary health care, care in hospitals, and surgical-dental services.How is the term "medically necessary" interpreted by the provinces and the territories?
A)There is provincial and territorial variability in terms of how some "medically necessary" services are interpreted.
B)All provinces and territories follow the same interpretation, and provide all "medically necessary" services to Canadians.
C)Home care, medications outside of hospital, physiotherapy, and optometry services are provided to all Canadians.
D)The level of funding provided for all "medically necessary" services is the same throughout Canada.
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Chapter 23: Relationships, Roles, and Transitions
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Q1) Which older person will have the highest economic risk at the beginning of retirement?
A)An older divorced female who has lived in this country for eight years
B)An older male veteran, who is an above-the-knee amputee, and who was a teacher
C)An older female, who is a widow and a primary care nurse practitioner
D)An older male, who immigrated from China, and designs computer software
Q2) Which of the following statements about older-person relationships is true?
A)After 50 years of marriage, a couple can face new and severe challenges to their relationship.
B)Older persons are usually alienated from their family members and their care is abandoned to institutions.
C)Older persons find rewarding relationships by becoming a member of a church.
D)For older persons, friends can never take the place of family.
Q3) What is the most important element for older persons to have to enhance their transition into retirement?
A)Good health
B)A private pension
C)A registered retirement savings plan (RRSP)
D)Preretirement planning
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Page 25
Chapter 24: Mental Health and Wellness in Later Life
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Q1) An older female adult with dementia exhibits new behaviours, including crying and verbalizing the same phrase repeatedly; furthermore, the behaviour has increased over two days.Which intervention should the nurse implement in response to this behaviour?
A)The nurse tells the older person that he will remember what she says if she stops crying.
B)The nurse attributes these findings to deterioration in cognitive function.
C)The nurse checks the medication administration record for missed doses or drug interactions.
D)The nurse presents probing questions to the patient about her behaviour.
Q2) An older male adult who had radical surgery for oral cancer is refusing to see visitors and is losing weight, despite aggressive nutrition therapy.The nurse assesses this older person and recognizes that he is not coping well and appears to be grieving.What is the most important patient outcome, in light of this nursing assessment?
A)The patient discusses how his coping mechanisms are overwhelmed.
B)The patient performs self-feedings through gastrostomy tube daily.
C)The patient uses nonverbal forms of communication effectively.
D)The patient exhibits self-confidence in regaining a sense of control.
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26
Chapter 25: Loss, Death, and Palliative Care
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Q1) Nurses have had strong opinions both for and against medically assisted dying.Considerable confusion exists regarding terminology and interpretation of what effects the nurse's role may have in end-of-life care or palliative care.Which one of the following might constitute an example of medically assisted dying?
A)Relieving patient suffering and improving the person's quality of living until death.
B)Discontinuing tube feeds, but continuing with intravenous fluids.
C)The physician providing the patient with sleeping pills and instructions about a lethal dose.
D)A patient voluntarily requesting to be helped to die and receiving a lethal injection of pain-relieving medication by their doctor.
Q2) The actions of the family of an older person who just died are chaotic, and the family members are unable to decide on a funeral home.The nurse observes "functional disruption." Which recommendation should the nurse implement?
A)Help them make a list of the problems.
B)Provide a list of preferred funeral homes.
C)Allow them privacy to work it out alone.
D)Suggest they call someone who can help.
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Page 27
Chapter 26: Care Across the Continuum
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Q1) The nurse prepares to transfer an older person to a long-term care facility and calls the facility to give a report.Which nursing actions are the responsibilities of both the transferring nurse and the receiving nurse?
A)Incorporating patient goals into the care plan
B)Ensuring the patient is stable for transfer
C)Supplying patient documents for planning
D)Providing continuity of care during transfer
Q2) An older female resident in a residential facility keeps a large collection of personal items and photos of her late husband on her bedside table, but the personal support worker (PSW) and the resident argue about this frequently.Why should the nurse intervene between the resident and the PSW?
A)The resident is attempting to maintain her sense of personal space.
B)The resident needs to accept the reality of her spouse's death.
C)The resident's argumentative nature can indicate early dementia.
D)The clutter from all the personal items is a safety and liability risk.
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