Mixed Deck — All Gerontological Nurse Test Topics Flashcards

Validation therapy, developed by Naomi Feil, is primarily used to:

Answer: Acknowledge and communicate with patients in their own reality

Validation therapy focuses on empathetically acknowledging the feelings and subjective reality of a person with dementia rather than correcting or reorienting them.

The following is the most significant factor linked to nonadherence in older adults:

Answer: Low health literacy

Health literacy is directly related to a lack of understanding about the purpose of the therapy and the significance of sustaining adherence, even though many other variables (such as lack of insurance) may also play a role in nonadherence. Patients who are unfamiliar with anatomy, bodily processes, or disease frequently struggle to understand instructions or the advantages of doing so.

A nurse is educating an older adult with hypertension on dietary modifications. The DASH diet primarily recommends:

Answer: Increased fruits, vegetables, low-fat dairy, and reduced sodium

The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes fruits, vegetables, low-fat dairy, whole grains, lean proteins, and reduced sodium to lower blood pressure.

A nurse is implementing universal fall precautions for all hospitalized older adults. Which intervention is a component of universal fall precautions?

Answer: Ensuring call lights are within reach and beds are in the lowest position

Universal fall precautions include keeping beds in the lowest position, call lights within reach, non-slip footwear provided, and bed brakes locked—applied to all patients regardless of assessed risk level.

The nurse notes that a dying patient's respirations have become irregular with periods of apnea. The nurse recognizes this pattern as:

Answer: Cheyne-Stokes respirations, a normal end-of-life change

Cheyne-Stokes respirations—cyclic periods of increasing then decreasing breathing depth with apneic episodes—are a normal physiologic sign of imminent death as brain stem regulation declines.

A nurse is discussing advance directives with an older adult patient. The POLST (Physician Orders for Life-Sustaining Treatment) form differs from a living will in that POLST:

Answer: Is a physician order that is actionable across all healthcare settings

POLST is a physician order that translates patient wishes into actionable medical orders honored across all care settings, unlike a living will which is a legal directive that must be interpreted.

When a conflict arises between two team members and the gerontological nurse (team leader) moves one of the parties to another team, the following conflict resolution technique is used:

Answer: Suppression

quarrel resolution in the form of suppression occurs when one side of a quarrel is moved to another team. The geriatric nurse is only avoiding situations where the conflict arises. This is frequently a band-aid fix for an issue that may later recur in another situation. The best way to resolve a problem is typically to come to a compromise or an agreement.

An older adult with a history of falls is started on a new antihypertensive. The nurse should prioritize teaching the patient to:

Answer: Rise slowly from sitting or lying positions and sit at the bedside before standing

Antihypertensives can cause or worsen orthostatic hypotension; teaching patients to change positions slowly allows time for compensatory cardiovascular adjustments and reduces fall risk.

An older adult patient with terminal cancer rates their pain as 8/10. The nurse administers the ordered PRN morphine. This action reflects which principle of palliative care?

Answer: Aggressive symptom management to promote comfort

In palliative care, effective and timely symptom management—including adequate analgesia—is a core ethical obligation to maintain patient comfort and dignity.

Terminal sedation (palliative sedation) is ethically appropriate when:

Answer: The patient has refractory, uncontrollable suffering near the end of life

Palliative sedation is ethically justified for patients with refractory symptoms causing intolerable suffering at end of life when all other symptom management strategies have failed.

A gerontological nurse is educating a patient about digoxin therapy. Which sign of digoxin toxicity should the patient report immediately?

Answer: Visual disturbances such as yellow-green halos

Yellow-green visual halos are a classic sign of digoxin toxicity, which is more common in older adults due to reduced renal clearance.

An older adult with hypertension has a consistently elevated blood pressure despite adherence to antihypertensive medications. The nurse should first assess for:

Answer: Secondary causes such as sleep apnea, medication interactions, or excessive sodium intake

Resistant hypertension warrants investigation for secondary causes including obstructive sleep apnea, pain, NSAIDs or other medications that raise blood pressure, and excessive dietary sodium.

Which laboratory value is the most reliable indicator of renal function for dosing medications in older adults?

Answer: Creatinine clearance calculated using the Cockcroft-Gault equation

Serum creatinine alone overestimates renal function in older adults due to decreased muscle mass; the Cockcroft-Gault equation provides a more accurate creatinine clearance estimate.

NSAIDs are generally considered inappropriate for older adults primarily because they increase risk of:

Answer: GI bleeding, renal impairment, and fluid retention

NSAIDs inhibit prostaglandins that protect the gastric mucosa and maintain renal perfusion, placing older adults at significantly higher risk for GI bleeding and kidney injury.

Reminiscence therapy is used with older adults with dementia because it:

Answer: Promotes well-being by engaging intact long-term memories and sense of identity

Reminiscence therapy leverages the relative preservation of long-term autobiographical memory in dementia patients to enhance self-esteem, social engagement, and emotional well-being.

The Mini-Mental State Examination (MMSE) is used in gerontological nursing primarily to:

Answer: Screen for and monitor cognitive impairment

The MMSE is a standardized screening tool that assesses multiple cognitive domains and tracks changes over time; it cannot independently diagnose a specific dementia type.

A patient with frontotemporal dementia (FTD) exhibits disinhibited behavior and inappropriate social conduct. The nurse understands this is primarily due to:

Answer: Degeneration of the frontal and temporal lobes affecting personality and behavior

FTD primarily affects the frontal and temporal lobes, which regulate behavior, personality, and social conduct, resulting in disinhibition and inappropriate social behavior.

When communicating with a patient who has moderate Alzheimer's disease, the nurse should:

Answer: Use short, simple sentences and allow extra time for responses

Short, simple sentences reduce cognitive load for patients with dementia, and allowing extra response time respects their slowed processing without adding pressure.

A nurse is teaching an older adult patient with heart failure about the 'rule of 5' for fluid restriction. The patient should report weight gain of more than how many pounds in 24 hours?

Answer: 2–3 pounds in 24 hours

A weight gain of 2–3 pounds in 24 hours in a heart failure patient typically indicates significant fluid retention and warrants prompt notification of the healthcare provider.

A 70-year-old woman with minor dyspareunia and vaginal dryness consults the gerontological nurse for suggestions on how to lessen her suffering. The geriatric nurse should advise:

Answer: Water-based (K-Y Jelly) lubricant

As dryness of the vaginal tissues is frequently a contributing factor to dyspareunia in older adults, the gerontological nurse should advise the patient to try using a water-based lubricant (like K-Y Jelly). Petrolatum jelly shouldn't be used on the patient since it doesn't get absorbed by the tissues. The gerontological nurse should advise the patient to ask the doctor about an estrogen-based lubricant if the issue worsens or the lubricant is insufficient.