1.An 80-year-old man has no chronic diseases and is alert, oriented, and physically active. Which of the
following nursing diagnoses is likely to be present as a result of the normal aging process?
* Constipation, related to slowed peristalsis. Correct
>Constipation is a common nursing diagnosis for older adults in otherwise good health. In addition to
peristalsis slowing, most older adults experience decreased taste and smell resulting in decreased
appetite and food intake, as well as decreased physical mobility.
2.A 76-year-old neighbor confides to the nurse that she is having to get up in the middle of the night to
void and often wets herself before she can get to the bathroom during the day. The nurse’s best
explanation would be:
* “As you get older, your bladder muscle loses tone and you can hold less urine.” Correct
>Physiological changes of aging include decreased bladder and sphincter tone, resulting in stress
incontinence and more frequent voiding.
3.The home health nurse assesses the older patients in her case load for signs of abuse. The nurse is
aware that the primary incidence of abuse is ______________.
*neglect
>In patients over the age of 80 who suffer abuse, the primary type of abuse is neglect.
4.The nurse is aware that cultural influences shape the worldview of all people, which define for each
person the concepts of the: (Select all that apply.)
* meaning of life’s events. Correct
*basis of a value system. Correct
*rational explanation of life’s mysteries. Correct
*difference between good and evil. Correct
>The “worldview” of an individual shapes his or her value system, defines right and wrong, and helps to
explain life’s events and mysteries. Significance of employment is not included in a worldview.
5.When the parents of a child who is on life support ask what indicates brain death, the nurse responds
that brain death occurs when:
* there is an absence of EEG waves. Correct
>Brain death, which is defined as the absence of brain activity as evidenced by the absence of
electroencephalogram (ECG) waves.
6.A terminal patient in a skilled nursing home has stated that he does not want to get out of bed,
because he is too tired and weak to sit in a chair. He sleeps on and off all day and night, his position is
changed every 2 hours, and he is comfortable on his pain regimen. The next day the nurse will:
* assess his strength and desire to get out of bed, but permit him to remain in bed if he chooses,
because that is his position of comfort. Correct
>Comfort care recognizes that the patient is the best judge of his energy; if he does not wish to get out
of bed, then frequent turning and positioning and use of appropriate pressure and pain relief measures
are a better choice.
7.After a patient death, the nurse is preparing to perform postmortem care. The body is placed supine
with the head raised so that:
* blood will not pool in the face and cause discoloration. Correct
>After death, the head of the deceased is raised to prevent discoloration by the pooling of blood in the
face.
8.What is the most common chronic health problem in people over 75 years?
*Hypertension Correct
>Hypertension is the most common chronic health problem in people over 75 years, affecting over half
of older adults, followed by arthritis and heart disease. Lung disease is a leading cause of death in older
adults.
9.A person who believes and practices the Christian Science religion is most likely to:
* use spiritual practices and altered thinking to correct the causes of illness and disease. Correct
>A person of the Christian Science belief does not normally seek traditional health care and uses prayer
for healing.
10.An oncologist has recommended that a hospice patient receives palliative radiation to reduce the
pain of bony metastases. The patient reacts with anger, saying, “I don’t want any more treatments that
don’t cure my cancer!” The hospice nurse tells the patient that the use of radiation:
* of this type is not curative and is part of hospice care. Correct
>The goal of palliative care is to reduce or relieve the symptoms of a disease without attempting to
provide a cure (WHO, 2015a).
11.The nurse understands that when an Asian patient refers to yin, the patient is referring to a balancing
force that is represented by:
* cold and feminine elements. Correct
>Yin is the balancing force to yang that is represented by elements that are dark, cold, and feminine.
12.________ are specialists in the study of aging people.
*Gerontologists
>Gerontologists are specialists in the study of aging. Some gerontologists claim that aging is primarily
determined by genetics and others believe that environment and lifestyle play important roles.
13.What is an early sign of dementia?
* Disordered thinking Correct
>Confusion, memory loss, and disordered thinking are early signs of dementia. Weight loss, poor
appetite, and change in appearance are not early signs of dementia.
14.Which branch of Judaism follows the strictest interpretation of Jewish law?
* Orthodox Jews Correct
>Orthodox Jews follow the strictest interpretation of Jewish law.
15.The nurse is sensitive to the fact that Hispanics believe that some foods and fluids have “hot and
cold” properties that affect their health by:
* restoring equilibrium to the body. Correct
>Hispanics believe that certain foods through their hot or cold properties can restore the body’s
equilibrium.
16.A young Hindu woman who is part of a traditional Hindu family is in a coma and is going to be
transferred to the ICU. The family member whom the nurse should consult about this health matter
would be the:
*eldest woman in the family. Correct
>Traditional Hindu families consider the eldest woman in the family to be the authority on health and
healing matters. She should be consulted and included in any patient education.
Awarded 0.007519 points out of 0.007519 possible points.
17.The concept of ____________ described by Dr. Madeline Leininger is the force that allows people to
grow, remain well, and avoid or face death.
*human caring
>Dr. Leininger described human caring as the force that allows people to grow, remain well, avoid illness,
and face or survive death.
18.A patient has experienced the recent death of a spouse. During a conversation with a nurse, the
patient begins to cry. An appropriate response from the nurse is to:
*hand a tissue to the patient. Correct
>Crying may be embarrassing for the patient, and a simple act of handing a tissue to a patient
acknowledges the acceptability of weeping. The patient will not be offended by a nurse's crying and may
draw support from a shared experience. Avoid comparing oneself to the patient or telling them "don't
cry" because these responses minimize the patient's feelings.
19.Which term involves knowledge of a people's history and an appreciation for their customs?
* Cultural awareness Correct
>Cultural awareness involves knowledge of a people's history and ancestry and an appreciation for their
artistic expressions, foods, and celebrations. Cultural sensitivity is refraining from speaking in ways that
are disrespectful of a person's cultural-beliefs. Cultural competence involves examining your own values,
attitudes, beliefs, and prejudices. Cultural practices are practices specific to a culture.
20.To promote cognitive health for a 79-year-old, the nursing student should encourage the patient to do
which of the following? (Select all that apply.)
* Read the newspaper. Correct
* Put together puzzles. Correct
*Write letters. Correct
>Mental stimulation such as these activities maintains active and healthy neural connections, which
promotes cognitive health.
21.Which are grief indications? (Select all that apply.)
*Denial Correct
*Anger Correct
* Acceptance Correct
>The five grief indicators are denial, yearning, anger, depression and acceptance. Hopelessness is not a
grief indicator.
22.A terminally ill patient and his family have requested hospice care. The nurse clarifies hospice care
philosophy as:
* focusing on symptom management and comfort care. Correct
>The primary goal of hospice and palliative care is to improve quality of life, alleviate suffering, and
improve end-of-life experience for the patients and their loved ones.
23.The largest religion in the world is:
*Christianity. Correct
>The largest religion in the world is Christianity, with its three main divisions: Roman Catholic, Eastern
Orthodox, and the Protestant faiths.
24.The nurse understands that the best explanation of why a particular person lives into his 90s in
relatively good health is that the person:
* has lived a healthful lifestyle, which has included preventative care, good nutrition, exercise, and a
positive outlook. Correct
>Lifestyle and personality together probably contribute to longevity more than genetics, new medical
approaches, or old-fashioned home remedies, although those may contribute in important ways. A
healthy lifestyle decreases the risk of disease and its sequelae.
25.When a 68-year-old recent retiree confides in the health clinic nurse that he has felt depressed and
withdrawn since retirement, the nurse suggests that he:
* set a small goal for himself to be met every day. Correct
>Setting a small goal to be met allows for direction in the day. Many recent retirees miss the regulation
of employment.
26.A patient refuses to eat pork and drink alcohol and fasts during the month of Ramadan. The patient's
religion is likely to be:
* Islam. Correct
>Islam prohibits consumption of pork and alcohol, and fasting is done during Ramadan. Some Jewish
people observe the kosher dietary restrictions. Some Buddhists are vegetarians and many will fast on
Holy Days. Some Hindus are vegetarians and their belief is to not kill any living creature.
27.During the dying process, patients may experience a bad taste in their mouth. Which of the following
are appropriate nursing actions? (Select all that apply.)
* Offer the patient hard candy. Correct
*Assist the patient with frequent oral care. Correct
*Offer the patient mouthwash. Correct
>Hard candy, mouthwash, and oral care help stimulate saliva production and relieve the dryness and any
bad taste in the patient’s mouth related to the dryness.
28.An 85-year-old has been increasingly confused and disoriented to place and time over the last several
months. He also has difficulty remembering what he ate, who visited, and where the recreation room is.
This behavior is indicative of ________________.
*dementia
>Confusion, memory loss, and disordered thinking are early signs of dementia. Causes of dementia
include malnutrition, medications, mini strokes, and Alzheimer disease.
29.A woman who is part of a traditional Muslim family is hospitalized after an accident. It is most
important for the nurse to include in the care to:
* respect her need for modesty in keeping her body covered. Correct
>Traditional Muslim women are extremely modest and keep their bodies covered.
30.A 25-year-old female is involved in an auto accident and needs a blood transfusion; however, she
refuses a transfusion based on her beliefs. The woman is most likely a:
*Jehovah's Witness. Correct
>Taking blood into the body is prohibited and transfusion of blood or blood products is not permitted for
those of the Jehovah's Witness denomination.
31.The nurse supervisor becomes concerned when observing the nurse caring for an Orthodox Jewish
patient preparing to trim the patient’s beard with a(n):
* razor blade. Correct
>Practicing members of Orthodox Judaism view the beard as a sign of holiness, and no blade must touch
the skin. Scissors or an electric razor may be used.
32.Which older adult population is the fastest growing group?
* Very old Correct
>The very old-people aged 85 and beyond-are the most rapidly growing group, and this group will
continue to increase in the future.
33.The five stages identified by Dr. Elisabeth Kübler Ross are __________, _________, ___________,
____________, and _____________.
*Correct Responses: "null"
34.A practicing member of the Church of Jesus Christ of Latter Day Saints is being prepared for surgery
on his left knee. The nurse should remove all the personal possessions with the exception of:
* undergarments. Correct
>Members of the Church of Jesus Christ of Latter Day Saints may wear sacred undergarments that should
only be removed in an emergency. If removed, the undergarments should be put back on as soon as
possible.
35.A home health nurse caring for a patient of American Indian ancestry will be particularly alert to
symptoms of ________ because of a genetic predisposition to that illness.
*diabetes mellitus Correct
>Diabetes is more common among the Hispanic and American Indian populations because of a genetic
susceptibility.
36.When the nurse notes an increase in the level of daily function in the terminal patient, the nurse
assesses that this patient has reached Kübler Ross’s level of:
* acceptance. Correct
>Kübler Ross’s stages of coping with death include the acceptance stage in which the struggle is over, the
pain is gone, and the patient has found peace. The patient frequently demonstrates a heightened level of
activity in his or her daily function during this stage.
37.When a patient admitted for terminal care is asked by the admitting nurse, “What has your doctor
told you about your illness?” the patient states, “She says that I have a terminal illness, but I know she’s
wrong.” The nurse recognizes that:
*the patient is in denial and is unable to consciously admit what he has been told by the doctor.
>The patient’s statement indicates Kübler Ross’s stage of denial in which patients will not accept
information and buffer themselves from information that may be painful.
38.Laura is a nurse who is not answering the requests of a patient based on the fact that she is
scheduled for an abortion. This is an example of:
* racism. Correct
>Prejudice can be defined as an emotional manifestation of negative stereotypes and deeply held beliefs
about a group. Racism is a form of prejudice that takes place when individuals, groups, and/or institution
exercise power against groups that are judged to be inferior.
39.Which theory suggests it is normal for older people and society to withdraw from each other?
* Disengagement theory Correct
>Disengagement theory suggests it is normal for older people to withdraw from each other. The activity
theory states that people who remain interested and active will continue to enjoy life and to live longer.
The free-radical theory states that cells are damaged by toxins, ions break off from ion pairs, and the
resulting free radicals are unstable. Lifestyle theory is not a true theory of aging.
40.An 85-year-old widow who lives alone has fallen several times in the last month and has been noted
by her children to be confused about her medications and to frequently “forget” what is cooking on the
stove until it is burned. These observations indicate that:
* further assessment is needed to evaluate an increased level of assistance. Correct
>The widow is showing signs of needing additional assistance. It might include home delivered meals or
nursing home placement, but further assessment needs to be performed. Acute care hospitalization is
not indicated in this situation.
41.When a patient chooses to die by refusing treatment that would prolong life, it is called ___________.
*passive euthanasia
>Passive euthanasia is when the patient is choosing to refuse treatment for himself or herself, which will
result in death.
42.The nurse is aware that in order to provide effective support to grieving patients and families, the
nurse must:
* solidify his or her own view of death. Correct
>Nurses must understand and solidify their own view of death before they can offer effective support to
dying patients and their significant others. Constant optimism and positive attitudes are not always
appropriate.
43.Protestant denominations that use their own holy books in addition to the Bible include: (Select all
that apply.)
*Christian Scientists. Correct
*Mormons. Correct
>Protestant denominations that use another holy book in addition to the Bible are Christian Scientists,
Mormons, Jehovah’s Witnesses, and the Unification Church.
44.When the nurse is conducting a class for senior citizens at a local assisted living facility, to enhance
physical health, he encourages the older residents to engage in some form of exercise for at least:
* 30 minutes a day, five times a week. Correct
>Exercise for as little as 30 minutes a day 5 days a week is beneficial.
45.Persons of African extraction are predisposed to the three disorders of ____________,
_____________, and _______________.
*Correct Responses: "null"
46.Individuals move through the stages of grief at their own pace. When a person is “stuck” in a stage
and cannot move forward, this is called ___________.
*dysfunctional grieving
>Dysfunctional grieving is visible grief over a prolonged period of time. Some theorists say grief after 6
months is dysfunctional; others say up to 2 years.
47.A terminally ill patient is experiencing a great deal of dyspnea and noisy, “rattling,” rapid respirations.
The nurse administers morphine in a very small liquid or intramuscular dose. The purpose of this is to:
* decrease respiratory rate and relieve dyspnea. Correct
>Morphine is used to ease terminal dyspnea by reducing the rate and increasing the depth of
respirations.
48.A nurse caring for an older adult suspects that he is experiencing depression. Which of the following
are true for the older adult and depression?
* If experiencing suicidal thoughts, the older adult more likely to act on them successfully. Correct
>It is estimated that more than one million older adults experience depression, and older adults who
have suicidal thoughts are more likely to act on them successfully than younger people with similar
thoughts (Aziz and Steffans, 2013). Signs and symptoms of depression in the older adults are listed in Box
13-2. Depression can often be treated successfully with medications and counseling. Depression is a risk
factor and possibly an early sign of dementia (degeneration of brain tissue).
49.The nurse understands that acupuncture and acupressure are alternative therapies based on:
* interrupting or changing the flow of energy fields in the body. Correct
>Acupressure, massage, and acupuncture all are based on theories of energy flow in the body that can
be manipulated to affect health.
50.A resident in a skilled nursing facility indicates that she is an agnostic and is afraid of what will happen
to her when she dies. An appropriate nursing intervention for this patient is to:
*ask the patient whether she would like to talk to the facility social worker or chaplain to address her
spiritual distress. Correct
>Exploring spiritual (meaning of life and death) issues with a social worker or spiritual care person is
appropriate to address spiritual distress as demonstrated by the patient’s anxiety over her impending
death.
51.The nurse caring for a terminally ill patient with renal failure would question an order for pain control
that prescribed:
* meperidine. Correct
>Patients in renal failure cannot adequately clear meperidine (Demerol) from their system and will
become oversedated.
52.A nurse is caring for a Catholic patient who has just given birth to a nonviable fetus. When
considering the religion of this patient, the nurse should:
*baptize the fetus if a priest is not immediately available. Correct
>Within the Catholic religion, infants must be baptized soon after birth because of the belief that babies
not baptized will not go to Heaven. Even aborted fetuses must be baptized. If a priest is not immediately
available, the nurse may baptize by pouring holy water on the head and saying, “I baptize you in the
name of the Father, of the Son, and of the Holy Spirit.”
53.A nurse referring to an older Asian man says, “He probably uses acupuncture and believes in yin and
yang.” This remark is an example of:
* stereotyping of the patient. Correct
>Stereotyping occurs when common characteristics of a cultural group are applied to an individual with
no attention to the individual’s characteristics.
54.A nurse is caring for a prisoner who is hospitalized for injuries received during a terrorist attack at a
nightclub in which several people were killed. While the hospital staff’s safety is well managed by the
police, to remain grounded in providing care to this patient, an important principle for the nurse to
remember about transcultural nursing is:
* all cultures provide what every human needs in order to grow, remain well, avoid illness, and survive or
face death. Correct
>Leininger’s theory postulates that human caring is a universal aspect of every culture. As such, it is
present in all cultures although it may be expressed in culturally unique ways. It provides what every
human needs in order to grow, remain well, avoid illness, and survive or face death.
55.An older patient with dementia-related memory problems will demonstrate:
* struggles to perform. Correct
>A patient with dementia may struggle to perform. Consistent depressive mood is consistent with
depression-related memory problems. A patient with dementia-related memory loss has impaired recent
memory and intact remote memory. A patient with dementia-related memory loss has a slow or
stepwise progression of symptoms.
56.A 76-year-old Hispanic woman is in the skilled nursing facility where she is to participate in a
rehabilitation program following a hip replacement. She is alert, oriented, and cooperative but speaks
only Spanish; her adult children interpret for her when they are present. The nurse plans the most
effective way to communicate with this patient is to:
*create a translation guide with commonly used Spanish and English words and phrases. Correct
>A simple translation guide can be used with a cooperative patient in this nonacute setting. The other
solutions are unworkable and unrealistic.
57.Which statement is true regarding older adults?
* Ageism is illegal in the United States. Correct
>Discrimination because of age is illegal in the United States. Widows usually adjust better than do
widowers. The majority of older adults live within 40 miles of one of their children. The primary type of
elder abuse is neglect.
58.Karen is a recent graduate. She is planning to go to India with her church group as a nurse on a
medical mission trip. She will be working in a church funded clinic. Which of the following shows
willingness for the development of cultural competence?
* She is reviewing her materials from school on public health. Correct
>Nurses must develop cultural competence in order to deliver care that meets standards of culturally
congruent care. Developing cultural competence is a lifelong process. It begins with the development of
cultural awareness and cultural sensitivity. Cultural awareness involves developing understanding that
health is expressed differently across cultures, and that culture influences an individual’s response to
health, illness, disease, and death. Cultural sensitivity is the ability to engage and communicate with an
individual from another culture in a manner that demonstrates respect for their cultural norms and
beliefs.
59.The nurse warns that infection after exposure to respiratory illness in the older adult:
* is more likely to result in serious lower respiratory infection related to weakened respiratory muscles
and fewer cilia. Correct
>Changes in the older adult respiratory system make older adults more susceptible to infections that can
be very serious. Although some infections are life threatening, most are not.
60.The nurse takes into consideration that culture and religion influence life choices that include: (Select
all that apply.)
*smoking. Correct
*drug use. Correct
*nutrition. Correct
*reading material. Correct
*use of caffeine. Correct
>The use of drugs (including caffeine, tobacco, and alcohol), nutritional choices, and food preparation
are influenced by culture.
61.An 84-year-old patient who is hospitalized for pneumonia says to the nurse, “I don’t know why I’ve
lived so long. All my friends are gone, my children and grandchildren are all independent and successful
—nobody needs me anymore.” An appropriate response by the nurse is:
* “Tell me about your children and what it was like when you were raising them.” Correct
>Encouraging reminiscing helps the older adult put her life in perspective and acquire a sense of ego.
62.An example of an ethnocentric remark would be:
* “I don’t see why Muslims can’t pray in church like we Protestants do.” Correct
>Ethnocentrism is the tendency of human beings to think that their way of thinking, believing, and doing
things is the only way or the only right way. Beliefs that greatly differ from one’s own are seen as strange
and are therefore considered wrong.
63.The nurse is aware that Muslims and Orthodox Jews have similar dietary restrictions in that both
groups require that their followers:
*eat only meat that has been slaughtered according to their religious law. Correct
>Muslim and Jewish followers require food to be prepared according to religious law. In the Jewish faith,
it is called kosher, which also requires the separation of milk and meat.
64.The nurse points out that there are many myths about older adults that are not true. The statement
that reflects the most accuracy about older adults is:
* the optimistic, happy person generally lives longer. Correct
>Myths about old people include: most old people live in nursing homes, genetics is the main factor in
longevity, and most old people are isolated from their families. It is true that a major contributor to
longer life is that the optimistic, happy person generally lives longer.
65.An 82-year-old patient expresses concern of always being cold. Based on knowledge of the physical
changes associated with aging, the nurse could appropriately respond: (Select all that apply.)
* “Subcutaneous fat is reduced as part of aging. This fat helps to keep you warm decreases.” Correct
*“A low level of thyroid hormone causes you to feel cold.” Correct
>Decreased subcutaneous fat and slowed thyroid production contribute to older people feeling cold.
66.A 70-year-old widower continues to work part time in a demanding business, while traveling in his
free time with a 68-year-old widow to visit longtime friends and relatives. He remains an active member
of several community organizations. His life is an example of a person who:
* is adjusting well to the changes of benign senescence. Correct
>Benign senescence is the normal changes of aging, and many healthy people at 70 years of age do not
fit the stereotype of “old” but are more like older adults of 45 to 70 years.
67.Which clinical sign or symptom is common in a dying patient?
* Constipation Correct
>Constipation is predictable for a patient receiving opiates, experiencing decreased fluid intake and
mobility, and having certain abdominal diseases. Decreased urine output is common in the dying patient.
Dysphagia, not sore throat, may be a problem in the dying patient. Weight loss is common in the dying
patient.
68.A nurse making a home visit to a 75-year-old woman discovers that the patient stays in bed or on the
couch most of the time because she is afraid of falling. The nurse should arrange for:
* a physical therapist to teach resistance training. Correct
>A physical therapist can teach resistance and balance training to help prevent falls.
69.The culturally sensitive nurse would delay a discussion relative to a patient’s terminal illness if that
patient were a:
* 35-year-old Mexican American farm laborer. Correct
>Persons with Hispanic and Korean backgrounds are less likely to want to know about their terminal
disease, feeling that the family should make the decisions about life-sustaining treatments.
70.A young African American man is admitted to the hospital in sickle cell crisis. He is unmarried and
lives with an extended family headed by his grandmother. The nurse takes into consideration that this
type of family arrangement is:
* matriarchal. Correct
>Matriarchal families are headed by women (mother) and are commonly seen in African American
families.
71.A nurse is caring for a postpartum patient who adheres to the beliefs of Orthodox Judaism. The
question that would be the most culturally sensitive would be:
* “Has your husband decided on a name for your new baby?” Correct
>Practicing members of Orthodox Judaism name their male children 8 days after being born, when
circumcision is performed. Babies are named by the father. The Orthodox Jewish man cannot touch the
woman until after the ritual bath (mikvah). Jewish persons are discouraged from eating shellfish.
72.The nurse clarifies that the immune system failure theory states that:
* older adults lose their ability to effectively respond to infections and are more likely to die from them.
Correct
>With advancing age, the immune system of older adults has less ability to fight infections.
73.The most culturally sensitive and useful question the admitting nurse should ask the Jewish patient
would be:
* “Tell me about any religious practices you observe that we need to incorporate into your care.” Correct
>The response to the general question requesting any special concerns would include information
relative to food, spiritual practices, and rabbinical visitation. The other questions do have importance,
but the general question will allow the nurse to hear what is most significant to the patient.
74.The nurse can assess Cheyne-Stokes respiration by its characteristics of respirations that are:
* shallow followed by periods of apnea. Correct
>Cheyne-Stokes respirations become more and more shallow followed by periods of apnea, and then
respirations resume.
75.The nurse is aware that when an Orthodox Jewish family has a baby boy, it is expected that the:
* baby will be circumcised on the eighth day of life when he is named. Correct
>Male Orthodox Jewish children are named and circumcised by the mohel on the eighth day of life.
76.A 78-year-old man is admitted to the hospital after a fall from his bed at home that resulted in a
fractured hip and several fractured ribs. He states, “I don’t know how I broke so many bones. I only fell
out of bed.” The nurse can explain that:
loss of calcium from bone occurs in older adults and can result in fractures from minor trauma. Correct
>A physiological change of aging is loss of calcium from bone, resulting in osteoporosis and greater
likelihood of fractures.
77.A 33-year-old patient has been told that her disease is terminal. The patient is crying and states, “I
will just be a dependent drain on my family. I hate being a burden to them.” The nurse can best respond:
* “You have heard some very bad news today. Can you describe what you mean by burden?” Correct
>A person’s reaction to a loss is influenced by the importance of what that person perceives the loss
entails. To help the patient validate what the loss means is therapeutic.
78.A nursing instructor is educating a group of nursing students about cultural values practiced by Arab
Americans. The nursing instructor would recognize the need for further patient education if a nursing
student states, “I will:
* offer Arab American patient’s items using my left hand.” Correct
>Arab Americans do not eat pork or drink alcohol. It is considered rude to pass things with the left hand
because it is considered “unclean.” It is considered rude to sit with the sole of the shoe within view of
someone. Arab women are uncomfortable with care performed by males.
79.When the 75-year-old patient tells the nurse that he has had a good and rewarding life and has
enjoyed every minute of it, the nurse is aware that the patient has attained the Eriksonian stage of:
* integrity. Correct
>Erik Erikson’s psychosocial development theory includes the stage of ego integrity vs. despair, which is
characterized by reflection on one’s life and one’s achievements. A sense of pride or despair is developed
regarding the accomplishments in life that have been made or were lost.
80.A hospice patient is unable to tolerate food or fluids and has advance directives that indicate that he
does not want IV fluids or tube feedings if he is unable to take oral feedings. His family is concerned that
he will be very uncomfortable without food or fluids. The nurse should tell them that:
* IV fluids or tube feeding would likely make the patient more uncomfortable, and dehydration has been
shown to decrease pain and discomfort. Correct
>Dehydration in the terminally ill patient has been shown in research to decrease pain and to be a more
comfortable condition than when tube feeding is introduced into the intestine or when IV fluids are used
to reverse dehydration.
81.A nurse caring for a newborn of Eastern European Jewish ancestry is aware that this patient is
predisposed to:
* Tay Sachs disease. Correct
>People of Eastern European Jewish ancestry may carry the trait for a fatal neurological disorder of
infancy called Tay Sachs disease.
82.David is a nurse who is caring for a patient who is in the process of gender reassignment. He has
strong beliefs against this and discusses with the patient his strong beliefs. This is an example of which of
the following?
*Cultural imposition Correct
>Ethnocentrism is the belief that one’s own cultural group determines the standards by which other
groups’ behavior should be judged. Cultural blindness is an inability to recognize the differences
between one’s own cultural beliefs, values, and practices and those of another culture. Cultural
imposition is the act of imposing own cultural beliefs, values, and practices on individuals and groups
from another culture. It is different from cultural relativism, which is an ability to recognize that each
cultural group has its own set of beliefs and that each culture should be evaluated on its own merit.
Nurses often impose their values on patients by forcefully promoting western biomedical traditions
while ignoring the patients’ value of treatment forms.
83.The nurse who adopts the Maciejewski theory of grief assesses for the reduction of grief after a
period of ________ months.
*Correct Responses: "6"
84.The nursing theorist who described care that recognizes cultural diversity and is sensitive to the
cultural needs of the patient and family is:
* Leininger. Correct
>Transcultural nursing is a term used by Dr. Madeline Leininger to describe care that recognizes cultural
diversity and is sensitive to the cultural needs of the patient and family. Skinner is not a nursing theorist.
King's and Orem's theories are not associated with the cultural needs of patients.
85.Although the words spirituality and religion are often used interchangeably, spirituality actually refers
to which of the following? (Select all that apply.)
* Concerns of the spirit Correct
* Understanding one’s place in the world Correct
* An element of religion Correct
*Belief in a higher power or creative force Correct
>Spirituality and religion are similar, but both must be addressed for the patient’s psychosocial integrity
to improve.
86."All Hispanics like hot peppers" is an example of:
* stereotype. Correct
>A stereotype is a set opinion or belief about the group that is applied to an individual. Bias or prejudice
is a positive or negative attitude or opinion that is unsupported by evidence. A generalization identifies
common trends, patterns, and beliefs of a group. Bias or prejudice is a positive or negative attitude or
opinion that is unsupported by evidence.
87.Place the steps of postmortem care in their proper sequence. (Separate letters by a comma and space
as follows: A, B, C, D, E.)
*The correct order is:
Position the body with the head of the bed raised 15 degrees.
Replace dentures.
Cleanse the body of all body fluids.
Remove all tubing and equipment from the room.
Dress the deceased in a hospital gown and cover the deceased up to the chest.
>Postmortem care should be performed with dignity and reference for the deceased. The body should
be positioned with the head raised, dentures should be replaced, the body should be cleansed of all
body fluids and soiled dressings, all tubing and equipment should be removed from the room, and the
deceased should be dressed in a gown and covered up to the chest.
88.Who identified the five stages of the dying process?
* Kübler-Ross Correct
>Dr. Kübler-Ross identified the five stages of the dying process, which include denial, anger, bargaining,
depression, and acceptance.
89.A single African American working mother of three children who is in a state of poverty often misses
appointments for the children’s immunizations or well child checkups. The nurse understands that the
likely reason for this could be that she:
*is more concerned with surviving day-to-day problems than with taking a child to a clinic when there is
no obvious illness. Correct
>People who live in poverty are often focused on day-to-day living. Preventative medicine is future
oriented.
90.A physical change associated with aging is:
* heart and lungs being less efficient. Correct
>Heart and lungs gradually become less efficient with aging. There may be less blood flow to the brain.
The brain can adapt by growing more dendrites up to the age of 90 if the person is reasonably healthy.
Older people have smaller appetites.
91.A patient admitted to the nursing home for terminal care is determined that he should not receive
extraordinary measures such as resuscitation or the use of a ventilator if he stops breathing, or
intravenous (IV) fluids or a feeding tube if he is unable to eat or drink. The nurse explains that these
desires can best be honored by:
* filing an advance directive with the health care facility. Correct
>An advance directive outlines the patient’s desires relative to end-of-life issues. A DNR/DNI only
prevents the initiation of cardiopulmonary resuscitation (CPR). The naming of a durable power of
attorney for health care or a health care proxy appoints a person to carry out the advance directive.
92.Which statement is true regarding pain control in the dying patient?
* The goal is to allow a pain-free death. Correct
>Comfort is one goal of palliative care and the other goal is to allow a pain-free death. PRN, or asneeded, pain medication for breakthrough pain is often needed for effective pain management. There is
no concern for addiction when narcotics are increased in response to pain. Studies have shown that pain
relief, either total or at least to a level that is tolerable, is possible 75% to 97% of the time.
93.When the patient says, “I can die happily if I can live long enough to see my first grandchild that will
be born next month.” The nurse assesses that this patient is experiencing Kübler Ross’s stage of:
* bargaining. Correct
>Kübler Ross’s stages of coping with death include the bargaining stage in which the person seeks the
reward of extended life.
94.A patient who is terminally ill has been unable to maintain good nutrition because of nausea and
anorexia and has lost a great deal of weight. He is now unable to change his position in bed and needs
frequent perineal care because of urinary incontinence. The nurse planning his care would include in the
plan of care to:
* provide him with an air pressure mattress. Correct
>Provision of an air pressure mattress will help preserve the patient’s skin integrity that the weight loss,
inactivity, poor nutritional intake, and incontinence have caused.
95.A terminal patient asks the nurse if he could be given a deliberate overdose of medication that would
“end this.” According to the Code for Nurses, the nurse’s most ethical response would be:
* “I cannot ethically give you a deliberate overdose.” Correct
>The position of the American Nurses Association (ANA) expressly states that active euthanasia and
assisted suicide are considered a violation of the ANA’s Code for Nurses.
96.A neighbor who was widowed 2 months ago gives the nurse his wife Helen’s gardening books
“because the two of you loved flowers.” He tries to hold back tears, but begins to cry. To decrease his
discomfort, the nurse should say:
*“We certainly did, and I’m going to miss her help—she was a real expert.” Correct
>Sharing the feeling of loss is appropriate and supportive and recognizes the loss of the grieving
husband.
97.Which is a main characteristic that differentiates cultural groups from one another? (Select all that
apply.)
* Race Correct
*Color Correct
*Gender Correct
*Religious affiliation Correct
>The main characteristics that differentiate cultural groups from one another are nationality, race, color,
gender, age, and religious affiliation.
98.The home health nurse assesses an 80-year-old who has fallen twice in the last 10 days. The nurse
discovers that the patient uses a cane for ambulation stability, drinks up to 6 cups of coffee a day, has
altered depth perception because of cataracts, and has recently carpeted her home with a smooth tight
weave carpet. The nurse suspects the cause of her recent falls to be:
* the altered depth perception. Correct
>Altered depth perception, changes in gait, and slow reaction times may cause falls in older adults. The
cane helps with stability, and the smooth tight weave carpet should not cause falls.
99.The patient in hospice care says to the hospice nurse, “I want you to read my obituary that I just
wrote.” The nurse assesses that this patient is in the Satir Blevins (2008) stage of:
*practice. Correct
>According to the Satir Blevins theory of loss (2008), this patient is in the phase of practice. The patient
is practicing with the writing of the obituary the fact that life is coming to an end.
100.The wear-and-tear theory of aging is based on the belief that body cells and organs eventually wear
out like machinery. What type of theory is this?
* Biologic theory Correct
>Biologic theories are based on cellular function and body physiology and provide ways to look at the
physical aging process. Biologic theories are based on the belief that body cells and organs are
programmed to function for a specific length of time, after which they break down and die. Autoimmune
theory is a type of biologic theory that believes that the body no longer recognizes itself and begins to
attack itself and break down. Psychosocial theories relate to socialization and life satisfaction. The
continuity theory is a type of psychosocial theory.
101.A nurse caring for an African who is visiting the United States knows the following about
transcultural nursing to be true:
* Nursing care based on a patient’s cultural and spiritual needs, improves outcomes. Correct
>Research has repeatedly demonstrated that nursing care based on patients’ unique cultural and
spiritual needs significantly improves patients’ outcomes and overall quality of care. This understanding
has given a rise to the discipline of transcultural nursing.
102.A patient is approaching death and is growing physically weaker. What should the nurse expect?
* Respirations sounding moist. Correct
>Pooling of secretions in the lungs causes respirations to sound moist. Body temperature may rise. Urine
becomes more concentrated. Blood pressure declines.
103.Which factors contribute to longer life? (Select all that apply.)
* Good hygiene Correct
*Education Correct
*Optimism Correct
>Good hygiene has helped to eliminate many illnesses. Better educated people make more effort to stay
healthy. Optimistic, happy people live longer. Cultural origin is not a factor in longevity.
104.Keloid formations (abnormal scar formations) are more common in which group of people?
* African American Correct
>Keloid formations and sarcoidosis are more common in African Americans. Lactose deficiency is more
common in Chinese people. Lactose deficiency and diabetes are more common in Hispanic people.
Diabetes is more common in the American Indian population.
105.A nurse caring for a patient who is a practicing Jehovah’s Witness and who has had surgery confirms
that ___________ is on hand to be infused.
*Dextran. Correct
>Jehovah’s Witnesses are not permitted to take blood into their bodies, but blood expanders such as
Dextran can be infused.
106.A coroner is required to investigate death in which of the following situations? (Select all that apply.)
*Deaths from injury Correct
* Suspected suicides Correct
* Deaths of persons not under the care of a primary care provider Correct
>The coroner investigates death when there may be a question of cause.
107.An 82-year-old man is alert and oriented and in good physical health except for some arthritic pain
that “slows me down, but I just keep moving.” He lives alone in an apartment in a senior citizen complex
but enjoys the company of other residents and takes part in the social activities there. His lifestyle is an
example of:
* the activity theory. Correct
>The activity theory states that persons who remain active and interested in outside activities live longer.
108.A nurse’s neighbor confides that she has been treating a health problem through a faith healer in
her religion but is worried because the condition seems to be worsening. She asks the nurse what she
should do. The nurse’s best response would be:
* “Many people use medical treatment along with faith healing. Is there anything in your religion that
forbids medical treatment?” Correct
>A person’s health care choices are influenced by religious beliefs and culture. Many people use religious
or folk medicine in addition to modern medicine.
109.The nurse must be alert to nonverbal expressions to assess pain in patients from a(n):
* Pacific Islander background. Correct
>Pacific Islanders are reluctant to express emotion to others and are stoic about pain.
110.To help the family deal with the delirium of their dying relative, the nurse can suggest that they
should:
talk to the patient in quiet tones. Correct
>Talking with the patient is comforting to the patient. Even when unresponsive, patients can hear.
Stimulation is not helpful and may confuse the patient further.
111.The loved ones of a young man, who is in the intensive care unit on life support after suffering
irreversible brain damage resulting from a motorcycle accident, have been approached by the organ
transplant team to consider organ donation. When they ask the nurse about this process, the nurse’s
best response would be:
*“Often families are comforted by the knowledge that some good came from this tragedy.” Correct
>There are many more persons needing organs than there are donors. Nurses are in a position to
educate the public about organ donation.
112.The home health aide who visits an older adult reports to the nurse that the patient has many new
bruises on her arms and face. The patient states that her daughter “has a temper and got mad” when
she visited the day before. The nurse should:
* notify her nursing supervisor to report the incident to the authorities. Correct
>It is a legal requirement for licensed health care personnel to report suspected elder abuse to protect
the public (patient). An LPN should report to the RN supervisor first. The aide is supervised by the nurse
and thus the nurse is responsible. It is not the nurse’s responsibility to determine whether the daughter
is abusing the patient but only to report it so that it can be investigated by the proper agency.
113.A report to a coroner would be required in which situation?
* A death due to a stroke that occurred 12 hours after admission to a hospital Correct
>Any death within 24 hours after admission to the hospital is reported to the coroner. Reportable deaths
include those that result from injury, accident, murder, or suicide. A death from diabetic complications
after a 4-day hospitalization is not reportable. A death from pneumonia 36 hours after admission is not
reportable. A death from cardiac disease after a 10-day hospitalization is not reportable.
114.A patient who was admitted to hospice for comfort care of end-stage respiratory disease is asked
what his hope is for his remaining life. He says, “I’m hoping for a miracle—that I will wake up one of
these mornings and be able to breathe like when I was 20.” The nurse would best respond:
* “Your miracle may be in the form of medication that will improve your comfort.” Correct
>Instilling hope that the struggle for respiratory relief will be available is a comfort measure.
115.A nurse who practices in a culturally competent manner is one who is able to:
* look at the world through the eyes of the culturally diverse patient. Correct
>Cultural competence is attained when the nurse makes a conscious attempt to learn about people of
diverse cultures and look at the world through their perspective.
116.__________ is the state of having suffered a loss by death.
*Bereavement
>Bereavement is the state of having suffered a loss by death and is a component of the grieving process.
117.When a devout Muslim dies, the nurse makes arrangements to:
* notify a family member to come bathe the patient. Correct
>A family member must bathe the deceased person before anybody else touches the body.
118.The term developed to describe care that recognizes cultural diversity and that is sensitive to the
cultural needs of the patient is _________.
*transcultural nursing
>Recognizing the need for culturally diverse capabilities in nursing is a growing aspect of health care,
especially in our global community.
119.A 67-year-old submitted a job application at a local gas station. The station manager said, “Aren’t
you retired? I can’t hire you. You’re too old to be working!” This is an example of __________________.
*ageism
>Ageism is defined as any discrimination related to age, including job discrimination.
120.Which medical problem is included in the top 10 leading causes of death?
* Alzheimer's disease Correct
>Alzheimer's disease is the seventh leading cause of death. HIV/AIDS is no longer one of the 15 leading
causes of death. Pneumonia is not one of the top 10 leading causes of death. Renal failure and
pneumonia are not among the top 10 leading causes of death.
121.The nurse discusses the grief theory of Maciejewski, which outlines the stages of grief as including:
(Select all that apply.)
* yearning. Correct
*anger. Correct
*denial. Correct
*depression. Correct
>The grief theory of Maciejewski states that the loss is accepted, but followed by denial, yearning, anger,
depression, and acceptance.
122.A desired outcome for a patient with a nursing diagnosis of “spiritual distress” is that the patient
expresses:
*acceptance that she is not being punished by God with illness. Correct
>Spiritual distress is often caused by a belief that illness is a punishment for wrongdoing or sin.
123.A nurse is caring for a patient of the Muslim faith. The nurse would send the food tray back if it
contains:
* pork chops and sweet potatoes. Correct
>Practicing Muslims do not consume pork or alcoholic beverages. They also forbid cremation.
124.A nurse working for an assisted living facility is reviewing the Healthy People Objectives for Older
Adults. Which of the following would she incorporate into the environment to promote health for the
older adult population?
*Develop and implement strategies to prevent pressure ulcer formation. Correct
125.Increase the proportion of older adults who use the “Welcome to Medicare” benefit
Increase the proportion of older adults who are up to date on a core set of clinical preventive services
Increase the proportion of older adults with one or more chronic health conditions who report
confidence in managing their conditions
Increase the proportion of older adults who receive Diabetes Self-Management Benefits
Reduce the proportion of older adults who have moderate to severe functional limitations
Increase the proportion of older adults with reduced physical or cognitive function who engage in light,
moderate, or vigorous physical activities
Increase the proportion of the health care workforce with geriatric certification
Reduce the proportion of noninstitutionalized older adults with disabilities who have an unmet need for
long-term services and supports
Reduce the proportion of unpaid caregivers of older adults who report an unmet need for caregiver
support services
Reduce the rate of pressure ulcer-related hospitalizations among older adults
Reduce the rate of emergency department (ED) visits due to falls among older adults
>Increase the number of states and the District of Columbia that collect and make publicly available
information on the characteristics of victims, perpetrators, and cases of elder abuse, neglect, and
exploitation. (Source: https://www.healthypeople.gov/2020/topics-objectives/topic/older-adults)
125.A Roman Catholic patient going to surgery for an emergency cesarean delivery is afraid the baby
may not survive, and because she is Roman Catholic, she asks you to be sure that the baby is baptized
when it is born. Your response to her should be:
* “I will call your priest to come in, but if he is unable to be there, I’ll be sure the baby is baptized.”
Correct
>Baptism is very important to practicing Roman Catholic patients, and even stillborn is baptized. Baptism
should be performed by the priest, but any believer can baptize in an emergency.
126.The nurse seeks out residents with whom they reminisce in an interview regarding the resident’s life
story. The value of this activity is that:
* it can affirm the positives of the resident’s life and lead to ego integrity for the resident. Correct
>Erikson’s psychosocial task for older adults is ego integrity, which can be assisted by life review and
reminiscence.
127.A patient who is Native American and visiting a health care clinic for the first time keeps his eyes on
the floor and seldom makes eye contact with the nurse. The nurse would be correct in thinking that the
patient:
* finds direct or sustained eye contact rude or disrespectful. Correct
>Native Americans do not usually sustain eye contact in the same way as European Americans do
because they consider it rude.
128.Which is considered to be a violation of the American Nurses Association's (ANA's) Code for Nurses?
(Select all that apply.)
* Active euthanasia Correct
* Assisted suicide Correct
>Both active euthanasia and assisted suicide are considered to be a violation of the American Nurses
Association's Code for Nurses. Active euthanasia is not legal or permissible. Nurses must not participate
in assisted suicide according to the ANA's position statement. Passive euthanasia and deliberate suicide
are not violations of the Code for Nurses.
129.A 76-year-old recently lost her spouse. They lived in a large house with a yard that they managed
well until her spouse’s sudden death. She is in good health and stays active but is becoming concerned
about her ability to maintain the large house by herself. The nurse’s most helpful suggestion would be to:
(Select all that apply.)
*encourage her to investigate apartment rentals. Correct
*encourage her to involve family in any decisions related to her living arrangements. Correct
>Many older adults choose to rent an apartment when they cannot maintain a house and yard. Including
family members in important decisions keeps communication lines open. Family members can offer
support and recommendations to their parent(s), easing the decision-making process.
130.A terminally ill patient is angry and belligerent. He yells at the nurses and his family for not coming
quickly enough when he calls, and he states that he isn’t receiving the care he needs. The nurse’s most
informative response would be:
*“Anger is a reaction that dying people experience. You may be feeling some anger yourselves.” Correct
>Anger is one of the stages terminally ill patients and their caregivers may experience. It may be
prolonged, or it may be a passing stage or one that is returned to in the course of the final illness.
Reacting with anger or just passively ignoring it does not assist the patient in dealing with his feelings.
131.The nurse points out elements in our culture that support longevity in older people, which include:
(Select all that apply.)
*being actively involved in their own health care. Correct
* increasing education about health matters. Correct
>Active participation in one’s own health care, being better educated about illness, and illness
prevention are elements in attaining a longer life span.
132.A patient tells the nurse during an admission interview that his wife “went on to her reward.” The
nurse assesses that this statement is an indication that the patient:
* is uncomfortable with the term “death” and is using a euphemism. Correct
>In many societies there is avoidance of using words such as “died” or “death,” and euphemisms are
commonly used.
133.A formalized system of belief and worship is:
* religion. Correct
>Religion is a formalized system of belief and worship. Beliefs are convictions or opinions that one
considers to be true. Faith is a belief that cannot be proven, or for which no material evidence exists.
Spirituality concerns the intangible essence of our being that seeks to transcend the self, to understand
one's place in the world, and to find meaning in the purpose in life.