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Gerontology Nursing Questions And Answers PDF
1. Mr. K has dementia. Having a good deal of money, he has a private room at Haven Nursing Home. He is a retired industrialist whose children and current wife are already squabbling bitterly over his estate. During visits, they often get into shouting matches that disturb the other residents and Mr. K himself. How should an administrator handle this family?
- A. Emphasize that they must behave civilly when visiting
- B. Have them set up separate visiting schedules
- C. Ask them to stay away
- D. Close Mr. K's door when they visit
Correct answer: B
Rationale: There is little an administrator can do about this dysfunctional family's behavior, but Mr. K should not be upset by it, and the other residents deserve to be protected from shouting. By setting up separate visiting schedules, the family can continue to provide needed support for their husband and father. If they accidentally visit at the same time, the door can be kept closed until they leave.
2. A nurse is performing a health history on a client who identifies as Native American/First Nations. Based on familial history and racial disparities, for which health issue should the nurse prepare to monitor in this client?
- A. autoimmune disorders
- B. heart disease
- C. Alzheimer's disease
- D. lung cancer
Correct answer: B
Rationale: The correct answer is B: heart disease. Heart disease is a major health issue among Native American/First Nations populations, along with diabetes, malignant neoplasm, and unintentional injuries, contributing to a decreased lifespan. Autoimmune disorders, Alzheimer's disease, and lung cancer are not the primary health concerns that the nurse should monitor for in this client. By understanding the prevalent health issues in this population, the nurse can provide targeted care and interventions to promote better health outcomes.
3. During a busy shift, a registered nurse directed an unlicensed care provider to change the dressing and perform wound care on an older adult client's surgical incision, an act that exists outside of the unlicensed care provider's scope of practice. Which of the following statements best captures the legal context of this event?
- A. The unlicensed care provider is solely responsible for the inappropriate practice.
- B. The nurse can be held liable for the actions of the unlicensed care provider.
- C. Liability rests with the nurse manager of the unit.
- D. In the absence of documented harm to the client, the action is legally permissible.
Correct answer: B
Rationale: The correct answer is B. Under the doctrine of respondent superior, nurses can be held liable for the actions of individuals under their supervision. In this scenario, the registered nurse directed the unlicensed care provider to perform a task outside their scope of practice, making the nurse accountable for the consequences. Choice A is incorrect because the responsibility is shared between the nurse and the unlicensed care provider. Choice C is incorrect as the nurse manager may not be directly responsible for the actions of the registered nurse. Choice D is incorrect because legality is not determined solely by the absence of harm; acting within one's legal scope of practice is essential to ensure patient safety.
4. An elderly man has relied on one of his sons for his care. Now the son has become very involved with a religion other than the one in which he was raised. As a result, he now refuses to help his father. What can a nurse do to help in this family situation?
- A. Set up a family conference that includes the son
- B. Bring in help from other family members or outside
- C. Insist that the son help, along with other family members
- D. Ask the family's own spiritual adviser to intervene
Correct answer: A
Rationale: In this complex family situation, it is essential to approach the issue with sensitivity and understanding. Setting up a family conference that includes the son is the most appropriate action for the nurse to take. While it may seem challenging, there is a possibility that involving the son in a family discussion can help him understand the impact of his actions on his father and the rest of the family. By including him in the conversation, the son may realize the importance of his role in caring for his father. Insisting that the son help, along with other family members, could lead to resistance and further alienation. Asking the family's spiritual adviser to intervene may not be effective if the son is rebelling against the family's religion. If the family conference does not yield positive results, then bringing in help from other family members or an outside caregiver may become necessary to ensure the elderly man receives the care he needs.
5. When in doubt about using restraints on an agitated patient, it is prudent for nurses to:
- A. Restrain the patient for their own safety
- B. Use minor restraints such as a bed side rail or a tray on a wheelchair
- C. Use alternatives such as a bed alarm with increased staff supervision
- D. Avoid using any device or procedure to limit liability
Correct answer: C
Rationale: The correct answer is C: 'Use alternatives such as a bed alarm with increased staff supervision.' The Omnibus Budget Reconciliation Act (OBRA) established strict standards on restraint use in long-term care facilities. Restraints can be considered a form of false imprisonment and neglect, leading to potential litigation. Therefore, it is advisable to avoid restraints whenever possible. A bed alarm coupled with enhanced staff supervision provides an effective and non-restrictive approach for managing an agitated patient. Choices A, B, and D are incorrect because restraining the patient, using minor restraints, or avoiding all devices without providing an alternative can pose risks to patient safety, violate regulations, or increase liability concerns.
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