GERI 14-16 NUTRITION 5-6

Question 1

At what age is a person’s value system well established?

Answer 1

10

Question 2

How does a culturally sensitive nurse care for a patient with a different value system?

Answer 2

The nurse is open and nonjudgmental.

Question 3

An 80-year-old Orthodox Jewish patient dies in the hospital. What should be the first action by the nurse?

Answer 3

Notify the rabbi to send a member of the synagogue to stay with the body.

Question 4

The nurse is careful not to remove the yarmulke from the head of the Jewish patient. What does the yarmulke symbolize?

Answer 4

The belief that God is higher than man.

Question 5

What menu items would be inappropriate for a Muslim patient?

Answer 5

Pork chops and sweet potatoes

Question 6

Who does the home health nurse expect her 85-year-old Hispanic patient will seek health advice from?

Answer 6

Folk healer (curandero)

Question 7

What is included in the spiritual beliefs of many Native Americans?

Answer 7

All things in the world have a spirit.

Question 8

What would an 80-year-old African-American woman most likely believe would aid in improving her health?

Answer 8

A visit from her pastor to pray for her recovery.

Question 9

A nurse wants to provide culturally sensitive care. What is the most effective way to develop an appreciation and understanding of diverse beliefs and values?

Answer 9

Increase personal knowledge of another culture.

Question 10

The home health nurse is caring for an 85-year-old patient with conservative economic values. What does the nurse expect from the older adult?

Answer 10

Hoarding old prescription drugs for later use.

Question 11

A terminally ill Roman Catholic patient asks the nurse to place spiritual objects near her bed. What would the nurse place at the bedside?

Answer 11

Rosary and vial of holy water.

Question 12

What does the “R” remind the nurse to assess when using the spiritual assessment prompt SPIRIT?

Answer 12

Rituals

Question 13

How can a nurse best enhance a spiritual leader’s visit to a long-term care facility?

Answer 13

Take the resident’s roommate to the dayroom.

Question 14

What influences a patient’s value system? (Select all that apply.)
a. Religion
b. Philosophy
c. Family
d. Financial status
e. Society

Answer 14

a. Religion
b. Philosophy
c. Family
e. Society

Question 15

What are influenced by an individual’s values and beliefs? (Select all that apply.)
a. Health practices
b. Perception of illness
c. Social status
d. Spouse selection
e. Morality

Answer 15

a. Health practices
b. Perception of illness
d. Spouse selection
e. Morality

Question 16

What are included in the five pillars of the Islamic faith? (Select all that apply.)
a. To make a confession of faith
b. Perform five daily prayers at the appropriate time
c. Observe Ramadan
d. Make a pilgrimage to Mecca
e. To care for children

Answer 16

a. To make a confession of faith
b. Perform five daily prayers at the appropriate time
c. Observe Ramadan
d. Make a pilgrimage to Mecca

Question 17

What would the nurse include in the plan of care for a Muslim woman? (Select all that apply.)
a. Provide time for five daily prayers
b. Address all health questions to the husband
c. Assign only female caregivers
d. Keep all cut flowers and greenery out of the room
e. Remind caregivers to be especially protective of the patient’s modesty

Answer 17

a. Provide time for five daily prayers
c. Assign only female caregivers
e. Remind caregivers to be especially protective of the patient’s modesty

Question 18

The nurse is sensitive to the cultural beliefs of Native Americans; they practice rituals for the improvement of their health by creating harmony among ____________. (Select all that apply.)
a. mind
b. faith
c. wellness
d. spirit
e. body

Answer 18

a. mind
d. spirit
e. body

Question 19

What could be a cause of conflict between a 94-year-old Italian man and his grandchildren? (Select all
that apply.)

a. Hairstyle and clothing
b. Lack of reverence for age and wisdom
c. Rejection of traditional ethnic foods
d. Process of selecting a spouse
e. Desire for education

Answer 19

a. Hairstyle and clothing
b. Lack of reverence for age and wisdom
c. Rejection of traditional ethnic foods
d. Process of selecting a spouse

Question 20

What are indications that an older adult is in spiritual disconnection? (Select all that apply.)
a. Expressions of the meaningless of life
b. Verbalizations of guilt about past behavior
c. An expressed need to mend a broken relationship
d. Daily prayer to a supreme being
e. Diminished hope

Answer 20

a. Expressions of the meaningless of life
b. Verbalizations of guilt about past behavior
c. An expressed need to mend a broken relationship
e. Diminished hope

Question 21

When the patient asks the nurse to pray for him because he does not know how to pray, the nurse assures him that a supreme being can hear a prayer of any type, such as prayer that is ____________. (Select all that apply.)
a. ritualized
b. read from a holy book
c. structured
d. informal and conversational
e. recited from childhood memory

Answer 21

a. ritualized
b. read from a holy book
c. structured
d. informal and conversational
e. recited from childhood memory

Question 22

During the admission process, the nurse recognizes the patient is likely experiencingspiritual disconnection. Which question(s) may help clarify the situation? (Select all that apply.)
a. “What gives you meaning to life?”
b. “Are there any spiritual objects that you want in your room?”
c. “Do you want a particular spiritual counselor notified?”
d. “Is there any special religious practice that you would want us to be aware of?”
e. “What is your cultural background?”

Answer 22

a. “What gives you meaning to life?”
b. “Are there any spiritual objects that you want in your room?”
c. “Do you want a particular spiritual counselor notified?”
d. “Is there any special religious practice that you would want us to be aware of?”

Question 23

What does an advance directive indicate to the home health nurse?

Answer 23

The degree of intervention desired for life support

Question 24

The totally competent 76-year-old female with terminal cancer is fatigued and tearful about the ineffectiveness of her treatment. She tells the nurse that she wishes she had never started it but now feels obligated to continue. What would be the most appropriate explanation by the nurse regarding the treatment?

Answer 24

She may change her mind about treatment at any time.

Question 25

Why might a professional health care provider neglect to educate patients about end-of-life care?

Answer 25

They believe that death is a personal failure on their part.

Question 26

Why should an 86-year-old man with a terminal illness be encouraged to file an advance directive?

Answer 26

To indicate his wishes regarding end-of-life decisions

Question 27

Which patient would be a candidate for hospice care?

Answer 27

The patient who agrees to palliative measures.

Question 28

The patient with terminal liver cancer says to the nurse, “I’m going to take a long time to die, aren’t I? I’m going to get sicker and weaker every day.” What would be the best response by the nurse?

Answer 28

“What concerns you the most about dying?”

Question 29

The distraught wife of a terminally ill patient complains to the nurse, “My husband has not been shaved, and he has that miserable gown on instead of his own pajamas. Don’t you people care about things like that?” What would be the best response of the nurse?

Answer 29

“I delayed his morning care because he was sleeping comfortably. I’ll complete his care now that he’s awake.”

Question 30

The nurse becomes tearful at the death of a patient. What would be the most appropriate response of the nurse?

Answer 30

Touch the hand of the daughter and say, “We’ll miss your dad.”

Question 31

What is a cardiovascular sign of impending death?

Answer 31

Cyanosis of the extremities

Question 32

What is the objective of pain control for the dying patient?

Answer 32

Find a control level that reduces pain but allows the patient to interact.

Question 33

A dying patient is receiving 2 mg of morphine sulfate every hour. The patient’s daughter is worried about oversedation. What does the nurse explain that this small dose of morphine controls?

Answer 33

Dyspnea

Question 34

What would be the most acceptable intervention for the nurse dealing with a patient with a threat of aspiration?

Answer 34

Place the patient in a side-lying position, with the head turned to the side.

Question 35

What is the average fluid intake necessary for safe administration of a bulk-forming laxative to a dying patient?

Answer 35

2000 mL

Question 36

When the dying patient becomes delirious, what should the nurse encourage the family to do?

Answer 36

Touch the patient, call the patient by name, and speak in reassuring tones.

Question 37

What can caregivers do for a dying patient who suffers from diminished vision?

Answer 37

Come close to the bed and stand directly in front of the patient.

Question 38

Why is end-of-life planning often neglected? (Select all that apply.) a. There is a clear procedure to follow. b. People are uncomfortable talking about death. c. Young people do not see the need for end-of-life planning. d. End-of-life planning is a relatively new concept. e. Many persons are not really sure what they want to do.

Answer 38

b. People are uncomfortable talking about death. c. Young people do not see the need for end-of-life planning. d. End-of-life planning is a relatively new concept. e. Many persons are not really sure what they want to do.

Question 39

What are the benefits of a holistic caregiver at the end-of-life? (Select all that apply.) a. The caregiver communicates and responds to the patient’s concerns about death. b. The caregiver embraces the value of palliative care rather than curative care. c. The caregiver helps the patient and family face loss and grieve in anticipation of loss. d. The caregiver encourages the patient to focus on wellness and recovery. e. The caregiver collaborates with other professionals for patient support.

Answer 39

a. The caregiver communicates and responds to the patient’s concerns about death. b. The caregiver embraces the value of palliative care rather than curative care. c. The caregiver helps the patient and family face loss and grieve in anticipation of loss. e. The caregiver collaborates with other professionals for patient support.

Question 40

What should be done with copies of a signed advance directive? (Select all that apply.) a. Given to the person who has been named as power of attorney for medical decisions b. Posted in the home for emergency personnel c. Placed in the medical record in the physician’s office d. Filed with the hospital e. Given to the neighbor

Answer 40

a. Given to the person who has been named as power of attorney for medical decisions b. Posted in the home for emergency personnel c. Placed in the medical record in the physician’s office d. Filed with the hospital

Question 41

What are the benefits of an advance directive? (Select all that apply.) a. It is legally binding. b. It remains in effect until the family changes it. c. It prevents last-minute confusion about the wishes of the patient. d. It prevents violation of end-of-life choices. e. It clarifies end-of-life issues for the family.

Answer 41

a. It is legally binding. c. It prevents last-minute confusion about the wishes of the patient. d. It prevents violation of end-of-life choices. e. It clarifies end-of-life issues for the family.

Question 42

What are a person’s perceptions regarding end-of-life care dependent upon? (Select all that apply.) a. Age b. Gender c. Cultural background d. Caregivers e. Life experiences

Answer 42

a. Age b. Gender c. Cultural background e. Life experiences

Question 43

The charge nurse on an oncology unit encourages staff nurses to complete a values clarification exercise. What type of insight is provided by the exercise? (Select all that apply.) a. The nurses’ own values b. Values that influence care decisions c. Values that must be abandoned or changed d. Values that may cause an ethical dilemma e. Negative values

Answer 43

a. The nurses’ own values b. Values that influence care decisions d. Values that may cause an ethical dilemma

Question 44

The plan of care for a patient focuses on palliative care. Which aspect of care does the nurse expect to provide? (Select all that apply.) a. Treat symptoms of pain, dyspnea, and nausea. b. Promote acceptance of death. c. Provide CPR. d. Monitor mechanical ventilation machines. e. Enable the patient to have a better quality of life.

Answer 44

a. Treat symptoms of pain, dyspnea, and nausea. b. Promote acceptance of death. e. Enable the patient to have a better quality of life.

Question 45

How can a nurse encourage communication with a dying patient? (Select all that apply.) a. Address the patient by name at every opportunity. b. Use direct questions to inquire about the patient’s concerns relative to health and end-of-life issues. c. Complete care with a minimum of conversation to encourage questions from the patient. d. Provide empathetic touching during care to show concern. e. Sit down in the room to converse with the patient.

Answer 45

a. Address the patient by name at every opportunity. d. Provide empathetic touching during care to show concern. e. Sit down in the room to converse with the patient.

Question 46

What are benefits of dehydration for a person who is near death? (Select all that apply.) a. Better gas exchange because of reduction of fluid in the lungs b. Decreased need to suction because of reduction of respiratory secretions c. Improved bowel elimination because of reduced bulk in the stool d. Decreased pain related to release of endorphins e. Improved drug distribution via the circulating volume

Answer 46

a. Better gas exchange because of reduction of fluid in the lungs b. Decreased need to suction because of reduction of respiratory secretions d. Decreased pain related to release of endorphins

Question 47

A resident in the long-term care facility has just died, and the family is on the way to say their last goodbyes. What should the nurse do prior to the arrival of the family? (Select all that apply.) a. Remove equipment (e.g., IV poles and tubing, feeding tubes, oxygen equipment). b. Dress the resident in a clean gown and cover him or her with a clean sheet. c. Remove dentures. d. Apply an incontinent brief to catch draining body fluids. e. Provide privacy by drawing the curtain or moving the other resident to an unoccupied room.

Answer 47

a. Remove equipment (e.g., IV poles and tubing, feeding tubes, oxygen equipment). b. Dress the resident in a clean gown and cover him or her with a clean sheet. d. Apply an incontinent brief to catch draining body fluids. e. Provide privacy by drawing the curtain or moving the other resident to an unoccupied room.

Question 48

What would be appropriate actions of the nurse when dealing with a bereaved family at the time of death? (Select all that apply.) a. Review the stages of dying with them. b. Ensure privacy. c. Observe cultural and spiritual preferences. d. Legally pronounce the death. e. Allow the bereaved to express their feelings.

Answer 48

b. Ensure privacy. c. Observe cultural and spiritual preferences. e. Allow the bereaved to express their feelings.

Question 49

What are appropriate roles of the nurse when working with the bereaved? (Select all that apply.) a. Guidance b. Resource c. Advocacy d. Support e. Spiritual counseling

Answer 49

a. Guidance b. Resource c. Advocacy d. Support

Question 50

What is true of sexuality?

Answer 50

It remains part of life until death.

Question 51

A 72-year-old patient is on menopausal hormone therapy (MHT). What should the nurse suggest for the patient?

Answer 51

Pap smear annually

Question 52

The nurse is counseling a 70-year-old patient regarding vaginal dryness. Which statement by the patient would indicate a need for further teaching?

Answer 52

“Vaseline was good enough for my mother. It’s good enough for me.”

Question 53

What medical condition is known to contribute to erectile dysfunction?

Answer 53

Diabetes

Question 54

A 65-year-old male, although he is having painful symptoms related to a benign enlargement of the prostate, refuses to consider a prostatectomy because he fears that the surgery will cause erectile dysfunction. What information can the nurse provide as reassurance?

Answer 54

New techniques for a prostatectomy do not damage nerves.

Question 55

The 70-year-old woman who is considering coming off of menopausal hormone therapy (MHT) for the reduction of postmenopausal discomfort asks the nurse what advantage is offered by tamoxifen, also called a “designer estrogen.” What would be the best response by the nurse?

Answer 55

Tamoxifen provides estrogen to some tissues while acting as an antiestrogen to others.

Question 56

The nurse teaches that some persons have found relief from postmenopausal discomfort by using phytoestrogens. In what food can phytoestrogens be found?

Answer 56

Soybeans

Question 57

What statement by a 65-year-old man who had a myocardial infarction 6 months ago would indicate a need for further teaching?

Answer 57

“I’ve been told that I’m at risk for another heart attack if we have sex.”

Question 58

The nurse makes it clear to older adults in a long-term care facility that condoms are available from the medicine cart on request for which reason?

Answer 58

To reduce the incidence of sexually transmitted illnesses (STIs).

Question 59

Why does the nurse stress the importance of advance directives to a 70-year-old gay man who has been in a monogamous relationship for 20 years?

Answer 59

Life partners have no legal standing in many states.

Question 60

The horrified CNA runs to the nursing station and says, “Do you know what Mr. and Mrs. Smith are doing? They’re having sex right there in room 210!” What would be the best response of the nurse?

Answer 60

Give the CNA a “Do Not Disturb” sign to put on the door of room 210.

Question 61

A cognitively impaired man is openly masturbating in the dayroom of a long-term care facility. What is the most appropriate statement by the nurse?

Answer 61

“I think you may need some privacy” and take him to his room.

Question 62

What would be an appropriate statement regarding sexuality for a married couple upon their admission to a long-term care facility?

Answer 62

“Do you have any sexual concerns related to your admission here?”

Question 63

The CNA tearfully reports that a resident deliberately exposes himself to her and makes lewd suggestions. What would be an appropriate modification to this patient’s plan of care?

Answer 63

Modify clothing choices to one-piece garments or elastic waist trousers.

Question 64

What factors can alter the sexual practice of older adults? (Select all that apply.) a. Altered health status b. Inability to achieve orgasm c. Erectile dysfunction d. Loss of sexual partner e. Slowed sexual response time

Answer 64

a. Altered health status c. Erectile dysfunction d. Loss of sexual partner e. Slowed sexual response time

Question 65

What age-related changes of the female reproductive system can affect sexual intercourse? (Select all that apply.) a. Pruritus vulvae b. Atrophic vaginitis c. Frequent yeast infections d. Dyspareunia e. Decreased response time

Answer 65

a. Pruritus vulvae b. Atrophic vaginitis c. Frequent yeast infections d. Dyspareunia

Question 66

Menopausal Hormone therapy can increase the risk of women developing which condition(s)? (Select all that apply.) a. Stroke b. Myocardial infarction c. Liver disorders d. Cancer e. Bone demineralization

Answer 66

a. Stroke b. Myocardial infarction c. Liver disorders d. Cancer

Question 67

What age-related changes are common in older men and affect sexuality? (Select all that apply.) a. Erections take longer to achieve and are less firm than in younger years. b. Orgasm takes longer to achieve. c. Orgasm occurs at each intercourse. d. Erection loss occurs immediately after orgasm. e. There is an increase in time between orgasms.

Answer 67

a. Erections take longer to achieve and are less firm than in younger years. b. Orgasm takes longer to achieve. d. Erection loss occurs immediately after orgasm. e. There is an increase in time between orgasms.

Question 68

What drugs can contribute to erectile dysfunction? (Select all that apply.) a. calcium channel blockers b. Pancreatic enzyme replacement c. Antihistamines d. Antiparkinson drugs e. Antidepressants

Answer 68

a. calcium channel blockers c. Antihistamines e. Antidepressants

Question 69

What constraints may prevent an older widow from engaging in sexual activity? (Select all that apply.) a. Older women outnumber older adult men by 4:1. b. There is an expectation that men should initiate contact. c. Display of sexual interest is considered improper. d. Older women do not desire sexual expression. e. Older women associate sexual activity with marriage.

Answer 69

a. Older women outnumber older adult men by 4:1. b. There is an expectation that men should initiate contact. c. Display of sexual interest is considered improper. e. Older women associate sexual activity with marriage.

Question 70

What are factors that can discourage marriage between older adults? (Select all that apply.) a. Disapproval of children b. Financial loss in case of remarriage c. Concerns about chronic illness with either partner d. The lack of opportunity for sexual expression outside of marriage e. Religious and personal values that inhibit cohabitation

Answer 70

a. Disapproval of children b. Financial loss in case of remarriage c. Concerns about chronic illness with either partner

Question 71

The home health nurse takes into consideration the concerns of aging gay and lesbian couples, which include . (Select all that apply.) a. health care providers being willing to discuss a homosexual union b. the health care system’s focus on heterosexuality as the norm c. difficulty finding senior housing as a homosexual couple d. fear of discrimination based on sexual orientation, resulting in substandard health care e. delay of entry to a long-term care facility because of the possibility of not being able to share a room

Answer 71

b. the health care system’s focus on heterosexuality as the norm c. difficulty finding senior housing as a homosexual couple d. fear of discrimination based on sexual orientation, resulting in substandard health care e. delay of entry to a long-term care facility because of the possibility of not being able to share a room

Question 72

The nurse is conducting an admission assessment with an older adult. What can affect sexual function? (Select all that apply.) a. Increasing age b. Grief c. Illness d. Religion e. Physical changes

Answer 72

a. Increasing age b. Grief c. Illness e. Physical changes

Question 73

What questions would be appropriate for the nurse to ask in order to assess sexual function? (Select all that apply.) a. “How many alcoholic beverages do you drink a day?” b. “What over-the-counter and prescription medications do you take?” c. “How often do you engage in sexual activity?” d. “Have you had any recent health problems?” e. “When do you see your significant other?”

Answer 73

a. “How many alcoholic beverages do you drink a day?” b. “What over-the-counter and prescription medications do you take?” c. “How often do you engage in sexual activity?” d. “Have you had any recent health problems?”

Question 74

A nurse is providing a teaching to a client who is to begin taking phenelzine. Consuming which of the following foods while taking this medication can cause a hypertensive crisis?

Answer 74

Smoked fish

Question 75

A nurse is providing a teaching to a client who is to begin taking phenelzine. Consuming which of the following foods while taking this medication can cause a hypertensive crisis?

Answer 75

Smoked fish

Question 76

A nursing is providing teaching about food allergies to a group of new parents. Infants who react to which of the following foods typically outgrow the sensitivity? (Select all that apply.) a. soy b. wheat c. cow’s milk d. eggs

Answer 76

a. soy. c. cow’s milk

Question 77

A nurse is teaching about food safety and food borne illness to a group of adults at a local community center. Which of the following information should the nurse include?

Answer 77

“Unpasteurized fruit juice is a common cause of food borne illness.”

Question 78

A nurse is assisting a client with selecting food choices on a menu. Which of the following actions by the nurse demonstrates ethnocentrism?

Answer 78

Recommending one’s own favorite foods.

Question 79

A nurse is caring for a client who has hypertension. Which of the dietary patterns is sometimes followed by Asian clients and places clients at risk for this condition?

Answer 79

Preparation of foods using sodium.

Question 80

A nurse educator is teaching a class on culture and food to a group of newly hired nurses. Which of the following statements by a nurse indicates an understanding of the teaching?

Answer 80

“Most clients who practice orthodox Judaism do not eat meat with dairy products.”

Question 81

A nurse is reviewing the effect of culture on nutrition during a staff in-service. Which of the following groups prescribed eating specific foods to balance forces in the body during illness? (Select all that apply.) a. Asian culture b. African culture c. Roman Catholicism d. Hispanic/Latinx culture e. Buddhism

Answer 81

a. Asian culture d. Hispanic/Latinx culture

Question 82

When should food be consumed by individuals?

Answer 82

Only when they are conscious and have an intact gag or swallow reflex.

Question 83

When should the nurse monitor the client's ability to swallow?

Answer 83

Prior to eating.

Question 84

Stickiness indicated leakage of canned foods. What are some other things that should be taken into consideration when dealing with canned foods?

Answer 84

Any rusting, crushing, and denting.

Question 85

Who pose the greatest risk for food borne illnesses?

Answer 85

Children, older adults, immunocompromised clients, and pregnant clients.

Question 86

Viruses can cause the majority of food borne illnesses, but bacteria

Answer 86

are responsible for the majority of deaths caused by food borne illness.

Question 87

Most commonly foods that are associated with food borne illness are

Answer 87

Raw fruits and veggies contaminated with animal feces. Raw sprouts. Raw or undercooked foods of animal origin. Unpasteurized fruit juice and milk products. Uncooked food handled by someone who is ill.

Question 88

Food safety requirements involved proper

Answer 88

food storage, handling, and preparation.

Question 89

What pathogen can cause hemolytic uremic syndrome, which manifests as severe anemia and kidney failure?

Answer 89

Escherichia coli 0157:H7

Question 90

What is a food allergy?

Answer 90

A reaction that will occur each time the client is exposed to the food and initiate release of serotonin and histamine.