Expiration Date: December 31, 2011. No CE contact hours (CH) will be given after this date.
This continuing education module should be taken ONLY by those who have purchased the Gerontological Nursing Review and Resource Manual, 2nd Edition. During the process of purchasing this CE module, you will be asked to input the proof of purchase code which can be obtained by sending an e-mail to revmanuals@ana.org.
The actual questions that will be on the test have been posted below.
When you purchase the CE module, you will be issued a password which will allow you to access all CE modules purchased on the NursingWorld Web site. This password is NOT to be confused with the proof of purchase code you received when you purchased the manual. It is important that you remember this password, as you MUST use it if you wish to log out of the system and return at a later time to take the test or to print duplicates of your certificate of completion.
IMPORTANT NOTE: The test for Contact Hours for Cardiac Vascular Review and Resource Manual contains 25 questions. You may find that you are not able to complete the entire test in one sitting. If this is the case, simply click on "Grade My Test" at the bottom of the test page even though you have not yet completed the test. This will allow the system to store your test for your return visit.
When you wish to return, click on "Log Back In" from the CE home page menu and input the CE password you were issued when you first registered for ANA's online CE. Again, do not input the purchase code you were issued as proof of purchase of the manual. Once you are logged back into the system, you will see a list of the ISMs you have completed and ones that are incomplete. Click on "Take Test" next to any incomplete ISM and you will be told how many questions you have completed and how many are left to complete.
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Test Questions
1. Older adults experience many age-related changes in skin. They commonly develop raised, pigmented, warty lesions with a "stuck-on" appearance. These are known as:
a. Seborrheic keratoses
b. Solar lentigines
c. Basal cell carcinomas
d. Acrochordons
2. A "barrel chest" (increased anterior/posterior [A/P] diameter) is most commonly due to:
a. paralysis of the phrenic nerve.
b. air trapping from chronic obstructive lung disease.
c. excessive coughing and deep breathing.
d. inadequate mucous clearance.
3. Arcus senilis, or a light-colored ring around the iris of the eye, occurs from
a. overuse of eye drops.
b. increased intraocular pressure.
c. cataracts.
d. cholesterol deposition in the eye.
4. When an older patient is hospitalized, Medicare reimburses for this inpatient care by which of the following mechanisms?
a. Retrospective payment
a. Diagnosis-related group payment
a. Fee for service payment
a. Resource utilization group payment
5. As gerontological nurses, we are expected to keep abreast on current research that affects our patients. When we evaluate research studies, we need to assess how accurate the findings are, or the "validity of the study." In addition to the overall accuracy of the findings, as practicing clinicians we are interested in whether are not the findings can be generalized to all older individuals, not just the ones enrolled in the study that we are reviewing. If the research findings can be generalized to most older Americans, the study is thought to have strong _________.
a. internal validity
b. construct validity
c. external validity
d. ordinal validity
6. The biggest risk factor for developing a cognitive impairment is
a. socioeconomic status.
b. poor nutrition.
c. age.
d. female gender.
7. A 76-year-old woman presents in an ambulatory clinic. About 2 weeks ago she had difficulty finding words, felt weak, and noticed her right hand felt numb for several hours. Although she has recovered most of her function, she continues to have difficulty with her short-term memory. The most likely cause of these symptoms is:
a. Alzheimer's disease
b. organic delusional syndrome
c. vascular dementia
d. acute depressive syndrome
8. Which of the following describes drug use by the older adult population?
a. Community-dwelling residents most often use analgesics, diuretics, cardiovascular, and hypnotic drugs.
b. Long-term-care residents most often use analgesics, diuretics, cardiovascular, and hypnotic drugs.
c. Community-dwelling residents most often use antipsychotics and anxiolytics.
d. Long-term-care residents most often use thyroid replacement and dermatological agents.
9. Which of the following herbals is used as a psychoactive remedy?
a. Bitter orange
b. Valerian root
c. Ginseng panax
d. Feverfew
10. Mrs. Jones is a 78-year-old White female with a history of severe degenerative arthritis of her lower back. She suffers from chronic pain much of time. She describes the pain as burning and tingling. Over the past few months, she has been on a variety of analgesics without much effect on the symptoms. Her current regimen includes Tramadol 50 mg twice daily and Gabapentin 300 mg at bedtime. She states that she sleeps well, and that for the most part this regimen works better than previous ones that included Hydrocodone. This scenario describes with of the following categories of pain?
a. Nociceptive
b. Neuropathic
c. Visceral
d. Unspecified
11. This virus is spread by the fecal-oral route, and it is usually transmitted by contaminated food or water. There is no chronic form of this virus. This describes which of the following?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
12. A 70-year-old man is admitted to the hospital following a visit to his physician's office. He says that he has just had the flu and his legs ache, but he does not understand why he is in the hospital. Initial nursing assessment reveals that his BP is 90/60, temperature is 98 °F, pulse is 108/min, and respirations are 20/min. His skin and mucous membranes are dry. He is 5 ft 9 in and weighs 160 lb. He reports no allergies. He states that he takes a little white pill for his heart and another pill that "makes him go to the bathroom." His wife reports that his memory is worse and he has been falling some for the past 3 days. He has taken his medication, but has had no desire to eat or drink for 3 or 4 days. Based on the data given, this patient's most serious problem is probably related to:
a. malnutrition
b. dementia
c. anxiety
d. dehydration
13. Which of the following patients is most prone to developing hyperkalemia?
a. A 65-year-old woman with a fractured humerus
b. A 78-year-old man with a decreased creatinine clearance who takes ibuprofen daily for joint pain
c. An 85-year-old man with no health problems who eats a banana every day
d. An 88-year-old woman who takes amlodinpine 5 mg daily for her high blood pressure
14. Which of the following health promotion activities is labeled correctly?
a. Influenza vaccine: primary prevention
b. Blood pressure screening: primary prevention
c. Diabetic education: secondary prevention
d. Mammography: tertiary prevention
15. The general recommendation by most experts is that that screening for prostate cancer by prostate-specific antigen (PSA) is appropriate in patients with at least a ___ year life expectancy.
a. 10
b. 5
c. 2
d. 1
16. Ms. Jones is a 75-year-old woman with several risk factors for cardiovascular disease. Which of her risk factors can be modified to reduce her risk of an event?
a. Advancing age
b. Post-menopausal status
c. High blood pressure
d. Family history
17. The gerontological nursing expert knows that acute conditions often present with atypical signs and symptoms in older adults. Which of the following might be an example of an atypical presentation of pneumonia?
a. Fall
b. Cough
c. Fever
d. Chest pain
18. The older adult with Parkinson's disease is often plagued with some sort of gait disturbance. If the patient has a tendency to fall backwards when he or she walks, the person is said to have which of the following?
a. Festination
b. Propulsive gait
c. Retropulsion
d. Akinetic gait
19. Mrs. Blair comes into the clinic today complaining of a skin rash on her forearms. She states that the areas of concern have been there for many years, and they seem to be getting worse. The patient is an 82-year-old female who appears younger than her stated age. She is well groomed. On and about her forearms and anterior thorax, she has several 3–4 mm brownish black lesions that have a "stuck on" appearance. The lesions have a greasy brown appearance, and the patient tells you that she can sometimes rub them off with a towel after her bath. She wants to make sure they are not skin cancers. Based on this information, the gerontological nurse recognizes Mrs. Blair's lesions as:
a. Cherry angiomas
b. Seborrheic keratosis
c. Psoriasis
d. Eczema
20. Overdoses of acetaminophen have been linked to
a. weight loss
b. falls
c. liver failure
d. constipation
21. Which of the following is the best definition for the advance directive known as a "living will"?
a. A statement of a person's wishes for how one wishes to die and be treated at the end of life.
b. Naming another to make decisions in case the patient cannot make his or her own decisions.
c. Seeking advice from a judge in a court of law.
d. Asking the next of kin to make decisions consistent with the older person's values and beliefs.
22. Which of the following behaviors in a grieving older widow may indicate the need for a mental health referral and counseling?
a. Feelings of sadness 3 months after a loved one dies
b. Feelings of sadness 4 months after the loss of a pet
c. Failure to eat properly and refusal take medications to control hypertension
d. Family reports that the grieving older person often talks about her dead husband.
23. An older Arab woman has requested all her care be provided by female caregivers according to her religious beliefs. The nurse should respond:
a. That is impossible. We have many fine male attendants and nurses on this floor.
b. I'll speak to the head nurse about this. No one has ever requested this before.
c. Did one of the male nurses or attendants offend you? Why have you made such a request?
d. Yes, I understand your request and will make every attempt to accommodate your wishes. I'll make a notation on your nursing care plan.