SAS 19-23

1. The nurse is counseling a postmenopausal woman about her new stress incontinence. Which
statement by the nurse is most important?
a. "You can try a variety of briefs and undergarments."
b. "It will be important to keep that area clean and dry."
c. "I can refer you to a good incontinence clinic."
d. "Unfortunately, incontinence is common in women your age."

2. An older woman is asking the nurse about her husband's sexual functioning. Which statement
by the nurse is most accurate?
a. "Men his age tend to have a rapid decline in sexual abilities."
b. "His testosterone levels will decrease only slightly until he is quite old."
c. "Changes in testosterone levels do not affect sexual performance."
d. "You are lucky your husband is healthy enough for sexual activity."

3. The nurse is conducting a reproductive assessment of a postmenopausal woman. Which

assessment finding reported by the client requires immediate intervention by the nurse?
a. Urinary incontinence
b. Vaginal dryness
c. Painful intercourse
d. Returning periods

4. A postmenopausal client says that she is experiencing difficulty with vaginal dryness during
intercourse and wonders what might be causing this. Which is the nurse's best response?
a. "The less frequently you have intercourse, the drier the vaginal tissues become."
b. "Estrogen deficiency causes the vaginal tissues to become drier and thinner."
c. "Drinking at least 3 liters of water each day will make all your tissues less dry."
d. "Try using a water-soluble lubricant during intercourse."

5. The nurse is teaching a postmenopausal woman about nutrition. Which statement by the nurse
is most appropriate?
a. "Be sure to eat cereal fortified with folic acid and B vitamins."
b. "Make sure you take a calcium supplement every day."
c. "Vitamin C is important for the postmenopausal woman."
d. "You can get all the iron you need in two daily meat servings."

6. When performing an assessment of the external genitalia of an older man, the nurse observes
the scrotum to have smooth skin and to be very pendulous. Which action by the nurse is most
appropriate?
a. Suggest to the client that he should wear an athletic supporter while awake.
b. Ask the client if he has been treated for a sexually transmitted disease.
c. Document the observation and continue the assessment.
d. Notify the health care provider and facilitate a scrotal ultrasound.

7. The nurse counsels the 70-year-old female who has remained on hormone replacement therapy
(HRT) that she needs to have a:
a. semiweekly douche to wash out cervical debris.
b. liver function assessment annually.
c. mammogram biannually.
d. Pap smear annually.

8. The nurse evaluates a need for further instruction to reduce the symptoms of vaginal dryness
when the 70-year-old patient says:
a. "Vaseline was good enough for my mother. It's good enough for me."
b. "I use a water-soluble lubricant to aid intercourse."
c. "I'm trying an estrogen cream to see if it works."
d. "I'll let you know how wild yams work for vaginal dryness."

9. The nurse identifies the person most likely to experience erectile dysfunction as the 65-year-old
who has _____ sexually active in earlier years.
a. diabetes and was very
b. irritable bowel syndrome and was minimally
c. chronic pancreatitis and was very
d. osteoarthritis and was moderately

10. The nurse lists the age-related changes in the female reproductive system that affect sexual
intercourse, which are __________. (Select all that apply.)
a. pruritus vulvae
b. atrophic vaginitis
c. frequent yeast infections
d. dyspareunia
e. decreased response time

1. As we get older, we should limit our physical activities because they can be too taxing on our
bodies.
A. True
B. False
2. Exercising during the day will keep you up at night.
A. True
B. False

3. Many exercises can be done from a wheelchair.

A. True
B. False

4. An older person's exercise program should include activities that develop flexibility, balance,
strength training, and endurance.
A. True
B. False

5. Older people don't need to drink as much fluid during exercise as younger people.
A. True
B. False

Multiple Choice:
6. During the morning change-of-shift report at the long-term care facility, the nurse learns that
the patient with dementia has had sun downing. Which nursing action should the nurse take while
caring for the patient?

A. Provide hourly orientation to time of day.

B. Move the patient to a quieter room at night.
C. Keep blinds open during the daytime hours.
D. Have the patient take a brief mid-morning nap.

7. A long-term care patient with moderate dementia develops increased restlessness and
agitation. The nurse's initial action should be to

A. reorients the patient to time, place, and person.

B. administers the PRN dose of lorazepam (Ativan).
C. assesses for factors that might be causing discomfort.
D. has a nursing assistant stay with the patient to ensure safety.

8. Which statement(s) accurately describe(s) mild cognitive impairment (select all that apply)?

A. Always progresses to AD
B. Caused by variety of factors and may progress to AD
C. Should be aggressively treated with acetylcholinesterase drugs
D. Caused by vascular infarcts that, if treated, will delay progression to AD
E. Patient is usually not aware that there is a problem with his or her memory

9. Which patient is most at risk for developing delirium?

A. A 50-year-old woman with cholecystitis
B. A 19-year-old man with a fractured femur
C. A 42-year-old woman having an elective hysterectomy
D. A 78-year-old man admitted to the medical unit with complications related to heart
failure

10. 82-year-old Mr. Robeson together with his daughter arrived at the medical-surgical unit for
diagnostic confirmation and management of probable delirium. Which statement by the client’s
daughter best supports the diagnosis?

A.“Maybe it’s just caused by aging. This usually happens by age 82.”
B. “The changes in his behavior came on so quickly! I wasn’t sure what was happening.”
C.“Dad just didn’t seem to know what he was doing. He would forget what he had for

breakfast.”

D. “Dad has always been so independent. He’s lived alone for years since mom died.”

1. What are the benefits of telehealth? (Select all that apply)

A. Continuity of care
B. Centralized health records
C. Collaboration among healthcare professionals
D. Low quality of care

2. After instituting a new system for recording patient data, a nurse evaluates the "usability" of
the system. Which actions by the nurse BEST reflect this goal? Select all that apply.
A. The nurse checks that the screens are formatted to allow for ease of data entry.
B. The nurse reorders the screen sequencing to maximize effective use of the system.
C. The nurse ensures that the computers can be used by specified users effectively.
D. The nurse checks that the system is intuitive, and supportive of nurses.
E. The nurse improves end-user skills and satisfaction with the new system.
F. The nurse ensures patient data is able to be shared across health care systems.

3. Mr. Sanchez is using telehealth services. He can talk with this physician via videocall about his
condition. What type of telehealth applications is he using?
A. Synchronous
B. Store-and-Forward
C. Remote Patient Monitoring
D. Mobile Health

4. Mrs. Quezon noticed a rash on her face. She immediately took a picture and send it to her
dermatologist. What type of telehealth applications is she using?
A. Synchronous
B. Store-and-Forward
C. Remote Patient Monitoring
D. Mobile Health

5.Telehealth differs from telemedicine in that _____.

A. Telemedicine is a broader term than telehealth and emphasizes the provision of information to
healthcare providers
and consumers
B. Telemedicine uses the Internet to provide professionals with information while telehealth does
not
C. Telehealth encompasses telemedicine, but is a broader term that emphasizes the provision of
information to health
care providers and consumers
D. Telehealth is a narrow term referring only to wellness behaviors

6. A 79-year-old patient recently fractured her hip and had a Hemiarthroplasty bipolar hip repair.
Her daughter works during the day but provides care in the evening. Which service agency is most
appropriate to provide for this patients daily care?
A. Private duty agency
B. Home health agency
C. Nursing home facility
D. Outpatient rehabilitation agency

7. A student nurse asks her nurse educator why there is an increased demand for home health
care. Which response is the MOST accurate for the nurse educator?
A. Most family members want to care for their ill members at home.
B. There is a shortage of nurses who want to work in acute hospital care settings.
C. There is an increase in the number of older patients with chronic illnesses
D. There is increased technology in hospitals which provokes anxiety to many patients.

8. Nurse Abbie is assigned to home health care for an 83-year-old patient with a stroke who has
right-sided hemiplegia, difficulty swallowing, and speech impairment. He is receiving care in his
home from his wife and daughter. What should the home care nurse provide?
A. Strict regimen and care plan
B. Holistic, nonjudgemental philosophy
C. Teaching plan for all family members
D. Means of transporting the patient to his physician

9. A 68-year-old patient is recovering from an abdominoperineal Resection with a permanent

Colostomy. Her physician has ordered home health care nursing on her discharge. What is the
primary patient goal?
A. The patient will be able to return to previous lifestyle.
B. The patient will avoid dependency on medication therapy.
C. The patient will establish self-care and independence.
D. The patient will maintain a friendly relationship with family members.

10. The home health nurse has been assigned to provide care for a patient with cultural values
that differ from the nurse's. What is the BEST action for the nurse to take? (Select all that apply)
A. Ask for an assignment change to allow a colleague who has cultural values more in line with those
of the patient to be assigned.
B. Take time to consider the differences between the values held and those of the assigned patient
C. Research the culture of the assigned patient
D. Accept the assignment and provide the patient with information on the values of the nurse to
facilitate communication.