Free GNA Work Environment Questions and Answers — Questions and Answers
Question 1: In assisting aging client, it is important for the nurse to recognize?
- The client's ability to perform ADLs
- The financial status of the client
- The job that the client held prior to aging
- All components of well-being including biological function, psychological function and social function. (Correct answer)
Correct answer: All components of well-being including biological function, psychological function and social function.
Holistic nursing care requires addressing all dimensions of well-being—biological (physical health), psychological (mental and emotional health), and social (relationships and community). Focusing only on ADLs, finances, or prior employment misses critical aspects that affect an older adult's overall health and quality of life.
Question 2: Medications, slower mobility, lack of proper fluid intake, and poor diet can lead into what common symptom in the elder population?
- Urinary incontinences (Correct answer)
- Skin changes
- Mental changes
- Depression
Correct answer: Urinary incontinences
Medications (some cause urinary retention or urgency), reduced mobility (difficulty reaching the bathroom in time), inadequate fluid intake (concentrated urine irritates the bladder), and poor diet collectively impair bladder control, leading to urinary incontinence. The other options—skin changes, mental changes, and depression—are not the primary combined result of these specific factors.
Question 3: The nurse assessing the older population needs to have a basic understanding of which of the following?
- The economic status of the area
- The difference between normal and abnormal for the older age group (Correct answer)
- The signs of sexual dysfunction
- The signs of Cardiac Disease
Correct answer: The difference between normal and abnormal for the older age group
Effective geriatric assessment requires knowing what changes are normal with aging (e.g., slower reflexes, mild forgetfulness) versus abnormal findings that signal disease. Without this distinction, nurses may either over-pathologize normal aging or miss true illness. Economic status, sexual dysfunction signs, and cardiac disease signs are narrower concerns that don't form the foundational knowledge base needed.
Question 4: Which statement would be most appropriate to ask when assessing an aging adult for cognitive function?
- What is today's date?
- Can you count to 10 for me?
- Have you noticed anything different about your memory or thinking in the past few months? (Correct answer)
- Who is the president of the United States?
Correct answer: Have you noticed anything different about your memory or thinking in the past few months?
Open-ended questions invite the patient to self-report subjective changes in memory or thinking, which is more sensitive and respectful when screening for cognitive decline. Questions like 'What is today's date?' or 'Who is the president?' are formal cognitive tests, not conversational screening tools, and can feel demeaning rather than inviting honest disclosure.
Question 5: Which disease or ailment is often under diagnosed and undertreated in the aging population?
- Schizophrenia
- Depression (Correct answer)
- Associative disorders
- Attention deficit disorder
Correct answer: Depression
Depression in older adults is frequently mistaken for normal aging, grief, or dementia, and its symptoms (fatigue, withdrawal, cognitive slowing) overlap with many physical illnesses, causing it to be missed and untreated. Schizophrenia, associative disorders, and ADHD are far less prevalent in this population and are less likely to go systematically underdiagnosed.
Question 6: Which statement demonstrates normal cognitive function for an aging adult?
- Occasional memory lapses (Correct answer)
- Unable to recall the names of their children or siblings
- Unable to recall current address or phone number
- Unable to count to 10 or repeat a series of a consecutive numbers
Correct answer: Occasional memory lapses
Occasional forgetfulness—such as misplacing keys or momentarily forgetting a name—is a normal part of aging. Forgetting the names of close family members, current address, or being unable to count are signs of significant cognitive impairment, not normal aging, and would warrant further evaluation.
Question 7: Dementia and depression are strongly related to:
- Clients over the age of 60
- Clients over the age of 65
- A decreased quality of life and functional deficits (Correct answer)
- Past economic status and job performance
Correct answer: A decreased quality of life and functional deficits
Dementia and depression both directly impair a person's ability to perform daily activities, maintain independence, and experience satisfaction in life, resulting in decreased quality of life and functional deficits. Age thresholds and past economic status do not define the relationship; these conditions affect people across various ages and socioeconomic backgrounds.
Question 8: Which statement reflects the state of drug absorption in the geriatric patient?
- The rate of absorption is slowed (Correct answer)
- The rate of absorption is faster due to thinning of the mucosa
- The percentage of the medication that is absorbed is decreased
- There is a decreased in gastric pH as we age
Correct answer: The rate of absorption is slowed
Aging causes decreased gastric motility, reduced blood flow to the GI tract, and lower gastric acid production, all of which slow the rate at which drugs are absorbed into the bloodstream. The mucosa does not cause faster absorption when it thins, the percentage absorbed is generally unchanged, and gastric pH actually increases (becomes less acidic) with age.
Question 9: The absorption of medication in the geriatric client is most often affected by:
- A decrease if body fat
- An increase in serum albumin
- A decrease in body water and lean body weight (Correct answer)
- An increase in body water
Correct answer: A decrease in body water and lean body weight
With aging, body water and lean muscle mass decrease while body fat increases; since many drugs distribute into body water or lean tissue, these changes reduce the volume of distribution and alter drug absorption and distribution. Body fat actually increases with age, serum albumin decreases (not increases), and increased body water is the opposite of what occurs.
Question 10: Which organ is responsible for drug metabolism and must be considered when prescribing medication for an older adult?
- Kidneys
- Pancreas
- Intestines
- Liver (Correct answer)
Correct answer: Liver
The liver is the primary site of drug metabolism (biotransformation), and hepatic blood flow and enzyme activity decline with age, slowing the breakdown of medications and increasing the risk of drug accumulation and toxicity. The kidneys handle excretion, the pancreas handles digestion, and the intestines play a minor role in metabolism compared to the liver.
Question 11: An older adult on digoxin and furosemide is showing signs of toxicity. The gerontology nurse understands that:
- Digoxin and furosemide are excreted by the kidneys and the doses may need to be decreased due to impaired kidney function (Correct answer)
- Digoxin and furosemide are excreted through the intestinal tract, and dose changes would be ineffective
- An increase in fluid intake will fix the symptoms and no change in dosing an older adult.
- How a drug is excreted is not a consideration when dosing an older adult
Correct answer: Digoxin and furosemide are excreted by the kidneys and the doses may need to be decreased due to impaired kidney function
Both digoxin and furosemide are primarily excreted by the kidneys; age-related decline in glomerular filtration rate (GFR) slows their elimination, causing drug levels to build up and produce toxic effects. Adjusting the dose downward compensates for reduced renal clearance, making excretion route and kidney function central considerations in geriatric dosing.
Free GNA Work Environment Questions and Answers
In assisting aging client, it is important for the nurse to recognize?