Deck 11: The Long-Term Care Resident

Question 1

During orientation for a nursing assistant position at a nursing home, the nursing instructor mentions that some of the reasons why more people over the age of 65 are living longer can be related to: (Select all that apply.)

A) advances in health care making it possible to treat illnesses that in the past killed people.
B) development of newer and better medications that can treat chronic illness like diabetes or cancer.
C) nursing homes being able to keep people alive on machines (like ventilators) for extended periods of time.
D) decrease overall in new cases of degenerative conditions like multiple sclerosis or ALS.
E) technologic advances where residents and family members can diagnose their own illnesses (like heart failure or brain tumors) and seek treatment earlier.

Answer 1

advances in health care making it possible to treat illnesses that in the past killed people.
development of newer and better medications that can treat chronic illness like diabetes or cancer.

Question 2

The nursing assistant can project that as more and more people live longer lives, the impact on long-term care services will:

A) increase in the long-term projections.
B) increase because of the need to care for clients with chronic conditions.
C) remain the same because the baby boomers replace the previous generation.
D) decrease because newer developments for the older adults will decrease the need for long-term facilities.

Answer 2

increase in the long-term projections.

Question 3

Which resident(s) would be classified as having a chronic condition? Select all that apply.

A) Resident diagnosed with uncontrolled diabetes resulting in renal failure.
B) Resident recovering from a recent hip fracture.
C) Resident diagnosed with uterine cancer being treated with radiation and chemotherapy.
D) Resident diagnosed with Down syndrome resulting in heart failure and a mitral valve prolapse.
E) Resident whose ankle was fractured in a motorcycle accident requiring rigid casting.

Answer 3

Resident diagnosed with uncontrolled diabetes resulting in renal failure.
Resident diagnosed with uterine cancer being treated with radiation and chemotherapy.
Resident diagnosed with Down syndrome resulting in heart failure and a mitral valve prolapse.

Question 4

Which resident would be classified/listed as "unsafe to live on their own" upon admission to a nursing home?

A) A resident who experienced a stroke 6 days ago resulting in minor residual effects but needing physical, occupational, and speech therapy to regain previous level of health.
B) A resident diagnosed with having the middle stage of heart failure who gets short of breath and "winded" just walking to the commode.
C) A resident who needs intensive physical therapy after knee surgery to regain the ability to walk without appliances like a walker or cane.
D) A resident diagnosed with Alzheimer disease who is no longer able to speak or swallow, is incontinent of urine/feces, and frequently tries to climb out of bed.

Question 5

An example of a short-stay admission to a nursing home may is a resident who:

A) has experienced a traumatic head injury following a car accident and is still in a coma.
B) has a wound that will not heal because of a diagnosis of uncontrolled diabetes with morbid obesity.
C) lives alone and has recently fallen and broken their hip and requires physical therapy to assist with exercises.
D) has problems with speech, swallowing, and movement on their left side resulting from a stroke.

Question 6

An example of a resident who is having problems with instrumental activities of daily living (IADLs) would include one who: (Select all that apply.)

A) is unable to bath independently.
B) needs assistance with feeding themselves.
C) is unable to dress themselves.
D) is confused as to how to answer the telephone.
E) is unable to handle finances (money).

Question 7

The nursing assistant is caring for residents in the long-term facility and uses what tool to predict the best care to provide?

A) Use the Kardex to decide that more than 50% of the residents will need total care on a daily basis.
B) Examine the IADL to determine that 75% of residents will need help with complex care.
C) Apply the information from the ADL tool to establish that 75% of residents will need help with two ADLs.
D) Choose to help the independent residents with care first before providing care to residents needing more care.

Question 8

A resident is admitted unexpectedly to the nursing home. Because of the unplanned nature of the resident's arrival, which feeling(s) should the nursing assistant anticipate the resident experiencing at first? Select all that apply.

A) Fear and anxiety.
B) Concern about their finances.
C) Sad to be separated from family.
D) Anger because the resident will have to make new friends.
E) Confusion about how their daily schedules will change.

Question 9

The nursing assistant walks into the room of a newly admitted resident to the nursing home and witnesses the family yelling belittling comments at each other and at the resident. The family wants the resident to "get better" faster. The nursing assistant should give which report about this incident to the RN?

A) Family members were verbally abusing of the resident.
B) Family members should be banned from visiting this resident.
C) Family members might try to eat the resident's meals.
D) Family members made the nursing assistant fearful and the assistant would like to be reassigned.

Question 10

When older adult parents become dependent and their children begin to parent (make decisions) for their own parents, this is known as:

A) codependency.
B) interdependency.
C) role reversal.
D) conflict.

Question 11

Several of the residents the nursing assistant is caring for are reporting joint discomfort and back pain and so they do not want to do much care for themselves. What is the best approach for the nursing assistant to use to encourage the residents to be independent? Select all that apply.

A) Be flexible in approach and the amount of assistance provided.
B) Inform the residents they are just having a "bad" day but still need to take a bath and get dressed.
C) Encourage the residents to perform some of their own care to maintain a sense of independency.
D) Keep the residents on their schedule and try to have them all bathed, dressed, and come to the lunch room on time.
E) Allow the resident to stay in bed all day and just watch TV rather than join peers in the activities provided for the day.

Question 12

Conditions that may result in an adolescent living in a nursing home may include: (Select all that apply.)

A) traumatic spinal injury from a diving board accident.
B) traumatic brain injury from an impact during a football game.
C) severe case of asthma requiring steroids to decrease swelling of airways.
D) fracture of the orbit when hit in the face with a softball.
E) compound fracture of leg from a fall requiring surgery and long cast.

Question 13

When caring for a younger resident in the nursing home, the nursing assistant should provide which accommodation(s) to allow the resident to perform developmental tasks? Select all that apply.

A) Allow the resident to pick the music for a social activity when appropriate.
B) Ensure the young resident has access to Wi-Fi and the Internet in their living space.
C) Keep the gown and robe provided by the nursing home clean at all times.
D) Accommodate the need for private space when the resident's friends come to visit.
E) Take them to the lunchroom first so they can get extra helpings of food to help them grow.

Question 14

The nursing assistant would rate which resident first as having the highest quality of life?

A) Adult with Down syndrome who has to be fed and is noncommunicative, but smiles at the nursing assistant during morning care.
B) Older adult with Parkinson's with gait problems and worsening tremors who has been attending an experimental exercise study focusing on keeping muscles as strong as possible.
C) Older adult who uses a magnifying glass to read adventure and romance books and attends most of the activities provided for residents.
D) Resident with amyotrophic lateral sclerosis (ALS) who requires a ventilator to breathe during the night and is unable to control spasms in legs/arms.

Question 15

As a nursing assistant, one can show support of the activity staff in one's nursing home by: (Select all that apply.)

A) ensuring that the residents are ready on time for scheduled activities.
B) repeatedly reminding the resident with dementia about the activity on the schedule.
C) transporting the residents to the area where the activity is taking place.
D) participating in the activity with assigned residents if time allows.
E) setting limits on the resident when the resident has not followed instructions.

Question 16

The nursing assistant is caring for a younger resident who is a quadriplegic (paralyzed from the neck down) after a diving accident. What action(s) should the nursing assistant take to meet the resident's developmental needs? Select all that apply.

A) Help to access adaptive communication tools so the resident may participate in social media.
B) Knock on the door and ask to enter the room before doing so when guests are visiting.
C) Encourage the resident to join all the posted social events available at the long-term care facility.
D) Predict what clothes the resident would look best in when dressing the resident.
E) Contact the activity director and report the resident's specific hobbies and interests.

Question 17

The nursing assistant is caring for a resident who has rheumatoid arthritis with painful swollen joints on their hands. What is the best approach for the nursing assistant to encourage the resident to be independent?

A) Leave the room so the resident has privacy and time to get dressed on their own.
B) Encourage the resident to pick out their clothing and then dress the resident in the items chosen.
C) Provide the adaptive dressing tool the resident asks for so the resident can dress without help.
D) Choose clothing that has no buttons or zippers so the resident can easily slip it on and wear it.

Question 18

The nursing assistant is caring for a resident diagnosed with a chronic condition who states, "I can't do anything, and I can't stand how I look." What is the best approach for the nursing assistant to help the resident to be independent?

A) Explain that the resident is just having a bad day, and other days will be better.
B) Provide information about the facility's beauty salon to help create a new look.
C) Provide support by performing all the resident's basic care needs.
D) Encourage the resident to participate in their care at the level the resident can.

Question 19

What is the best action for the nursing assistant to take to help the newly admitted resident to make the transition to the long-term care facility?

A) Provide a brochure explaining the layout of the facility and the amenities offered.
B) Help the resident to personalize and organize their room the way they want it.
C) Take the resident to the first available activity and introduce them to everyone.
D) Explain the rules of the facility and how to contact their Ombudsman.

Question 20

What is the best way for the nursing assistant (NA) to take to help the resident diagnosed with a progressive disease to maintain the highest quality of life possible?

A) Explain to the resident that breakfast is served at 0730 in the dining room so the resident needs to get up at 0630 to get ready.
B) Ask the resident what a typical day should entail so the resident's schedule may be adhered and changed as the resident likes.
C) Provide comfort measures that the NA uses when the NA is in pain or discomfort so the resident may be kept comfortable.
D) Wheel the resident around the rose garden because it is a beautiful day, so the resident may enjoy the sunshine.