HOW TO OBTAIN CONTINUING EDUCATION UNITS BY READING THIS ISSUE
Instructions: Registered nurses may receive three contact hours by reading the articles in this issue and successfully answering the questions in the following post-test. To obtain continuing education unit credit;
1 . Read the articles carefully noting the tables and other illustrative materials which are provided to enhance your knowledge and understanding of the content.
2. Read each question and record your answer in the registration form provided.
3. Type or print your full name and address and your social security number in spaces provided on the registration form.
4. Forward the completed form with your check or money order for $12 made out to University of Maryland, School of Nursing. Photocopies of the quiz are not acceptable; use only the original quiz.
Continuing Education Units: Contact hours are granted by The University of Maryland School of Nursing Continuing Education Program which is accredited by the Eastern Regional Accrediting Committee of the American Nurses' Association. SLACK Inc. and University of Maryland School of Nursing are co-providers of this continuing education home stud y program.
Answers to the post-test will be graded and you will be advised that you have passed or failed within 60 days of receipt of your completed lest. A score of 70% or above will comprise a passing grade. A certificate will be awarded to participants who successfully complete the test.
Ten contact hours of participation in an educational offering is awarded one CEU. A contact hour is 50 minutes of instruction. Contact hour verification can only be awarded at the completion of a program.
CONTACT HOUR UNITS RECEIVED FOR SUCCESSFUL COMPLETION OF THE POST-TEST MAY BE USED FOR CERTIFICATION OR RECERTIFICATION CREDIT.
Objectives: After reading the articles in this issue, the participant will be able to:
1 . Identify situations for which estrogen replacement therapy is appropriate.
2. Describe the risks and contraindications of estrogen replacement therapy.
3. Identify economic factors which influence longterm care institutions.
4. Describe how primary nursing could be effective in long-term care institutions.
5. Describe factors which increase the need for discharge planning in elderly surgical patients.
6. Differentiate the pre-discharge perceptions of elderly patients from the post-discharge perceptions.
7. Identify factors which explain why men are rarely studied as family member caregivers.
8. Describe the difficulties encountered by men as caregivers of a demented family member.
9. Determine specific nursing interventions to maintain adequate oxygen levels for elderly adults at different levels.
10. Evaluate the oxygenation status of their clients in relation to altitude of their place of residence.
1 1 . Identify factors which interfere with normal sleep patterns in elderly hospitalized patients.
12. Implement nursing interventions to make the hospital environment more conducive for elderly persons to sleep.
Directions: Encircle the letter of the best answer on the registration form provided.
1 . According to McKeon, which oí the following statements is true regarding postmenopausal estrogen replacement therapy (ERT)?
A. ERT retards postmenopausal bone loss and reduces the risk of fracture.
B. Pre-existing hypertension is an absolute contraindication for ERT.
C. There is an increased risk of thromboembolism in postmenopausal women taking orally administered ERT.
D. The most widely known reason for prescribing ERT is to treat clinical depression.
2. Which of the following statements is true about menopause?
A. About 10% of American women reach menopause as a result of surgical removal of the ovaries.
B. Behavioral symptoms such as fatigue, insomnia, and the inability to concentrate are unrelated to hormonal changes and are "all in a woman's head."
C. Following surgical removal of the ovaries, a premenopausal woman may be plunged into an abrupt and severe menopause.
D. Menopause occurs spontaneously at a mean age of 58.
3. Which of the following is an absolute contraindication to ERT?
A. Family history of eslrogen-dependent neoplasia.
B. History of liver disease.
C. Insulin dependent diabetes.
4. When estrogen is given in combination with a progestin (administered for at least 1 0 days):
A. The incidence of endometrial cancer is slightly higher than that seen in the population of women taking no hormone replacement.
B. The risk of breast cancer is sharply reduced.
C. The risk of endometrial cancer is virtually eliminated.
D. Withdrawal bleeding is eliminated.
5. According to Henry, the primary sources of payment for nursing heme care are:
A. Medicare and Medicaid.
B. Med ica id and out-of-poc ket .
C. Private health insurance and Medicare.
D. Private health insurance and out-ofpocket.
6. Controlling costs of nursing home care is a national concern but some measures have led to a shortage in nursing home beds. According to Henry, which of the following has most influenced the shortage of beds?
A. "Certificate of need" legislation.
B. Inadequate reimbursement for the level o care needed.
C. Prospective payment for care.
D. The nursing shortage.
7. In studies of long-term care facilitie which have implemented primary nursing, al of the following outcomes have been docu mented except:
A. Decreased incidence of decubitus ulcers.
B. Decreased number of family complaints.
C. Increased patient satisfaction.
D. Increased transfers to acute care facilities.
8. A successful primary nursing practice model in long-term care facilities, accordinj to Henry, should have which of the following attributes:
A. Less need for staff supervisors.
B. No increase in cosi to the institution.
C. Registered nurse and nursing assistan teams.
D. All of lhe above.
9. What factors, according to Schaefer et al, put increased pressure on health-care workers to initiate discharge planning in elderly surgical patients?
A. Complex health problems.
B. DRG classification for reimbursement.
C. Length of stay.
D. All of the above.
10. Which of the following factors wa judged by elderly patients to be significantly different from pre-discharge to post-dis charge?
A. Functional ability.
1 1 . Elderly subjects, after surgery, identifie« similar areas pre- and post-discharge tha they would need help with at home. Whicl one of the following was »of a concern com mon to both time periods?
B. Meal preparation.
D. Wound care.
12. In Schaefer et al's study, what percentage of patients after abdominal and cardiac surgery thought that they were ready for discharge?
A. Less than 50%.
D. More than 95%.
3. According to the article by Mathew et al, most of the family caregivers are women, it is important to explore the role of men as caregivers because of all of the following except:
A decrease i ? the size of American fam i I ies providing less children as caregivers.
B. An increasing need for caregivers of the demented eideriy.
C. More women entering the work force which decreases their potential for caregiving time.
D. Women have not been successful and willing to care for demented family members.
14. Studies involving men as family member caregivers are few, according to Mathew et al, and is probably due to which of the following:
A. Men are often stoic and will not answer researchers questions honestly.
B. Men do not experience problems as caregivers.
C. Too often it is difficult to find men who are caregivers.
D. Usually men have no interest in research.
15. All of the following are attributes of the men who were caring for a family member at home except:
A. 50% were caring for a demented wife.
B. Of those who were employed, all were professionals.
C. They had similar levels of burden as men who had their family member in a nursing home.
D. They spent an average of 1 .7 hours in care daily.
16. The difficulty most often mentioned by the men in their roles as caregivers for a family member was:
A. A change in lifestyle.
B. Insufficient money.
C. Lack of socialization.
D. Stress induced physical problems.
17. According to Ogburn-Russell and Johnson, the aging process normally affects:
A. PO, and O, saturation.
B. PO, and CO,.
C. O, saturation and CO1.
D. Hemoglobin and CO >.
18. The decreased barometric pressure at moderate and high altitude results in:
A. A lower percentage of oxygen available in the ambient air.
B. An increased percentage of oxygen available in the ambient air.
C. A reduction in the actual amount of oxygen inhaled.
D. An increase in the actual amount of carbon dioxide inhaled.
19. Ogburn-Russell and Johnson found that the oxygen saturation of the well elderly was:
A. Below the normal range.
B. At the midpoint of the normal range.
C. At the upper limit of the normal range.
D. At the lower limit of the normal range.
20. In comparing well elderly living at low altitude, Ogburn-Russell and Johnson found that:
A. There was no difference in the oxygen saturation of the two groups.
B. The oxygen saturation of the group at moderate altitude was significantly lower than that of the group at low altitude.
C. The oxygen saturation of the group at moderate altitude was significantly higher than that of the group at lower altitude.
D. The pulse rate of the group at moderate altitude was significantly lower than that of the group at lower altitude.
21. According to Gall et al, prior investigators have documented that a reduction in hours of sleep is associated with:
A. Decreased corticosteroid levels and aggressiveness.
B. Increased fatigue, decreased pain tolerance, and changes in mood and basicdrives.
C. Lower catecholamine levels.
D. Decreased irritability and aggressiveness and increased pain tolerance.
22. The major difference between the nocturnal patterns of institutionalized elderly as studied by Gress and associates and the nocturnal patterns of hospitalized elderly was:
A. Institutionalized elderly demonstrated inconsistent unpredictable patterns of sleep.
B. Institutionalized elderly were over medicated for sleep.
C. Hospitalized elderly were documented to be sleeping less and awake more with each consecutive night observed.
D. Hospitalized elderly rarely were interrupted by staff.
23. Nurses possess considerable control over the sleep environment of hospitalized elderly. Which of the following may be incorporated into practice to promote sleep?
A. Establish the patients usual bedtime routine, keep interruptions to a minimum, schedule medications and treatments efficiently, and medicate for pain.
B. Schedule a daily nap, reduce visitors, and decrease fluids before bedtime.
C. Incorporate sleep medication routinely.
D. Promote tiredness through a hectic day and evening shift schedule.
24. The major finding of the study by Gall et al was in stark contrast to the finding of a study by Gress et al. This finding was:
A. Elderly patients were found to have highly individualized sleep patterns which varied from person to person.
B. There was difficulty in determining sleep patterns of the elderly because of medications and hospital environment.
C. Observations of the elderly patients by 1 17 nurses decreased and patient awareness increased as their hospital stay increased.
D. Observations of the elderly patients by 1 1 -7 nurses decreased as hospital stay increased and patients adjusted to the hospital.