TEST BANK
Toward Healthy Aging: Human Needs and Nursing Response
THERIS A. TOUHY, KATHLEEN F. JETT
11th Edition
,Chapter 01: Gerontological Nursing Across the Continuum of
Care Touhy: Toward Healthy Aging, 11th Edition
MULTIPLE CHOICE
1. When did serious and well-controlled research studies on aging first become available?
a. Only in the past 60 years.
b. Since the turn of the 20th century.
c. Following the Great Depression.
d. Since the year 2000.
ACCURATE ANSWER:- A
REASONING:->>>Only in the past 60 years have serious and carefully controlled
research studies flourished. Before that, anecdotal evidence was used to illustrate issues
assumed to be universal, making all the remaining options incorrect.
DIF: Cognitive Level: Remembering TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
2. The son of a nursing home resident asks a nursing attendant: “What is the significance
of being certified in gerontology? I see that you are, but not all of the nursing
attendants are.” What response best answers the family member’s question?
a. “National certification as a gerontological nursing attendant is a
way to demonstrate special knowledge in caring for older adults.”
b. “National certification in gerontology is required for all nursing attendants
who have worked in this setting for 2 or more years.”
c. “National certification is only available to nursing attendants who
have a Baccalaureate degree in nursing.”
d. “Only advanced practice nursing attendants, like nursing
attendant practitioners, are certified in gerontology.”
ACCURATE ANSWER:- A
REASONING:->>>National certification is a way to demonstrate special expertise in
caring for older adults. It is not required for practice in any setting across the continuum
of care, and it is not exclusive to nursing attendants with Baccalaureate degrees. There is
both a generalist and a specialist gerontological nursing certification. The generalist
functions in a variety of settings providing care to older adults and their families. The
specialist has advanced gerontological education at a master’s level.
DIF: Cognitive Level: Understanding
TOPIC: Integrated Process: Communication and Documentation
MSC: Patient Needs: Management of Care
3. The major goal of the NICHE (Nursing attendants Improving Care for
Healthsystem Elders) program includes which of the following?
a. Improve outcomes for hospitalized older adults.
b. Increase the number of older adults cared for in hospitals.
c. Increase the number of iatrogenic complications that occur in hospitalized
older adults.
1|Page
, d. Decrease 30-day readmission rates for hospitalized older adults.
ACCURATE ANSWER:-A
REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older
adults. Although option D is a good outcome for hospitalized older adults, it is not one of
the major goals of NICHE, which are broader. Options B and C are not goals that would
improve care for older adults but would be negative outcomes themselves.
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
MULTIPLE RESPONSE
1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on
avoidable readmissions? (Choose all that apply.)
a. Readmission rates for the selected conditions have dropped nationwide.
b. Many hospitals have instituted system-wide interventions to prevent readmissions.
c. Hospitals are keeping hospital patients longer to avoid readmissions.
d. Potentially avoidable hospitalizations among nursing home residents is increasing.
e. Hospitals have a financial incentive to develop programs to reduce readmissions.
ACCURATE ANSWER:-A, B, E
REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was
established as a provision in the Affordable Care Act (ACA) requiring Medicare to reduce
payments to hospitals with relatively high readmission rates for selected conditions for
hospital patients in traditional Medicare. Since the HRRP, readmission rates for the
selected conditions have dropped nationwide but estimates are that in 2018, about 80%
of hospitals evaluated by CMS will face penalties totaling $564 million (Advisory Board,
2017). Additionally, the HRRP has been the impetus for many hospitals to institute
system-wide interventions to prevent readmissions that have also contributed to the
decline in readmission rates. The rate of potentially avoidable hospitalizations among
SNF residents has fallen by nearly a third in recent years as a result of many quality
improvement initiatives.
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
2. Which of the following are true statements about the current health care workforce?
(Choose all that apply.)
a. Approximately 10% of registered nursing attendants (RNs) are
certified in gerontological nursing.
b. The number of geriatricians is expected to increase about 50% over the
next 25 years.
c. The professions of social work, physical therapy, and psychiatry are
demonstrating the same trends as nursing.
d. The world’s older population is expected to grow to at least 1.3 billion in the
next 20 years.
e. It is anticipated that there will be a need for approximately 3million
additional direct care and professional health care workers by the year
2030.
ACCURATE ANSWER:-C, D, E
2|Page
, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing.
Geriatric medicine faces similar challenges with about 7000 prepared geriatricians, 1 for
every 2546 older Americans; and this number is falling with the trend predicted to be
less than 5000 by 2040 (IOM, 2008). By 2040 the number of older adults in the world
will be at least 1.3 billion. Other professions such as social work, physical therapy, and
psychiatry have similar shortages. It is estimated that by 2030 nearly 3 million
additional health care professionals and direct care workers will be needed to meet the
care needs of a growing older adult population. Healthy People 2030 has addressed this
concern..
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
3. Best practice recommendations for nursing education in relation to gerontology include
which of the following? (Choose all that apply.)
a. Provision of a “stand-alone” course in gerontological nursing
b. Integration of gerontological content throughout the curriculum
c. Replacement of acute care pediatric clinical experiences with
gerontological clinical experiences
d. Recruitment of nursing attendants with Master and Doctoral degrees
and a specialty in gerontology to faculty roles
e. Requiring all undergraduate nursing students to obtain gerontological
certification as a requirement for graduation
ACCURATE ANSWER:-A, B, D
REASONING:->>>Best practices include providing a stand-alone gerontological nursing
course as well as integrating gerontology throughout the curriculum. Recruitment of
nursing attendants with a specialty in gerontology and a Master or Doctoral degree to
faculty roles is a critical step in making sure that the next generation of nursing
attendants is prepared to care for older adults. Best practices do not recommend
removing pediatric clinical experiences and replacing them with gerontological
experiences. Nursing certification is only available to practicing nursing attendants who
meet specific education and practice requirements. It is not applicable to nursing
students.
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
4. What are the current initiatives being implemented to enhance the specialty of
gerontological nursing? (Choose all that apply.)
a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care
for older adults
b. Geriatric Nursing Leadership Academy (GNLA) project
c. Promotion of geriatric nursing to excellence to the nursing community
d. Requiring a nursing certification specifically required to long-term care
e. Offering scholarships for study and research in geriatric nursing
ACCURATE ANSWER:-B, C, E
3|Page
Toward Healthy Aging: Human Needs and Nursing Response
THERIS A. TOUHY, KATHLEEN F. JETT
11th Edition
,Chapter 01: Gerontological Nursing Across the Continuum of
Care Touhy: Toward Healthy Aging, 11th Edition
MULTIPLE CHOICE
1. When did serious and well-controlled research studies on aging first become available?
a. Only in the past 60 years.
b. Since the turn of the 20th century.
c. Following the Great Depression.
d. Since the year 2000.
ACCURATE ANSWER:- A
REASONING:->>>Only in the past 60 years have serious and carefully controlled
research studies flourished. Before that, anecdotal evidence was used to illustrate issues
assumed to be universal, making all the remaining options incorrect.
DIF: Cognitive Level: Remembering TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
2. The son of a nursing home resident asks a nursing attendant: “What is the significance
of being certified in gerontology? I see that you are, but not all of the nursing
attendants are.” What response best answers the family member’s question?
a. “National certification as a gerontological nursing attendant is a
way to demonstrate special knowledge in caring for older adults.”
b. “National certification in gerontology is required for all nursing attendants
who have worked in this setting for 2 or more years.”
c. “National certification is only available to nursing attendants who
have a Baccalaureate degree in nursing.”
d. “Only advanced practice nursing attendants, like nursing
attendant practitioners, are certified in gerontology.”
ACCURATE ANSWER:- A
REASONING:->>>National certification is a way to demonstrate special expertise in
caring for older adults. It is not required for practice in any setting across the continuum
of care, and it is not exclusive to nursing attendants with Baccalaureate degrees. There is
both a generalist and a specialist gerontological nursing certification. The generalist
functions in a variety of settings providing care to older adults and their families. The
specialist has advanced gerontological education at a master’s level.
DIF: Cognitive Level: Understanding
TOPIC: Integrated Process: Communication and Documentation
MSC: Patient Needs: Management of Care
3. The major goal of the NICHE (Nursing attendants Improving Care for
Healthsystem Elders) program includes which of the following?
a. Improve outcomes for hospitalized older adults.
b. Increase the number of older adults cared for in hospitals.
c. Increase the number of iatrogenic complications that occur in hospitalized
older adults.
1|Page
, d. Decrease 30-day readmission rates for hospitalized older adults.
ACCURATE ANSWER:-A
REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older
adults. Although option D is a good outcome for hospitalized older adults, it is not one of
the major goals of NICHE, which are broader. Options B and C are not goals that would
improve care for older adults but would be negative outcomes themselves.
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
MULTIPLE RESPONSE
1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on
avoidable readmissions? (Choose all that apply.)
a. Readmission rates for the selected conditions have dropped nationwide.
b. Many hospitals have instituted system-wide interventions to prevent readmissions.
c. Hospitals are keeping hospital patients longer to avoid readmissions.
d. Potentially avoidable hospitalizations among nursing home residents is increasing.
e. Hospitals have a financial incentive to develop programs to reduce readmissions.
ACCURATE ANSWER:-A, B, E
REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was
established as a provision in the Affordable Care Act (ACA) requiring Medicare to reduce
payments to hospitals with relatively high readmission rates for selected conditions for
hospital patients in traditional Medicare. Since the HRRP, readmission rates for the
selected conditions have dropped nationwide but estimates are that in 2018, about 80%
of hospitals evaluated by CMS will face penalties totaling $564 million (Advisory Board,
2017). Additionally, the HRRP has been the impetus for many hospitals to institute
system-wide interventions to prevent readmissions that have also contributed to the
decline in readmission rates. The rate of potentially avoidable hospitalizations among
SNF residents has fallen by nearly a third in recent years as a result of many quality
improvement initiatives.
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
2. Which of the following are true statements about the current health care workforce?
(Choose all that apply.)
a. Approximately 10% of registered nursing attendants (RNs) are
certified in gerontological nursing.
b. The number of geriatricians is expected to increase about 50% over the
next 25 years.
c. The professions of social work, physical therapy, and psychiatry are
demonstrating the same trends as nursing.
d. The world’s older population is expected to grow to at least 1.3 billion in the
next 20 years.
e. It is anticipated that there will be a need for approximately 3million
additional direct care and professional health care workers by the year
2030.
ACCURATE ANSWER:-C, D, E
2|Page
, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing.
Geriatric medicine faces similar challenges with about 7000 prepared geriatricians, 1 for
every 2546 older Americans; and this number is falling with the trend predicted to be
less than 5000 by 2040 (IOM, 2008). By 2040 the number of older adults in the world
will be at least 1.3 billion. Other professions such as social work, physical therapy, and
psychiatry have similar shortages. It is estimated that by 2030 nearly 3 million
additional health care professionals and direct care workers will be needed to meet the
care needs of a growing older adult population. Healthy People 2030 has addressed this
concern..
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
3. Best practice recommendations for nursing education in relation to gerontology include
which of the following? (Choose all that apply.)
a. Provision of a “stand-alone” course in gerontological nursing
b. Integration of gerontological content throughout the curriculum
c. Replacement of acute care pediatric clinical experiences with
gerontological clinical experiences
d. Recruitment of nursing attendants with Master and Doctoral degrees
and a specialty in gerontology to faculty roles
e. Requiring all undergraduate nursing students to obtain gerontological
certification as a requirement for graduation
ACCURATE ANSWER:-A, B, D
REASONING:->>>Best practices include providing a stand-alone gerontological nursing
course as well as integrating gerontology throughout the curriculum. Recruitment of
nursing attendants with a specialty in gerontology and a Master or Doctoral degree to
faculty roles is a critical step in making sure that the next generation of nursing
attendants is prepared to care for older adults. Best practices do not recommend
removing pediatric clinical experiences and replacing them with gerontological
experiences. Nursing certification is only available to practicing nursing attendants who
meet specific education and practice requirements. It is not applicable to nursing
students.
DIF: Cognitive Level: Understanding TOPIC: Integrated Process:
Teaching/Learning MSC: Patient Needs: Health Promotion and
Maintenance
4. What are the current initiatives being implemented to enhance the specialty of
gerontological nursing? (Choose all that apply.)
a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care
for older adults
b. Geriatric Nursing Leadership Academy (GNLA) project
c. Promotion of geriatric nursing to excellence to the nursing community
d. Requiring a nursing certification specifically required to long-term care
e. Offering scholarships for study and research in geriatric nursing
ACCURATE ANSWER:-B, C, E
3|Page
