Toward Healthy Aging: Human Needs and Nursing Response, 11th Edition by Theris A. Touhy & Kathleen F. Jett | All Chapters 1–35 | Practice Questions & Verified Answers

Toward Healthy Aging: Human Needs and
Nursing Response, 11th Edition by Theris A.
Touhy & Kathleen F. Jett | All Chapters 1–35 |
Practice Questions & Verified Answers

,Chapter 01: Gerontological Nursing Across the Continuum of Care
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Touhy: Toward Healthy Aging, 11th Edition
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MULTIPLE CHOICE q




1. When did serious and well-controlled research studies on aging first become available?
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a. Only in the past 60 years. q q q q q




b. Since the turn of the 20th century. q q q q q q




c. Following the Great Depression. q q q




d. Since the year 2000. q q q




ACCURATE ANSWER:- q




A
REASONING:->>>Only in the past 60 years have serious and carefully controlled research q q q q q q q q q q q




studies flourished. Before that, anecdotal evidence was used to illustrate issues assumed to be
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universal, making all the remaining options incorrect.
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DIF: Cognitive Level: Remembering TOPIC: Integrated Process: q q q q




Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
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2. The son of a nursing home resident asks a nursing attendant: “What is the significance of being
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certified in gerontology? I see that you are, but not all of the nursing attendants are.” What
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response best answers the family member’s question?
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a. “National certification as a gerontological nursing attendant is a way to q q q q q q q q q q




demonstrate special knowledge in caring for older adults.”
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b. “National certification in gerontology is required for all nursing attendants who have q q q q q q q q q q q




worked in this setting for 2 or more years.”
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c. “National certification is only available to nursing attendants who have a q q q q q q q q q q




Baccalaureate degree in nursing.”
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d. “Only advanced practice nursing attendants, like nursing attendant
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practitioners, are certified in gerontology.”
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ACCURATE ANSWER:- q




A
REASONING:->>>National certification is a way to demonstrate special expertise in caring for q q q q q q q q q q q




older adults. It is not required for practice in any setting across the continuum of care, and it is not
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exclusive to nursing attendants with Baccalaureate degrees. There is both a generalist and a
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specialist gerontological nursing certification. The generalist functions in a variety of settings
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providing care to older adults and their families. The specialist has advanced gerontological
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education at a master’s level.
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DIF: Cognitive Level: Understanding q q




TOPIC: Integrated Process: Communication and Documentation
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MSC: Patient Needs: Management of Care
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3. The major goal of the NICHE (Nursing attendants Improving Care for Healthsystem Elders)
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program includes which of the following?
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a. Improve outcomes for hospitalized older adults. q q q q q




b. Increase the number of older adults cared for in hospitals. q q q q q q q q q




c. Increase the number of iatrogenic complications that occur in hospitalized older q q q q q q q q q q




adults. q

, d. Decrease 30-day readmission rates for hospitalized older adults. q q q q q q q




ACCURATE ANSWER:-A q




REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older adults. q q q q q q q q q q q




Although option D is a good outcome for hospitalized older adults, it is not one of the major goals
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of NICHE, which are broader. Options B and C are not goals that would improve care for older
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adults but would be negative outcomes themselves.
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: q q q q




Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
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MULTIPLE RESPONSE q




1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on avoidable
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readmissions? (Choose all that apply.)
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a. Readmission rates for the selected conditions have dropped nationwide. q q q q q q q q




b. Many hospitals have instituted system-wide interventions to prevent readmissions.
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c. Hospitals are keeping hospital patients longer to avoid readmissions. q q q q q q q q




d. Potentially avoidable hospitalizations among nursing home residents is increasing. q q q q q q q q




e. Hospitals have a financial incentive to develop programs to reduce readmissions. q q q q q q q q q q




ACCURATE ANSWER:-A, B, E q q q




REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was established as a q q q q q q q q q




provision in the Affordable Care Act (ACA) requiring Medicare to reduce payments to hospitals
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with relatively high readmission rates for selected conditions for hospital patients in traditional
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Medicare. Since the HRRP, readmission rates for the selected conditions have dropped
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nationwide but estimates are that in 2018, about 80% of hospitals evaluated by CMS will face
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penalties totaling $564 million (Advisory Board, 2017). Additionally, the HRRP has been the
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impetus for many hospitals to institute system-wide interventions to prevent readmissions that
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have also contributed to the decline in readmission rates. The rate of potentially avoidable
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hospitalizations among SNF residents has fallen by nearly a third in recent years as a result of many
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quality improvement initiatives.
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: q q q q




Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
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2. Which of the following are true statements about the current health care workforce? (Choose all
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q that apply.)
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a. Approximately 10% of registered nursing attendants (RNs) are certified in q q q q q q q q q




gerontological nursing.
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b. The number of geriatricians is expected to increase about 50% over the next 25
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q years.
c. The professions of social work, physical therapy, and psychiatry are demonstrating the
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q same trends as nursing. q q q




d. The world’s older population is expected to grow to at least 1.3 billion in the next 20
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q years.
e. It is anticipated that there will be a need for approximately 3million additional
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q direct care and professional health care workers by the year 2030.
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ACCURATE ANSWER:-C, D, E q q q

, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing. Geriatric q q q q q q q q q q




medicine faces similar challenges with about 7000 prepared geriatricians, 1 for every 2546 older
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Americans; and this number is falling with the trend predicted to be less than 5000 by 2040 (IOM,
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2008). By 2040 the number of older adults in the world will be at least 1.3 billion. Other
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professions such as social work, physical therapy, and psychiatry have similar shortages. It is
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estimated that by 2030 nearly 3 million additional health care professionals and direct care
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workers will be needed to meet the care needs of a growing older adult population. Healthy People
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2030 has addressed this concern..
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: q q q q




Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
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3. Best practice recommendations for nursing education in relation to gerontology include which of
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the following? (Choose all that apply.)
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a. Provision of a “stand-alone” course in gerontological nursing q q q q q q q




b. Integration of gerontological content throughout the curriculum q q q q q q




c. Replacement of acute care pediatric clinical experiences with gerontological q q q q q q q q




clinical experiences
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d. Recruitment of nursing attendants with Master and Doctoral degrees and a q q q q q q q q q q




specialty in gerontology to faculty roles
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e. Requiring all undergraduate nursing students to obtain gerontological certification as q q q q q q q q q




a requirement for graduation
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ACCURATE ANSWER:-A, B, D q q q




REASONING:->>>Best practices include providing a stand-alone gerontological nursing q q q q q q q




course as well as integrating gerontology throughout the curriculum. Recruitment of nursing
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attendants with a specialty in gerontology and a Master or Doctoral degree to faculty roles is a
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critical step in making sure that the next generation of nursing attendants is prepared to care for
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older adults. Best practices do not recommend removing pediatric clinical experiences and
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replacing them with gerontological experiences. Nursing certification is only available to
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practicing nursing attendants who meet specific education and practice requirements. It is not
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applicable to nursing students.
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: q q q q




Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
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4. What are the current initiatives being implemented to enhance the specialty of gerontological
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q nursing? (Choose all that apply.) q q q q




a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care for q q q q q q q q q q q q q q




older adults
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b. Geriatric Nursing Leadership Academy (GNLA) project q q q q q




c. Promotion of geriatric nursing to excellence to the nursing community q q q q q q q q q




d. Requiring a nursing certification specifically required to long-term care q q q q q q q q




e. Offering scholarships for study and research in geriatric nursing q q q q q q q q




ACCURATE ANSWER:-B, C, E q q q