TEST BANK FOR HAM’S PRIMARY CARE
GERIATRICS: A CASE-BASED APPROACH
7TH EDITION BY RICHARD J. HAM :ISBN-
10; 0323721680/ISBN-13; 978-0323721684
,Chapter 1. Principles of Primary Care of Older Adults
MULTIPLE CHOICE
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.
The nurse would use these standards to:
a. promote the practice of gerontologic nursing within the acute care setting.
b. define the concepts and dimensions of gerontologic nursing practice.
c. elevate the practice of gerontologic nursing.
d. incorporate suggested interventions from others who practice gerontologic nursing.
ANS: D
The current publishing of the Standards and Scope of Gerontological Nursing Practice in 2010
incorporates the input of gerontologic nurses from across the United States. It was not intended
to promote gerontologic nursing practice within acute care settings, define concepts or
dimensions of gerontologic nursing practice, or elevate the practice of gerontologic nursing.
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 1-1
TOP: N/A MSC: Safe and Effective Care Environment
2. When attempting to minimize the effect of ageism on the practice of nursing older adults, a
nurse needs to first:
a. recognize that nurses must act as advocates for aging patients.
b. accept that this population represents a substantial portion of those requiring nursing care.
c. self-reflect and formulate ones personal view of aging and the older patient.
d. recognize ageism as a form of bigotry shared by many Americans.
ANS: C
Ageism is an ever-increasing prejudicial view of the effects of the aging process and of the older
population as a whole. With nurses being members of a society holding such views, it is critical
that the individual nurse self-reflect on personal feelings and determine whether such feelings
will affect the nursing care that he or she provides to the aging patient. Acting as an advocate is
an important nursing role in all settings. Simply accepting a fact does not help end ageism, nor
does recognizing ageism as a form of bigotry.
DIF: Applying (Application) REF: N/A OBJ: 1-9
TOP: Teaching-Learning MSC: Safe and Effective Care Environment
3. When discussing factors that have helped to increase the number of healthy, independent older
Americans, the nurse includes the importance of:
a. increased availability of in-home care services.
b. government support of retired citizens.
c. effective antibiotic therapies.
d. the development of life-extending therapies.
,ANS: C
The health and ultimate autonomy of older Americans has been positively impacted by the
development of antibiotics, better sanitation, and vaccines. These public health measures have
been more instrumental in increasing the numbers of healthy, independent older Americans than
have in-home care services, government programs, or life-extending therapies.
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
4. Based on current data, when presenting an older adults discharge teaching plan, the nurse
includes the patients:
a. nonrelated caretaker.
b. paid caregiver.
c. family member.
d. intuitional representative.
ANS: C
Less than 4% of older adults live in a formal health care environment. The majority of the
geriatric population lives at home or with family members.
DIF: Applying (Application) REF: N/A OBJ: 3-3
TOP: Nursing Process: Planning MSC: Safe and Effective Care Environment
5. The nurse planning care for an older adult who has recently been diagnosed with rheumatoid
arthritis views the priority criterion for continued independence to be the patients:
a. age.
b. financial status.
c. gender.
d. functional status.
ANS: D
Maintaining the functional status of older adults may avert the onset of physical frailty and
cognitive impairment, two conditions that increase the likelihood of institutionalization.
DIF: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
TOP: Nursing Process: Planning MSC: Physiologic Integrity
6. A nurse working with the older adult population is most likely to assess a need for a financial
social services referral for a(n):
a. white male.
b. black female.
c. Hispanic male.
d. Asian American female.
ANS: B
The poverty rate among older black women is substantially higher than that seen among males or
females of other ethnic groups. White males had the least poverty.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
, 7. Which of the following statements made by a nurse preparing to complete a health assessment
and history on an older patient reflects an understanding of the general health status of this
population?
a. Ill need to document well regarding the medications the patient is currently prescribed.
b. I would like to understand how supportive the patients family members are.
c. Most older patients are being treated for a variety of chronic health care issues.
d. It will be interesting to see whether this patient sees herself as being healthy.
ANS: D
It is a misconception that old age is synonymous with disease and illness. The nurse should
always determine the patients sense of wellness and independence when conducting a health and
history assessment. An assessment of medication use and family support is important for any
patient. Many older adults do have chronic health conditions, but their perception is more
important than a single number.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Health Promotion
8. The nurse is caring for an older adult who has been admitted to an acute care hospital for
treatment of a fractured femur. The family expresses concern about the patients pending transfer
to a subacute care facility. What response by the nurse is best?
a. Acute care facilities lack the long-term physical therapy support your dad requires.
b. Your dad will be much happier in a more serene, private environment.
c. The subacute facility will focus on helping your dad maintain his independence.
d. Insurance, including Medicare, will cover only a limited amount of time here.
ANS: C
The transfer of the patient to a subacute facility is based on the need to maintain the patients
level of function and independence, a task the acute care facility is not prepared to address once
the patient is physiologically stable. The patient may or may not be happier in the new setting;
the nurse should not make this judgment. It is true that insurance only pays for a limited amount
of time in an acute care facility, but this is not the best reason for the patient to transfer.
DIF: Applying (Application) REF: N/A OBJ: 1-6
TOP: Communication and Documentation
MSC: Health Promotion and Maintenance
9. To best assure both the quality of care and the safety of the older adult patient who requires in-
home unlicensed assistive personal (UAP) assistance, the geriatric nurse:
a. evaluates the competency of the UAP staff.
b. assumes the roles of case manager and patient advocate.
c. arranges for the needed UAP provided services.
d. assesses the patient for functional limitations.
ANS: A
As more care traditionally provided by professional nurses is being transferred to UAP, the nurse
must assume more responsibility for educating, training, and evaluating the competency of UAP
staff to provide safe, effective care for the older adult patient.
DIF: Applying (Application) REF: N/A OBJ: 1-2
GERIATRICS: A CASE-BASED APPROACH
7TH EDITION BY RICHARD J. HAM :ISBN-
10; 0323721680/ISBN-13; 978-0323721684
,Chapter 1. Principles of Primary Care of Older Adults
MULTIPLE CHOICE
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.
The nurse would use these standards to:
a. promote the practice of gerontologic nursing within the acute care setting.
b. define the concepts and dimensions of gerontologic nursing practice.
c. elevate the practice of gerontologic nursing.
d. incorporate suggested interventions from others who practice gerontologic nursing.
ANS: D
The current publishing of the Standards and Scope of Gerontological Nursing Practice in 2010
incorporates the input of gerontologic nurses from across the United States. It was not intended
to promote gerontologic nursing practice within acute care settings, define concepts or
dimensions of gerontologic nursing practice, or elevate the practice of gerontologic nursing.
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 1-1
TOP: N/A MSC: Safe and Effective Care Environment
2. When attempting to minimize the effect of ageism on the practice of nursing older adults, a
nurse needs to first:
a. recognize that nurses must act as advocates for aging patients.
b. accept that this population represents a substantial portion of those requiring nursing care.
c. self-reflect and formulate ones personal view of aging and the older patient.
d. recognize ageism as a form of bigotry shared by many Americans.
ANS: C
Ageism is an ever-increasing prejudicial view of the effects of the aging process and of the older
population as a whole. With nurses being members of a society holding such views, it is critical
that the individual nurse self-reflect on personal feelings and determine whether such feelings
will affect the nursing care that he or she provides to the aging patient. Acting as an advocate is
an important nursing role in all settings. Simply accepting a fact does not help end ageism, nor
does recognizing ageism as a form of bigotry.
DIF: Applying (Application) REF: N/A OBJ: 1-9
TOP: Teaching-Learning MSC: Safe and Effective Care Environment
3. When discussing factors that have helped to increase the number of healthy, independent older
Americans, the nurse includes the importance of:
a. increased availability of in-home care services.
b. government support of retired citizens.
c. effective antibiotic therapies.
d. the development of life-extending therapies.
,ANS: C
The health and ultimate autonomy of older Americans has been positively impacted by the
development of antibiotics, better sanitation, and vaccines. These public health measures have
been more instrumental in increasing the numbers of healthy, independent older Americans than
have in-home care services, government programs, or life-extending therapies.
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
4. Based on current data, when presenting an older adults discharge teaching plan, the nurse
includes the patients:
a. nonrelated caretaker.
b. paid caregiver.
c. family member.
d. intuitional representative.
ANS: C
Less than 4% of older adults live in a formal health care environment. The majority of the
geriatric population lives at home or with family members.
DIF: Applying (Application) REF: N/A OBJ: 3-3
TOP: Nursing Process: Planning MSC: Safe and Effective Care Environment
5. The nurse planning care for an older adult who has recently been diagnosed with rheumatoid
arthritis views the priority criterion for continued independence to be the patients:
a. age.
b. financial status.
c. gender.
d. functional status.
ANS: D
Maintaining the functional status of older adults may avert the onset of physical frailty and
cognitive impairment, two conditions that increase the likelihood of institutionalization.
DIF: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
TOP: Nursing Process: Planning MSC: Physiologic Integrity
6. A nurse working with the older adult population is most likely to assess a need for a financial
social services referral for a(n):
a. white male.
b. black female.
c. Hispanic male.
d. Asian American female.
ANS: B
The poverty rate among older black women is substantially higher than that seen among males or
females of other ethnic groups. White males had the least poverty.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
, 7. Which of the following statements made by a nurse preparing to complete a health assessment
and history on an older patient reflects an understanding of the general health status of this
population?
a. Ill need to document well regarding the medications the patient is currently prescribed.
b. I would like to understand how supportive the patients family members are.
c. Most older patients are being treated for a variety of chronic health care issues.
d. It will be interesting to see whether this patient sees herself as being healthy.
ANS: D
It is a misconception that old age is synonymous with disease and illness. The nurse should
always determine the patients sense of wellness and independence when conducting a health and
history assessment. An assessment of medication use and family support is important for any
patient. Many older adults do have chronic health conditions, but their perception is more
important than a single number.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Health Promotion
8. The nurse is caring for an older adult who has been admitted to an acute care hospital for
treatment of a fractured femur. The family expresses concern about the patients pending transfer
to a subacute care facility. What response by the nurse is best?
a. Acute care facilities lack the long-term physical therapy support your dad requires.
b. Your dad will be much happier in a more serene, private environment.
c. The subacute facility will focus on helping your dad maintain his independence.
d. Insurance, including Medicare, will cover only a limited amount of time here.
ANS: C
The transfer of the patient to a subacute facility is based on the need to maintain the patients
level of function and independence, a task the acute care facility is not prepared to address once
the patient is physiologically stable. The patient may or may not be happier in the new setting;
the nurse should not make this judgment. It is true that insurance only pays for a limited amount
of time in an acute care facility, but this is not the best reason for the patient to transfer.
DIF: Applying (Application) REF: N/A OBJ: 1-6
TOP: Communication and Documentation
MSC: Health Promotion and Maintenance
9. To best assure both the quality of care and the safety of the older adult patient who requires in-
home unlicensed assistive personal (UAP) assistance, the geriatric nurse:
a. evaluates the competency of the UAP staff.
b. assumes the roles of case manager and patient advocate.
c. arranges for the needed UAP provided services.
d. assesses the patient for functional limitations.
ANS: A
As more care traditionally provided by professional nurses is being transferred to UAP, the nurse
must assume more responsibility for educating, training, and evaluating the competency of UAP
staff to provide safe, effective care for the older adult patient.
DIF: Applying (Application) REF: N/A OBJ: 1-2
