Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 5th Edition
MULTIPLE CHOICE
1. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this
man‘s wellness?
a. Wellness can only be achieved with aggressive medical
interventions.
b. Wellness is not a real option for this client because he
is terminally ill.
c. Wellness is defined as the absence of disease.
d. Nursing interventions can help empower a client to
achieve a higher level of wellness.
ANS: D
Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse can foster wellness in
his or her clients. Wellness is defined by the individual and is multidimensional. It is not just the absence of disease.
A wellness perspective is based on the belief that every person has an optimal level of health independent of his or
her situation or functional level. Even in the presence of chronic illness or while dying, a movement toward wellness
is possible if emphasis of care is placed on the promotion of well-being in a supportive environment.
PTS: 1 DIF: Apply REF: p. 7 TOP: Nursing Process: Diagnosis
MSC: Health Promotion and Maintenance
2. In differentiating between health and wellness in health care, which of the following statements
is true?
a. Health is a broad term encompassing attitudes and
behaviors.
b. The concept of illness prevention was never considered
by previous generations.
c. Wellness and self-actualization develop through learn-
ing and growth.
d. Wellness is impossible when one‘s health is compro-
mised.
ANS: A
Health is a broad term that encompasses attitudes and behaviors; holistically, health includes wellness, which in-
volves one‘s whole being. The concept of illness prevention was never considered by previous generations; through-
out history, basic self-care requirements have been recognized. Wellness and self-actualization develop through
learning and growth—as basic needs are met, higher level needs can be satisfied in turn, with ever-deepening rich-
ness to life. Wellness is possible when one‘s health is compromised—even with chronic illness, with multiple dis-
abilities, or in dying, movement toward a higher level of wellness is possible.
PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation
MSC: Health Promotion and Maintenance
3. Which racial or ethnic group has the highest life expectancy in the United States?
a. Native Americans
b. African Americans
c. Hispanic Americans
d. Asian and Pacific Island Americans
ANS: C
As shown in Figure 1.4, Hispanic men and women have the highest life expectancy of all. In 2011, for those of His-
panic origin of any race, the overall life expectancy at 65 years of age was 20.7 more years in 2011 (19.1 years for
men and 21.8 years for women).
PTS: 1 DIF: Understand REF: p. 6
,TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment
4. Historical influences that have shaped the lives of the majority of the in-between cohort in the
United States today include which of the following?
a. Influenza epidemic of 1918
b. World War I
c. Child rearing in the Depression
d. World War II
ANS: D
Those who are in the in-between cohort in 2016 were born between 1915 and 1945. The men were likely to have
fought in World War II. The last of the Holocaust survivors are in this group. A person who survived the influenza
epidemic would be at least 98 years old in 2016 and therefore would be considered old-old or a centenarian. Most of
those who are of the in-between cohort had not reached childbearing age by the end of the Depression. Individuals
in the in-between cohort would not have been old enough to fight in World War II.
PTS: 1 DIF: Understand REF: p. 5
TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment
5. According to researchers, which characteristic do most centenarians share?
a. Female
b. Hispanic
c. Living in rural areas
d. Located in the Midwestern states
ANS: A
Based on the U.S. census report of 2010, centenarians were overwhelmingly white, female, and living in the urban
areas of the Southern states.
PTS: 1 DIF: Remember REF: p. 5
TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment
6. Which nursing intervention is a holistic approach to an older adult?
a. Performs glucose testing during the weekly worship
service
b. Wheels ambulatory adults to exercise when running
late
c. Assigns female nurses to older women who are Islamic
d. Allows older adults in a nursing home to eat meals
alone
ANS: C
The nurse uses a holistic approach to the care of an older female adult who is Islamic because the woman and her
family are more likely to be willing participants in a therapeutic regimen that respects a tenet of their culture. Inter-
rupting an older adult‘s worship with glucose testing can be interpreted as a lack of respect for spiritual needs. The
nurse can provide for and respect the physical and spiritual aspects of the older adult‘s life by testing for glucose
before the service begins. In transporting ambulatory adults to the exercise program in wheelchairs to save time, the
nurse disregards the need for self-esteem and exercise, both important aspects of physical well-being. Ambulatory
adults can walk with assistance, if needed, to exercise programs and can benefit from the additional activity and
independence. The nurse can be tempted to allow an older adult to eat meals alone in his or her room if this will
motivate the person to eat or if the older adult has dysphasia and is embarrassed. However, although focusing on
physical needs, the nurse ignores psychosocial and other aspects of health and well-being.
PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation
MSC: Health Promotion and Maintenance
, 7. An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL. Which
nursing intervention is most likely to assist this man in achieving his highest level of wellness?
a. Instruct him about increasing dietary fiber.
b. Ask the health care provider for a low-fat diet.
c. Schedule a consultation for him with the dietitian.
d. Review a menu with him to choose suitable foods.
ANS: D
The nurse collaborates with the older adult to choose suitable foods, which is likely to be an effective nursing inter-
vention to help an older adult with hyperlipidemia achieve optimal health and well-being; it gives him some control
over the regimen and thus engages him in the process of lowering serum cholesterol. Informing the older man about
dietary fiber offers no control to him because he is not part of the decision. Nursing interventions developed with the
older adult‘s collaboration are most likely to help the older adult achieve health and wellness. Collaborating with the
health care provider for a low-fat diet is a reasonable approach to help this man with hyperlipidemia to achieve
health and wellness. However, he is more likely to have motivation and enthusiasm for a therapeutic regimen over
which he has had some control. Scheduling a consultation with a dietitian is a reasonable approach to an older adult
with hyperlipidemia and is a part of a multifaceted approach to optimizing his health. However, the older adult is
more likely to engage in a regimen over which he has input.
PTS: 1 DIF: Analyze REF: p. 7 TOP: Nursing Process: Planning
MSC: Health Promotion and Maintenance
8. Which zapproach zrequires zthe znurse zto zintegrate zand zbalance zall zaspects zof zan
zindividual‘s zlife zinto zthe zplan zof zcare?
a. Holistic znursing
b. Healthy zPeople z2020
c. Maslow‘s zhierarchy zof zhuman zneeds
d. Orem‘s zself-care zrequirements
ANS: A
Holistic znursing zintegrates zall zaspects zof zan zindividual‘s zlife zinto zthe zplan zof zcare zby zbalancing zan
zindividual‘s zinter- znal zand zexternal zenvironment z with zpsychosocial, zspiritual, zcultural, zand zphysical
zprocesses. z Healthy zPeople z2020, zan zupdated zdocument zfrom z2000 zthat zoutlines zthe zgoals zfor
zachieving zhealth zin zthis zcountry, zis za zmandate zfor zhealth zcare zprofessionals zto zfollow zwith z467
zobjectives zin z28 zfocus zareas. zMaslow‘s zhierarchy zof zhuman zneeds zprovides za zbasis zfor zunderstanding
zindividuals z in zcontext zand zfor zranking znursing zassessments, zdiagnoses, zgoals, zand zinterventions zin
zorder zof zimportance. zDorothea zOrem‘s zself-care zrequirements zlists zhuman zneeds, zincluding zthe zneed
zfor zair, zfluids, znutrition, zhygiene, zelimination, zactivity, zcomfort, zrelief zfrom zsuffering, zand zskin
zintegrity. zThe znurse zhelps zindividu- zals zmeet zthese zneeds zto zachieve zoptimal zhealth zand zwellness.
PTS: 1 DIF: Remember REF: p. z7
TOP: Nursing zProcess: zAssessment MSC: Safe, zEffective zCare zEnvironment
9. The znurse zplans zactivities z for zolder zwomen zborn zbetween z1920 zand z1930 zand
zwho z reside zin zanzassisted-living zfacility. zWhich zis zthe zbest zintervention zfor zthe znurse zto zimplement?
a. Have zthem zbake zcookies ztwice za zweek.
b. Conduct zinterviews zfor zspecific zinterests.
c. Arrange zdog zand zcat zvisits zfrom zvolunteers.
d. Take zthem zto zthe zlibrary zfor zguest zspeakers.
ANS: B
The znurse zconducts z individual zinterviews z with zthe zwomen zto zdetermine ztheir zinterests zand zto zavoid
zgeneralizing; zas zpeople zlive zlonger, zthey zbecome z more zand zmore zunique. zBecause zmost zof zthese
zwomen zare zin ztheir z80s zand z90s zwere zborn zbetween z1920 zand z1930 zand zhave zgenerally zspent ztheir
zlives z as zhomemakers, zthe znurse zpresumes zto zknow zwhat
, activities zthey zwill zenjoy. zThe znurse zavoids zarranging zgroup zactivities zuntil zindividual zinterests zare
zdetermined. zIn zaddition, zthe znurse zmust zassess zfor zallergies zand zindividual zfears zof zanimals zbefore
zexposing zan zolder zadult zto za zpet zvisit. zUnless zit zis zorganized zon za z voluntary zbasis, zthe znurse zavoids
zarranging z visits zby zguest zspeakers. zIn zaddition, zthe znurse zwill zassess zeach zolder z woman zbefore zan
zoutside z visit zto zavoid zembarrassing zevents, zincluding zincontinence zand zhearing zand zvision zproblems.
PTS: 1 DIF: Analyze REF: p. z5
TOP: Nursing zProcess: zImplementation MSC: Safe, zEffective zCare zEnvironment
10. Which zof zthe zfollowing zissues zin zthe zcare zof zolder zadults zare zidentified zin zHealthy zPeople
z2020?
a. Delineating znursing zstaffing zlevels zin zlong zterm
zcare
b. Eradicating zpressure zulcers zin zall zcare zsettings
c. Identifying zminimum zlevels zof ztraining zfor zpeople
zwhozcare zfor zolder z adults
d. Instituting zmandatory ztraining zin zidentification zof
zelderzabuse zfor zall zcaregivers zof zolder zadults
ANS: C
Identifying zminimum ztraining zlevels zfor zpeople zwho zcare zfor zolder zadults zis zone zof zthe zissues
zidentified zin zHealthy zPeople z2020. zThe zrest zof zthe zissues zare znot zdiscussed zin zHealthy zPeople z2020.
PTS: 1 DIF: Remember REF: p. z8 TOP: Teaching zand
zLearningzMSC: Health zPromotion zand zMaintenance
11. An zolder z man zasks za znurse: z―How zdo zyou zdefine zaging? zDo zI zmeet zthe zcriteria zof
za zsenior zcitizen?‖ zThe znurse z understands z that zone zcan zdefine zaging zin z many zdifferent z manners. zIf
zthe znurse zchooses z to zdefine zaging zas z―social zaging,‖ zthe znurse zwould zconsider zwhich zof zthe
zfollowing zaspects?
a. The zman zretired zfrom zhis zjob zas za zpolice zofficer.
b. The zman ztakes zsix zdifferent zmedications zmultiple
ztimeszover zthe zcourse zof zthe zday.
c. The zman zwalks zwith za zrolling zwalker.
d. The zman zcelebrated zhis z65th zbirthday.
ANS: A
Social zaging zis zdetermined zby zchanges zin zroles. zTaking zmultiple zmedications zmultiple ztimes zover zthe
zcourse zof zthe zday zand zwalking zwith za zrolling zwalker zare zfunctional zdeterminants zof zaging. zAge
zrefers zto zchronological zaging.
PTS: 1 DIF: Understand REF: p. z7
TOP: Nursing zProcess: zAssessment MSC: Health zPromotion zand zMaintenance
12. The zholistic z health zmovement zhas zimpacted zhealth zcare zin zwhich zof zthe zfollowing zways?
a. It zhas zfocused zhealth zcare zon zdisease zprevention.
b. It zhas zreshaped zhow zhealth zand zhealth zcare zare
zper-zceived.
c. It zhas zimproved zaccess zto zhealth zcare.
d. It zhas zintroduced znumerous zalternative zmodalities
zintozhealth zcare.
ANS: B
The zholistic zparadigm zhas zreshaped zhow zhealth zand zhealth zcare zare zperceived. zWellness zis zseen zas za
zstate zof zbeing zwhich zcan zbe zdefined zanywhere zalong zthe zcontinuum zof zhealth.
PTS: 1 DIF: Understand REF: p. z7 TOP: Teaching zand
zLearningzMSC: Health zPromotion zand zMaintenance
MULTIPLE zRESPONSE