TOWARD HEALTH AGING: Human Needs and
Nursing Responses 11TH EDITION/ALL CHAPTERS 1-
35
,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.
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
, 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
Nursing Responses 11TH EDITION/ALL CHAPTERS 1-
35
,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.
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
, 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
