TOWARD HEALTH AGING: Human Needs and
in in in in in
Nursing Responses 11TH EDITION/ALL
in in in in
CHAPTERS 1-35
in in
,Chapter 01: Gerontological Nursing Across the Continuum of Care
in in in in in in in in
Touhy: Toward Healthy Aging, 11th Edition
in in in in in in
MULTIPLE CHOICE in
1. When did serious and well-controlled research studies on aging first become available?
in in in in in in in in in in in
a. Only in the past 60 years. in in in in in
b. Since the turn of the 20th century. in in in in in in
c. Following the Great Depression. in in in
d. Since the year 2000. in in in
ACCURATE ANSWER:- in
A
REASONING:->>>Only in the past 60 years have serious and carefully controlled research in in in in in in in in in in in
studies flourished. Before that, anecdotal evidence was used to illustrate issues assumed to be
in in in in in in in in in in in in in in
universal, making all the remaining options incorrect.
in in in in in in in
DIF: Cognitive Level: Remembering TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
2. The son of a nursing home resident asks a nursing attendant: ―What is the significance of
in in in in in in in in in in in in in in in
being certified in gerontology? I see that you are, but not all of the nursing attendants are.‖
in in in in in in in in in in in in in in in in in
What response best answers the family member‘s question?
in in in in in in in in
a. ―National certification as a gerontological nursing attendant is a way to in in in in in in in in in in
demonstrate special knowledge in caring for older adults.‖
in in in in in in in in
b. ―National certification in gerontology is required for all nursing attendants who in in in in in in in in in in
have worked in this setting for 2 or more years.‖
in in in in in in in in in in
c. ―National certification is only available to nursing attendants who have a in in in in in in in in in in
Baccalaureate degree in nursing.‖
in in in in
d. ―Only advanced practice nursing attendants, like nursing attendant
in in in in in in in
practitioners, are certified in gerontology.‖
in in in in in
ACCURATE ANSWER:- in
A
REASONING:->>>National certification is a way to demonstrate special expertise in caring in in in in in in in in in in
for older adults. It is not required for practice in any setting across the continuum of care, and
in in in in in in in in in in in in in in in in in in
it is not exclusive to nursing attendants with Baccalaureate degrees. There is both a generalist
in in in in in in in in in in in in in in in
and a specialist gerontological nursing certification. The generalist functions in a variety of
in in in in in in in in in in in in in
settings providing care to older adults and their families. The specialist has advanced
in in in in in in in in in in in in in
gerontological education at a master‘s level.
in in in in in in
DIF: Cognitive Level: Understanding in in
TOPIC: Integrated Process: Communication and Documentation
i n in in in in
MSC: Patient Needs: Management of Care
in i n in in in in
3. The major goal of the NICHE (Nursing attendants Improving Care for Healthsystem
in in in in in in in in in in in
Elders) program includes which of the following?
in in in in in in in
a. Improve outcomes for hospitalized older adults. in in in in in
b. Increase the number of older adults cared for in hospitals. in in in in in in in in in
c. Increase the number of iatrogenic complications that occur in hospitalized older
in in in in in in in in in in
adults. in
, d. Decrease 30-day readmission rates for hospitalized older adults. in in in in in in in
ACCURATE ANSWER:-A in
REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older adults. in in in in in in in in in in in
Although option D is a good outcome for hospitalized older adults, it is not one of the major
in in in in in in in in in in in in in in in in in in
goals of NICHE, which are broader. Options B and C are not goals that would improve care
in in in in in in in in in in in in in in in in in
for older adults but would be negative outcomes themselves.
in in in in in in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
MULTIPLE RESPONSE in
1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on avoidable
in in in in in in in in in in in in
readmissions? (Choose all that apply.)
in in in in in
a. Readmission rates for the selected conditions have dropped nationwide. in in in in in in in in
b. Many hospitals have instituted system-wide interventions to prevent readmissions.
in in in in in in in in
c. Hospitals are keeping hospital patients longer to avoid readmissions. in in in in in in in in
d. Potentially avoidable hospitalizations among nursing home residents is increasing. in in in in in in in in
e. Hospitals have a financial incentive to develop programs to reduce readmissions.
in in in in in in in in in in
ACCURATE ANSWER:-A, B, E in in in
REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was established in in in in in in in
as a provision in the Affordable Care Act (ACA) requiring Medicare to reduce payments to
in in in in in in in in in in in in in in in
hospitals with relatively high readmission rates for selected conditions for hospital patients in
in in in in in in in in in in in in in
traditional Medicare. Since the HRRP, readmission rates for the selected conditions have
in in in in in in in in in in in in
dropped nationwide but estimates are that in 2018, about 80% of hospitals evaluated by CMS
in in in in in in in in in in in in in in in
will face penalties totaling $564 million (Advisory Board, 2017). Additionally, the HRRP
in in in in in in in in in in in in
has been the impetus for many hospitals to institute system-wide interventions to prevent
in in in in in in in in in in in in in
readmissions that have also contributed to the decline in readmission rates. The rate of
in in in in in in in in in in in in in in
potentially avoidable hospitalizations among SNF residents has fallen by nearly a third in
in in in in in in in in in in in in in
recent years as a result of many quality improvement initiatives.
in in in in in in in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
2. Which of the following are true statements about the current health care workforce? (Choose
in in in in in in in in in in in in in
in all that apply.)
in in
a. Approximately 10% of registered nursing attendants (RNs) are certified in in in in in in in in in in
in gerontological nursing. in
b. The number of geriatricians is expected to increase about 50% over the next 25
in in in in in in in in in in in in in
in years.
c. The professions of social work, physical therapy, and psychiatry are demonstrating
in in in in in in in in in in
in the same trends as nursing.
in in in in
d. The world‘s older population is expected to grow to at least 1.3 billion in the next
in in in in in in in in in in in in in in in
20 years.in in
e. It is anticipated that there will be a need for approximately 3million additional
in in in in in in in in in in in in
direct care and professional health care workers by the year 2030.
in in in in in in in in in in in
ACCURATE ANSWER:-C, D, E in in in
, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing. Geriatric in in in in in in in in in in
medicine faces similar challenges with about 7000 prepared geriatricians, 1 for every 2546
in in in in in in in in in in in in in
older Americans; and this number is falling with the trend predicted to be less than 5000 by
in in in in in in in in in in in in in in in in in
2040 (IOM, 2008). By 2040 the number of older adults in the world will be at least 1.3
in in in in in in in in in in in in in in in in in in
billion. Other professions such as social work, physical therapy, and psychiatry have similar
in in in in in in in in in in in in in
shortages. It is estimated that by 2030 nearly 3 million additional health care professionals
in in in in in in in in in in in in in in
and direct care workers will be needed to meet the care needs of a growing older adult
in in in in in in in in in in in in in in in in in
population. Healthy People 2030 has addressed this concern..
in in in in in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
3. Best practice recommendations for nursing education in relation to gerontology include which
in in in in in in in in in in in
in of the following? (Choose all that apply.)
in in in in in in
a. Provision of a ―stand-alone‖ course in gerontological nursing in in in in in in in
b. Integration of gerontological content throughout the curriculum in in in in in in
c. Replacement of acute care pediatric clinical experiences with gerontological in in in in in in in in
in clinical experiences in
d. Recruitment of nursing attendants with Master and Doctoral degrees and a in in in in in in in in in in
in specialty in gerontology to faculty roles in in in in in
e. Requiring all undergraduate nursing students to obtain gerontological certification
in in in in in in in in
in as a requirement for graduation
in in in in
ACCURATE ANSWER:-A, B, D in in in
REASONING:->>>Best practices include providing a stand-alone gerontological nursing in in in in in in in
course as well as integrating gerontology throughout the curriculum. Recruitment of nursing
in in in in in in in in in in in in
attendants with a specialty in gerontology and a Master or Doctoral degree to faculty roles is a
in in in in in in in in in in in in in in in in in
critical step in making sure that the next generation of nursing attendants is prepared to care
in in in in in in in in in in in in in in in in
for older adults. Best practices do not recommend removing pediatric clinical experiences
in in in in in in in in in in in in
and replacing them with gerontological experiences. Nursing certification is only available to
in in in in in in in in in in in in
practicing nursing attendants who meet specific education and practice requirements. It is not
in in in in in in in in in in in in in
applicable to nursing students.
in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
4. What are the current initiatives being implemented to enhance the specialty of gerontological
in in in in in in in in in in in in
in nursing? (Choose all that apply.) in in in in
a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care for in in in in in in in in in in in in in in
older adults
in in
b. Geriatric Nursing Leadership Academy (GNLA) project in in in in in
c. Promotion of geriatric nursing to excellence to the nursing communityin in in in in in in in in
d. Requiring a nursing certification specifically required to long-term care
in in in in in in in in
e. Offering scholarships for study and research in geriatric nursing
in in in in in in in in
ACCURATE ANSWER:-B, C, E in in in
in in in in in
Nursing Responses 11TH EDITION/ALL
in in in in
CHAPTERS 1-35
in in
,Chapter 01: Gerontological Nursing Across the Continuum of Care
in in in in in in in in
Touhy: Toward Healthy Aging, 11th Edition
in in in in in in
MULTIPLE CHOICE in
1. When did serious and well-controlled research studies on aging first become available?
in in in in in in in in in in in
a. Only in the past 60 years. in in in in in
b. Since the turn of the 20th century. in in in in in in
c. Following the Great Depression. in in in
d. Since the year 2000. in in in
ACCURATE ANSWER:- in
A
REASONING:->>>Only in the past 60 years have serious and carefully controlled research in in in in in in in in in in in
studies flourished. Before that, anecdotal evidence was used to illustrate issues assumed to be
in in in in in in in in in in in in in in
universal, making all the remaining options incorrect.
in in in in in in in
DIF: Cognitive Level: Remembering TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
2. The son of a nursing home resident asks a nursing attendant: ―What is the significance of
in in in in in in in in in in in in in in in
being certified in gerontology? I see that you are, but not all of the nursing attendants are.‖
in in in in in in in in in in in in in in in in in
What response best answers the family member‘s question?
in in in in in in in in
a. ―National certification as a gerontological nursing attendant is a way to in in in in in in in in in in
demonstrate special knowledge in caring for older adults.‖
in in in in in in in in
b. ―National certification in gerontology is required for all nursing attendants who in in in in in in in in in in
have worked in this setting for 2 or more years.‖
in in in in in in in in in in
c. ―National certification is only available to nursing attendants who have a in in in in in in in in in in
Baccalaureate degree in nursing.‖
in in in in
d. ―Only advanced practice nursing attendants, like nursing attendant
in in in in in in in
practitioners, are certified in gerontology.‖
in in in in in
ACCURATE ANSWER:- in
A
REASONING:->>>National certification is a way to demonstrate special expertise in caring in in in in in in in in in in
for older adults. It is not required for practice in any setting across the continuum of care, and
in in in in in in in in in in in in in in in in in in
it is not exclusive to nursing attendants with Baccalaureate degrees. There is both a generalist
in in in in in in in in in in in in in in in
and a specialist gerontological nursing certification. The generalist functions in a variety of
in in in in in in in in in in in in in
settings providing care to older adults and their families. The specialist has advanced
in in in in in in in in in in in in in
gerontological education at a master‘s level.
in in in in in in
DIF: Cognitive Level: Understanding in in
TOPIC: Integrated Process: Communication and Documentation
i n in in in in
MSC: Patient Needs: Management of Care
in i n in in in in
3. The major goal of the NICHE (Nursing attendants Improving Care for Healthsystem
in in in in in in in in in in in
Elders) program includes which of the following?
in in in in in in in
a. Improve outcomes for hospitalized older adults. in in in in in
b. Increase the number of older adults cared for in hospitals. in in in in in in in in in
c. Increase the number of iatrogenic complications that occur in hospitalized older
in in in in in in in in in in
adults. in
, d. Decrease 30-day readmission rates for hospitalized older adults. in in in in in in in
ACCURATE ANSWER:-A in
REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older adults. in in in in in in in in in in in
Although option D is a good outcome for hospitalized older adults, it is not one of the major
in in in in in in in in in in in in in in in in in in
goals of NICHE, which are broader. Options B and C are not goals that would improve care
in in in in in in in in in in in in in in in in in
for older adults but would be negative outcomes themselves.
in in in in in in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
MULTIPLE RESPONSE in
1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on avoidable
in in in in in in in in in in in in
readmissions? (Choose all that apply.)
in in in in in
a. Readmission rates for the selected conditions have dropped nationwide. in in in in in in in in
b. Many hospitals have instituted system-wide interventions to prevent readmissions.
in in in in in in in in
c. Hospitals are keeping hospital patients longer to avoid readmissions. in in in in in in in in
d. Potentially avoidable hospitalizations among nursing home residents is increasing. in in in in in in in in
e. Hospitals have a financial incentive to develop programs to reduce readmissions.
in in in in in in in in in in
ACCURATE ANSWER:-A, B, E in in in
REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was established in in in in in in in
as a provision in the Affordable Care Act (ACA) requiring Medicare to reduce payments to
in in in in in in in in in in in in in in in
hospitals with relatively high readmission rates for selected conditions for hospital patients in
in in in in in in in in in in in in in
traditional Medicare. Since the HRRP, readmission rates for the selected conditions have
in in in in in in in in in in in in
dropped nationwide but estimates are that in 2018, about 80% of hospitals evaluated by CMS
in in in in in in in in in in in in in in in
will face penalties totaling $564 million (Advisory Board, 2017). Additionally, the HRRP
in in in in in in in in in in in in
has been the impetus for many hospitals to institute system-wide interventions to prevent
in in in in in in in in in in in in in
readmissions that have also contributed to the decline in readmission rates. The rate of
in in in in in in in in in in in in in in
potentially avoidable hospitalizations among SNF residents has fallen by nearly a third in
in in in in in in in in in in in in in
recent years as a result of many quality improvement initiatives.
in in in in in in in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
2. Which of the following are true statements about the current health care workforce? (Choose
in in in in in in in in in in in in in
in all that apply.)
in in
a. Approximately 10% of registered nursing attendants (RNs) are certified in in in in in in in in in in
in gerontological nursing. in
b. The number of geriatricians is expected to increase about 50% over the next 25
in in in in in in in in in in in in in
in years.
c. The professions of social work, physical therapy, and psychiatry are demonstrating
in in in in in in in in in in
in the same trends as nursing.
in in in in
d. The world‘s older population is expected to grow to at least 1.3 billion in the next
in in in in in in in in in in in in in in in
20 years.in in
e. It is anticipated that there will be a need for approximately 3million additional
in in in in in in in in in in in in
direct care and professional health care workers by the year 2030.
in in in in in in in in in in in
ACCURATE ANSWER:-C, D, E in in in
, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing. Geriatric in in in in in in in in in in
medicine faces similar challenges with about 7000 prepared geriatricians, 1 for every 2546
in in in in in in in in in in in in in
older Americans; and this number is falling with the trend predicted to be less than 5000 by
in in in in in in in in in in in in in in in in in
2040 (IOM, 2008). By 2040 the number of older adults in the world will be at least 1.3
in in in in in in in in in in in in in in in in in in
billion. Other professions such as social work, physical therapy, and psychiatry have similar
in in in in in in in in in in in in in
shortages. It is estimated that by 2030 nearly 3 million additional health care professionals
in in in in in in in in in in in in in in
and direct care workers will be needed to meet the care needs of a growing older adult
in in in in in in in in in in in in in in in in in
population. Healthy People 2030 has addressed this concern..
in in in in in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
3. Best practice recommendations for nursing education in relation to gerontology include which
in in in in in in in in in in in
in of the following? (Choose all that apply.)
in in in in in in
a. Provision of a ―stand-alone‖ course in gerontological nursing in in in in in in in
b. Integration of gerontological content throughout the curriculum in in in in in in
c. Replacement of acute care pediatric clinical experiences with gerontological in in in in in in in in
in clinical experiences in
d. Recruitment of nursing attendants with Master and Doctoral degrees and a in in in in in in in in in in
in specialty in gerontology to faculty roles in in in in in
e. Requiring all undergraduate nursing students to obtain gerontological certification
in in in in in in in in
in as a requirement for graduation
in in in in
ACCURATE ANSWER:-A, B, D in in in
REASONING:->>>Best practices include providing a stand-alone gerontological nursing in in in in in in in
course as well as integrating gerontology throughout the curriculum. Recruitment of nursing
in in in in in in in in in in in in
attendants with a specialty in gerontology and a Master or Doctoral degree to faculty roles is a
in in in in in in in in in in in in in in in in in
critical step in making sure that the next generation of nursing attendants is prepared to care
in in in in in in in in in in in in in in in in
for older adults. Best practices do not recommend removing pediatric clinical experiences
in in in in in in in in in in in in
and replacing them with gerontological experiences. Nursing certification is only available to
in in in in in in in in in in in in
practicing nursing attendants who meet specific education and practice requirements. It is not
in in in in in in in in in in in in in
applicable to nursing students.
in in in in
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: in in i n in
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
in in i n in in in in in
4. What are the current initiatives being implemented to enhance the specialty of gerontological
in in in in in in in in in in in in
in nursing? (Choose all that apply.) in in in in
a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care for in in in in in in in in in in in in in in
older adults
in in
b. Geriatric Nursing Leadership Academy (GNLA) project in in in in in
c. Promotion of geriatric nursing to excellence to the nursing communityin in in in in in in in in
d. Requiring a nursing certification specifically required to long-term care
in in in in in in in in
e. Offering scholarships for study and research in geriatric nursing
in in in in in in in in
ACCURATE ANSWER:-B, C, E in in in
