,Chapter 01: Gerontological Nursing Across the Continuum of Care
Touhy: Toward Healthy Aging, 11th Edition
MULTIPLEthCHOICE
1. Whenthdidthseriousthandthwell-
controlledthresearchthstudiest h onthagingthfirstthbecomethavailable?
a. Onlythint h thethpastt h 60t h years.
b. Sinceththethturnthofththeth20ththcentury.
c. FollowingththethGreatthDepression.
d. Sincet h thethyeart h 2000.
ACCURATEt
hANSWER:-
A
REASONING:-
>>>Onlythinththethpastth60thyearsthhavethseriousthandthcarefullythcontrolledthresearcht
h studiesthflourished.thBeforeththat,thanecdotalthevidencethwasthusedthtothillustratethissue
sthassumedthtothbet h t h universal,thmakingthallththethremainingthoptionsthincorrect.
DIF:t h CognitivethLevel:thRememberingt h TOPIC:thIntegratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealt
hthPromotionthandthMaintenance
2. Thet h sont h oft h at h nursingt h homet h residentt h askst h at h nursingt h attendant:t h
“Whatt h ist h thet h significancet h oft h t h beingt h certifiedt h int h gerontology?t h It h seet h th
att h yout h are,t h butt h notthallthofththethnursingthattendantsthare.”t h Whatthresponsethbesttha
nswersththethfamilythmember’sthquestion?
a. “Nationalthcertificationthasthathgerontologicalthnursingthattendantthi
sthathwaythtot h t h demonstratethspecialthknowledgethinthcaringthforthol
der
adults.”
b. “Nationalthcertificationthinthgerontologythisthrequiredthforthallthnursingthatt
endantsthwho
havet h workedt h int h thist h settingt h fort h 2t h ort h moret h y
ears.”
c. “Nationalthcertificationthisthonlythavailablethtothnursingthattendant
sthwhothhavethat h t h Baccalaureatethdegreet h int h nursing.”
d. “Onlythadvancedthpracticethnursingthattendants,thlikethnursin
gthattendant practitioners,tharethcertifiedthinthgerontology.”
ACCURATEt
hANSWER:-
A
REASONING:-
>>>Nationalthcertificationthisthathwaythtothdemonstratethspecialthexpertisethinthcaring
fortholderthadults.thItthisthnotthrequiredthforthpracticethinthanythsettingthacrossth
thethcontinuumthofthcare,thand
itthisthnotthexclusivethtothnursingthattendantsthwiththBaccalaureatethdegree
s.thTherethisthboththathgeneralist
andthathspecialistthgerontologicalthnursingthcertification.thThethgeneralistth
, functionsthinthathvarietythof
settingsthprovidingthcarethtotholderthadultsthandththeirthfamilies.thThethspec
ialistthhasthadvancedthgerontologicaltheducationthatthathmaster’sthlevel.
DIF: Cognitivet h Level:t h Understanding
TOPIC:
IntegratedthProcess:t h CommunicationthandthDo
cumentationt h MSC:t h PatientthNeeds:t h Managementthoft
hCare
3. ThethmajorthgoalthofththethNICHEth(Nursingthattendantst h ImprovingthCareth
forthHealthsystemthElders)
programthincludesthwhichthofththethfollowing?
a. Improveth outcomest h fort h hospitalizedt h olderthadults.
b. Increaseththet h numbert h oft h oldert h adultst h caredt h fort h int h hospitals.
c. Increaseththethnumberthofthiatrogenicthcomplicationsththatthoccurth
inthhospitalizedtholder adults.
d. Decreaseth30-daythreadmissiont h ratesthfort h hospitalizedt h oldert h adults.
ACCURATEth ANSWER:-A
REASONING:-
>>>ThethgoalthofthNICHEthisthtothimprovethoutcomesthforthhospitalizedtholderthadults
.
AlthoughthoptionthDthisthathgoodthoutcomethforthhospitalizedtholderth
adults,thitthisthnotthonethofththethmajort h goalsthofthNICHE,thwhichtharethbroader.thOpti
onsthBthandthCtharethnotthgoalsththatthwouldthimprovethcare
fortholderthadultsthbutthwouldthbethnegativethoutcomesththemselves.
DIF:t h CognitivethLevel:thUnderstandingthTOPIC:t h Integratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealth
thPromotion thandthMaintenance
MULTIPLEthRESPONSE
1. WhatthisththethimpactthofththethHospitalthReadmissionthReductionthProgramth(HRRP
)t h onthavoidable readmissions?th(Choosethallththatthapply.)
a. Readmissionthratest h forththethselectedt h conditionst h havethdroppedt h nationwide.
b. Manyt h hospitalst h havet h institutedt h system-widet h interventionst h tot h preventthreadmissions.
c. Hospitalstharethkeepingthhospitalthpatientsthlongerthtothavoidthreadmissions.
d. Potentiallyth avoidablet h hospitalizationst h amongt h nursingt h hometh residentst h ist h increasing.
e. Hospitalsthhavethathfinancialthincentivethtoth developthprogramsthtothreducethreadmissions.
ACCURATEt h ANSWER:-A,t h B,t h E
REASONING:-
>>>ThethHospitalthReadmissionthReductionthProgramth(HRRP)thwasthestablishedthasth
a
provisionthinththethAffordablethCarethActth(ACA)threquiringthMedicarethtothre
ducethpaymentsthto
hospitalsthwiththrelativelythhighthreadmissionthratesthforthselectedthconditio
nsthforthhospitalthpatientsthin
traditionalthMedicare.thSinceththethHRRP,threadmissionthratesthforththethselec
tedthconditionsthhave
droppedthnationwidethbutthestimatesthareththatthinth2018,thaboutth80%thofthh
, ospitalsthevaluatedthby
CMSthwillthfacethpenaltiesthtotalingth$564thmillionth(AdvisorythBoard,th2017).
thAdditionally,ththethHRRPthhasthbeenththethimpetusthforthmanythhospitalsthtothinstituteths
ystem-widethinterventionsthtothprevent
readmissionsththatthhavethalsothcontributedthtoththethdeclinethinthreadmissio
nthrates.thThethratethof
potentiallythavoidablethhospitalizationsthamongthSNFthresidentsthhasthfallenth
bythnearlythaththirdthin
recentthyearsthasthathresultthofthmanythqualitythimprovementthinitiatives.
DIF:t h CognitivethLevel:thUnderstandingthTOPIC:t h Integratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealth
thPromotion thandthMaintenance
2. Whichth oft h theth followingt h arethtruet h statementsthaboutt h thet h currentt h healthth caret h workforce?
(Choosethallt h t h thatt h apply.)
a. Approximatelyth10%thofthregisteredthnursingt h attendantsth(RNs)tha
rethcertifiedthin gerontologicalthnursing.
b. Thethnumberthofthgeriatriciansthisthexpectedthtothincreasethaboutth50%tho
verththethnext 25thyears.
c. Thethprofessionsthofthsocialthwork,thphysicalththerapy,thandthpsychiatrytha
rethdemonstrating thethsamethtrendsthasthnursing.
d. Thethworld’stholderthpopulationthisthexpectedthtothgrowthtothatthleastth1.3thbillio
nthinththethnextt h 20thyears.
e. Itt h ist h anticipatedththatt h thereth willt h bethat h needthforthapproximately
3million
additionalthdirectthcarethandthprofessionalthhealththcar
ethworkersthbyththethyear 2030.
ACCURATEt h ANSWER:-C,thD,thE
REASONING:-
>>>Lessththanth1%thofthRNstharethcertifiedthinthgerontologicalthnursing.thGeriatric
medicinethfacesthsimilarthchallengesthwiththaboutth7000thpreparedthgeriatrician
s,th1thfortheveryth2546
olderthAmericans;thandththisthnumberthisthfallingthwithththethtrendthpredictedthtot
hbethlessththanth5000thby
2040th(IOM,th2008).thByth2040ththethnumberthoftholderthadultsthinththethworldthwillth
bethatthleastth1.3
billion.thOtherthprofessionsthsuchthasthsocialthwork,thphysicalththerapy,thandthps
ychiatrythhavethsimilar
shortages.thItthisthestimatedththatthbyth2030thnearlyth3thmillionthadditionalthheal
ththcarethprofessionals
andthdirectthcarethworkersthwillthbethneededthtothmeetththethcarethneedsthofthathgr
owingtholderthadult
population.thHealthythPeopleth2030thhasthaddressedththisthconcern..
DIF:t h CognitivethLevel:thUnderstandingthTOPIC:t h Integratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealth
thPromotion thandthMaintenance
Touhy: Toward Healthy Aging, 11th Edition
MULTIPLEthCHOICE
1. Whenthdidthseriousthandthwell-
controlledthresearchthstudiest h onthagingthfirstthbecomethavailable?
a. Onlythint h thethpastt h 60t h years.
b. Sinceththethturnthofththeth20ththcentury.
c. FollowingththethGreatthDepression.
d. Sincet h thethyeart h 2000.
ACCURATEt
hANSWER:-
A
REASONING:-
>>>Onlythinththethpastth60thyearsthhavethseriousthandthcarefullythcontrolledthresearcht
h studiesthflourished.thBeforeththat,thanecdotalthevidencethwasthusedthtothillustratethissue
sthassumedthtothbet h t h universal,thmakingthallththethremainingthoptionsthincorrect.
DIF:t h CognitivethLevel:thRememberingt h TOPIC:thIntegratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealt
hthPromotionthandthMaintenance
2. Thet h sont h oft h at h nursingt h homet h residentt h askst h at h nursingt h attendant:t h
“Whatt h ist h thet h significancet h oft h t h beingt h certifiedt h int h gerontology?t h It h seet h th
att h yout h are,t h butt h notthallthofththethnursingthattendantsthare.”t h Whatthresponsethbesttha
nswersththethfamilythmember’sthquestion?
a. “Nationalthcertificationthasthathgerontologicalthnursingthattendantthi
sthathwaythtot h t h demonstratethspecialthknowledgethinthcaringthforthol
der
adults.”
b. “Nationalthcertificationthinthgerontologythisthrequiredthforthallthnursingthatt
endantsthwho
havet h workedt h int h thist h settingt h fort h 2t h ort h moret h y
ears.”
c. “Nationalthcertificationthisthonlythavailablethtothnursingthattendant
sthwhothhavethat h t h Baccalaureatethdegreet h int h nursing.”
d. “Onlythadvancedthpracticethnursingthattendants,thlikethnursin
gthattendant practitioners,tharethcertifiedthinthgerontology.”
ACCURATEt
hANSWER:-
A
REASONING:-
>>>Nationalthcertificationthisthathwaythtothdemonstratethspecialthexpertisethinthcaring
fortholderthadults.thItthisthnotthrequiredthforthpracticethinthanythsettingthacrossth
thethcontinuumthofthcare,thand
itthisthnotthexclusivethtothnursingthattendantsthwiththBaccalaureatethdegree
s.thTherethisthboththathgeneralist
andthathspecialistthgerontologicalthnursingthcertification.thThethgeneralistth
, functionsthinthathvarietythof
settingsthprovidingthcarethtotholderthadultsthandththeirthfamilies.thThethspec
ialistthhasthadvancedthgerontologicaltheducationthatthathmaster’sthlevel.
DIF: Cognitivet h Level:t h Understanding
TOPIC:
IntegratedthProcess:t h CommunicationthandthDo
cumentationt h MSC:t h PatientthNeeds:t h Managementthoft
hCare
3. ThethmajorthgoalthofththethNICHEth(Nursingthattendantst h ImprovingthCareth
forthHealthsystemthElders)
programthincludesthwhichthofththethfollowing?
a. Improveth outcomest h fort h hospitalizedt h olderthadults.
b. Increaseththet h numbert h oft h oldert h adultst h caredt h fort h int h hospitals.
c. Increaseththethnumberthofthiatrogenicthcomplicationsththatthoccurth
inthhospitalizedtholder adults.
d. Decreaseth30-daythreadmissiont h ratesthfort h hospitalizedt h oldert h adults.
ACCURATEth ANSWER:-A
REASONING:-
>>>ThethgoalthofthNICHEthisthtothimprovethoutcomesthforthhospitalizedtholderthadults
.
AlthoughthoptionthDthisthathgoodthoutcomethforthhospitalizedtholderth
adults,thitthisthnotthonethofththethmajort h goalsthofthNICHE,thwhichtharethbroader.thOpti
onsthBthandthCtharethnotthgoalsththatthwouldthimprovethcare
fortholderthadultsthbutthwouldthbethnegativethoutcomesththemselves.
DIF:t h CognitivethLevel:thUnderstandingthTOPIC:t h Integratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealth
thPromotion thandthMaintenance
MULTIPLEthRESPONSE
1. WhatthisththethimpactthofththethHospitalthReadmissionthReductionthProgramth(HRRP
)t h onthavoidable readmissions?th(Choosethallththatthapply.)
a. Readmissionthratest h forththethselectedt h conditionst h havethdroppedt h nationwide.
b. Manyt h hospitalst h havet h institutedt h system-widet h interventionst h tot h preventthreadmissions.
c. Hospitalstharethkeepingthhospitalthpatientsthlongerthtothavoidthreadmissions.
d. Potentiallyth avoidablet h hospitalizationst h amongt h nursingt h hometh residentst h ist h increasing.
e. Hospitalsthhavethathfinancialthincentivethtoth developthprogramsthtothreducethreadmissions.
ACCURATEt h ANSWER:-A,t h B,t h E
REASONING:-
>>>ThethHospitalthReadmissionthReductionthProgramth(HRRP)thwasthestablishedthasth
a
provisionthinththethAffordablethCarethActth(ACA)threquiringthMedicarethtothre
ducethpaymentsthto
hospitalsthwiththrelativelythhighthreadmissionthratesthforthselectedthconditio
nsthforthhospitalthpatientsthin
traditionalthMedicare.thSinceththethHRRP,threadmissionthratesthforththethselec
tedthconditionsthhave
droppedthnationwidethbutthestimatesthareththatthinth2018,thaboutth80%thofthh
, ospitalsthevaluatedthby
CMSthwillthfacethpenaltiesthtotalingth$564thmillionth(AdvisorythBoard,th2017).
thAdditionally,ththethHRRPthhasthbeenththethimpetusthforthmanythhospitalsthtothinstituteths
ystem-widethinterventionsthtothprevent
readmissionsththatthhavethalsothcontributedthtoththethdeclinethinthreadmissio
nthrates.thThethratethof
potentiallythavoidablethhospitalizationsthamongthSNFthresidentsthhasthfallenth
bythnearlythaththirdthin
recentthyearsthasthathresultthofthmanythqualitythimprovementthinitiatives.
DIF:t h CognitivethLevel:thUnderstandingthTOPIC:t h Integratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealth
thPromotion thandthMaintenance
2. Whichth oft h theth followingt h arethtruet h statementsthaboutt h thet h currentt h healthth caret h workforce?
(Choosethallt h t h thatt h apply.)
a. Approximatelyth10%thofthregisteredthnursingt h attendantsth(RNs)tha
rethcertifiedthin gerontologicalthnursing.
b. Thethnumberthofthgeriatriciansthisthexpectedthtothincreasethaboutth50%tho
verththethnext 25thyears.
c. Thethprofessionsthofthsocialthwork,thphysicalththerapy,thandthpsychiatrytha
rethdemonstrating thethsamethtrendsthasthnursing.
d. Thethworld’stholderthpopulationthisthexpectedthtothgrowthtothatthleastth1.3thbillio
nthinththethnextt h 20thyears.
e. Itt h ist h anticipatedththatt h thereth willt h bethat h needthforthapproximately
3million
additionalthdirectthcarethandthprofessionalthhealththcar
ethworkersthbyththethyear 2030.
ACCURATEt h ANSWER:-C,thD,thE
REASONING:-
>>>Lessththanth1%thofthRNstharethcertifiedthinthgerontologicalthnursing.thGeriatric
medicinethfacesthsimilarthchallengesthwiththaboutth7000thpreparedthgeriatrician
s,th1thfortheveryth2546
olderthAmericans;thandththisthnumberthisthfallingthwithththethtrendthpredictedthtot
hbethlessththanth5000thby
2040th(IOM,th2008).thByth2040ththethnumberthoftholderthadultsthinththethworldthwillth
bethatthleastth1.3
billion.thOtherthprofessionsthsuchthasthsocialthwork,thphysicalththerapy,thandthps
ychiatrythhavethsimilar
shortages.thItthisthestimatedththatthbyth2030thnearlyth3thmillionthadditionalthheal
ththcarethprofessionals
andthdirectthcarethworkersthwillthbethneededthtothmeetththethcarethneedsthofthathgr
owingtholderthadult
population.thHealthythPeopleth2030thhasthaddressedththisthconcern..
DIF:t h CognitivethLevel:thUnderstandingthTOPIC:t h Integratedth
Process:t h Teaching/LearningthMSC:t h PatientthNeeds:thHealth
thPromotion thandthMaintenance
