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CASEBASED APPROACH 7TH EDITION /COMPLETE
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GUIDE
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, Chapter 1. Principles of Primary Care of Older Adults df df df df df df df df
MULTIPLE CHOICE df
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was
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published.The nurse would use these standards to:
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a. promote the practice of gerontologic nursing within the acute care setting. df df df df df df df df df df
b. define the concepts and dimensions of gerontologic nursing practice.
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c. elevate the practice of gerontologic nursing.
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d. incorporate suggested interventions from others who practice gerontologic df df df df df df df
nursing.ACCURATE ANSWER:-D
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Reasoning:->>>The current publishing of the Standards and Scope of Gerontological Nursing Practice in df df df df df df df df df df df df
20
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incorporates the input of gerontologic nursing attendants from across the United States. It
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was not intended to promote gerontologic nursing practice within acute care settings, define
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concepts ordimensions of gerontologic nursing practice, or elevate the practice of
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gerontologic nursing.
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DIFFICULT: Remembering (Knowledge) REF: msc: 2 df df df df df
OBJ: 1-1TOPIC:N/A MSC: Safe and Effective Care
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Environment
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2. When attempting to minimize the effect of ageism on the practice of nursing older
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adults, anursing attendant needs to first:
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a. recognize that nursing attendants must act as advocates for aging hospital clients. df df df df df df df df df df df
b. accept that this population represents a substantial portion of those requiring nursing care.
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c. self-reflect and formulate ones personal view of aging and the older hospital client.
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d. recognize ageism as a form of bigotry shared by many df df df df df df df df df
Americans.ACCURATE ANSWER:-C
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Reasoning:->>>Ageism is an ever-increasing prejudicial view of the effects of the aging process and of df df df df df df df df df df df df df df
theolder
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population as a whole. With nursing attendants being members of a society holding such
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views, it is critical that the individual nursing attendant self-reflect on personal feelings and
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determine whether such feelings will affect the nursing care that he or she provides to the
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aging hospital client. Acting as anadvocate is an important nursing role in all settings.
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Simply accepting a fact does not help end ageism, nor does recognizing ageism as a form
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of bigotry.
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DIFFICULT: Applying (Application) REF: N/A OBJ: 1-9 df df df df df df
TOPIC: Teaching-Learning MSC: Safe and Effective Care Environment
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3. When discussing factors that have helped to increase the number of healthy, independent
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olderAmericans, the nursing attendant includes the importance of:
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a. increased availability of in-home care services. df df df df df
b. government support of retired citizens. df df df df
c. effective antibiotic therapies. df df
d. the development of life-extending therapies.
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,ACCURATE ANSWER:-C df
Reasoning:->>>The health and ultimate autonomy of older Americans has been positively df df df df df df df df df df
impacted by the development of antibiotics, better sanitation, and vaccines. These public
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healthmeasures have been more instrumental in increasing the numbers of healthy,
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independent olderAmericans than have in-home care services, government programs, or life-
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extending therapies.DIFFICULT: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
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TOPIC:Nursing Process: Implementation MSC: Health Promotion and Maintenance df df df df df df df
4. Based on current data, when presenting an older adults discharge teaching plan,
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thenursing attendant includes the hospital clients:
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a. nonrelated caretaker. df
b. paid nursing attendant.
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c. family member. df
d. intuitional
representative.ACCURATE
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ANSWER:-C
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Reasoning:->>>Less than 4% of older adults live in a formal health care environment. The majority of df df df df df df df df df df df df df df df
the
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geriatric population lives at home or with family
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members.DIFFICULT: Applying (Application) REF: N/A
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OBJ: 3-3
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TOPIC:Nursing Process: Planning MSC: Safe and Effective Care Environment df df df df df df df df
5. The nursing attendant planning care for an older adult who has recently been
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diagnosed with rheumatoid arthritis views the priority criterion for continued
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independence to be the hospital clients:
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a. age.
b. financial status. df
c. gender.
d. functional
status.ACCURATE
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ANSWER:-D
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Reasoning:->>>Maintaining the functional status of older adults may avert the onset of physical frailty df df df df df df df df df df df df df
and
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cognitive impairment, two conditions that increase the likelihood of
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institutionalization.DIFFICULT: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
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TOPIC: Nursing Process: Planning MSC: Physiologic Integrity
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6. A nursing attendant working with the older adult population is most likely to assess
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a need for afinancial social services referral for a(n):
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a. white male. df
b. black female. df
c. Hispanic male. df
d. Asian American df
female.ACCURATE ANSWER:-B
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Reasoning:->>>The poverty rate among older black women is substantially higher than that seen among df df df df df df df df df df df df df
maor
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females of other ethnic groups. White males had the least
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poverty.DIFFICULT: Applying (Application) REF: N/A OBJ:
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1-4
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TOPIC:Nursing Process: Assessment MSC: Safe and Effective Care Environment df df df df df df df df
, 7. Which of the following statements made by a nursing attendant preparing to complete a
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health assessment and history on an older hospital client reflects an understanding of the
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general health statusof this population?
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a. Ill need to document well regarding the medications the hospital client is currently prescribed.
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b. I would like to understand how supportive the hospital clients family members are.
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c. Most older hospital clients are being treated for a variety of chronic health care issues.
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d. It will be interesting to see whether this hospital client sees herself asdf df df df df df df df df df df df
being healthy.ACCURATE ANSWER:-D
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Reasoning:->>>It is a misconception that old age is synonymous with illness and illness. The nursing df df df df df df df df df df df df df df
attendant sho
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always determine the hospital clients sense of wellness and independence when conducting a
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health andhistory assessment. An assessment of medication use and family support is
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important for any hospital client. Many older adults do have chronic health conditions, but
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their perception is more important than a single number.
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DIFFICULT: Applying (Application) REF: N/A OBJ: 1-4 df df df df df df
TOPIC:Nursing Process: Assessment MSC: Health Promotion df df df df df
8. The nursing attendant is caring for an older adult who has been admitted to an
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acute care healthcenter for treatment of a fractured femur. The family expresses
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concern about the hospital clients pending transfer to a subacute supported care
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facility. What response by the nursing attendant is best?
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a. Acute care facilities lack the long-term physical therapy support your dad requires. df df df df df df df df df df df
b. Your dad will be much happier in a more serene, private environment.
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c. The subacute facility will focus on helping your dad maintain his independence.
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d. Insurance, including Medicare, will cover only a limited amount of time df df df df df df df df df df
here.ACCURATE ANSWER:-C
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Reasoning:->>>The transfer of the hospital client to a subacute facility is based on the need to maintain df df df df df df df df df df df df df df df df
the hospital clients
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level of function and independence, a task the acute supported care facility is not prepared
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to address oncethe hospital client is physiologically stable. The hospital client may or may
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not be happier in the new setting; the nursing attendant should not make this judgment. It is
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true that insurance only pays for a limited amountof time in an acute supported care facility,
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but this is not the best reason for the hospital client to transfer.
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DIFFICULT: Applying (Application) REF: N/A df df df df
OBJ: 1-6TOPIC:Communication and
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Documentation
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MSC: Health Promotion and Maintenance
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9. To best assure both the quality of care and the safety of the older adult hospital client who
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requires in-home unlicensed assistive personal (UAP) assistance, the geriatric nursing
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attendant:
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a. evaluates the competency of the UAP staff. df df df df df df
b. assumes the roles of case manager and hospital client advocate.
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c. arranges for the needed UAP provided services. df df df df df df
d. assesses the hospital client for functional df df df df df
limitations.ACCURATE ANSWER:-A
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Reasoning:->>>As more care traditionally provided by professional nursing attendants is being transferred df df df df df df df df df df df
to UAP,nursing attendant
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must assume more responsibility for educating, training, and evaluating the competency of
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UAPstaff to provide safe, effective care for the older adult hospital client.
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DIFFICULT: Applying (Application) REF: N/A OBJ: 1-2 df df df df df df