Basic Geriatric Nursing 5th Edition by Gloria Hoffman Wold - Test bank

Wold: Basic Geriatric Nursing, 5th Edition Chapter 04: Health Promotion, Health Maintenance, and Home Health Considerations Test Bank MULTIPLE CHOICE 1. The nurse reminds the 70-year-old male patient with hypertension who is on a sodium- restricted diet that the most effective health practice to reduce sodium intake is to: a. avoid all salty foods. b. discontinue eating at restaurants. c. read food labels on food containers carefully. d. limit the amount of salt added to food. ANS: C Reading labels will prevent the purchase of sodium-laden foods. Sodium-restricted foods are available on most menus. Simply avoiding salty foods does not guarantee less sodium because there are many foods containing sodium that are not salty. Adding salt should be absolutely restricted, not diminished. DIF: Cognitive Level: Analysis REF: 75 OBJ: 1 TOP: Sodium Restriction KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. The nurse takes into consideration that older adults may abuse alcohol because they use it as a(n): a. sleep aid. b. appetite stimulant. c. socialization activity. d. food source. ANS: A Many older adults abuse alcohol to make themselves drowsy enough to sleep. DIF: Cognitive Level: Analysis REF: 76 OBJ: 7 TOP: Alcohol Abuse KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. When the 70-year-old female patient says, “Keeping up with when to take the flu vaccine is a big hassle. I’m not going to add trying to keep up with a pneumonia vaccine as well. It’s too expensive.” The nurse explains that the patient: a. can take both vaccines at the same time every fall. b. needs to take the pneumonia vaccine every 10 years. c. has Medicare coverage for both vaccines. d. can obtain both vaccines free of charge from the Public Health Department. Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-2 ANS: B Pneumonia vaccine is given to individuals usually between the ages of 65 and 70 years and is repeated every 10 years. Both inoculations can usually be obtained from community clinics for a small fee. DIF: Cognitive Level: Application REF: 76 OBJ: 7 TOP: Pneumonia Vaccine KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 4. The nurse reminds the 75-year-old that older adults should have visual and hearing examinations every: a. 6 months. b. 12 months. c. 2 years. d. 3 years. ANS: B Annual examinations for vision and hearing to check for glaucoma and diminished hearing are recommended. DIF: Cognitive Level: Knowledge REF: 76 OBJ: 1 TOP: Visual and Hearing Evaluations KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 5. To prevent polypharmacy or potential drug-drug interactions, the nurse encourages the 75-year-old male patient to: a. seek medical care from only one physician. b. read up on all drugs that are prescribed. c. keep a list of drugs that he is currently taking. d. use only one pharmacy to fill prescriptions. ANS: C Keeping a current drug list as a quick reference for any licensed professional to review before prescribing medication is one method to prevent polypharmacy. DIF: Cognitive Level: Comprehension REF: 77 OBJ: 1 TOP: Prevention of Polypharmacy KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 6. a. b. The 65-year-old overweight, hypertensive male farmer tells the home health nurse that he eats two fried eggs, four pieces of bacon, and biscuits with cream gravy every morning for breakfast because he believes that a robust breakfast keeps him healthy. The nurse’s best approach would be to say: “That sort of food is not on your low-sodium diet.” “You won’t be healthy long with a diet like that.” Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-3 c. “One egg and whole wheat toast would be even healthier.” d. “You should eat whole-grain cereal with fruit instead of all that fat and sodium.” ANS: C Health maintenance practices of the older adult are influenced by personal, religious, and cultural beliefs. Using the patient’s beliefs as a basis for changing eating habits will be more successful than radically departing from lifetime habits or suggesting that they are ineffective. DIF: Cognitive Level: Application REF: 78 OBJ: 2 TOP: Cultural Beliefs KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 7. The 60-year-old Asian man tells the home health nurse that he has stopped taking his antihypertensive medication because it causes him to be impotent. He reports that he is using acupuncture to control his hypertension. The nurse’s most effective response would be to say: a. “Uncontrolled hypertension is a real health problem.” b. “Does your acupuncturist check your blood pressure?” c. “Let me check your blood pressure to see how acupuncture is working.” d. “You need to talk to your real doctor about stopping this drug.” ANS: C Problems can occur when cultural remedies are used in place of conventional medicine. Assessment of the effectiveness of the alternate therapy for treating hypertension is necessary to encourage further discussion about his treatment choice. Acupuncture can be very effective. DIF: Cognitive Level: Analysis REF: 79 OBJ: 2 | 6 TOP: Cultural Beliefs KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 8. The nurse takes into consideration that the success of instructions about a diabetic diet will be largely reliant on the: a. clarity of the instructions. b. severity of the disease. c. timing of the instructions. d. motivation of the patient. ANS: D Motivation is necessary for mastery of material and compliance with the new health information. DIF: Cognitive Level: Analysis REF: 79 OBJ: 9 TOP: Knowledge and Motivation KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-4 9. The nurse is aware that the best predictor of a hypertensive patient complying with a low-sodium diet would be the fact that the patient: a. has adequate knowledge about the diet. b. is distressed about his illness. c. has followed a weight reduction program and lost 15 lb. d. does not want to have hypertensive complications. ANS: C Previous behavior is a good indicator of future practice. DIF: Cognitive Level: Application REF: 80 TOP: Predicting Compliance KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 10. An 80-year-old resident in an extended-care facility injured her foot on a piece of rusty wire. She tells the nurse she had a tetanus booster when she was 75. The nurse’s response will be based on the knowledge that tetanus boosters: a. should be repeated every 5 years. b. are not necessary for persons older than 70. c. do little good for the older adult. d. should be repeated with every injury, regardless of the previous booster. ANS: D Tetanus boosters should be repeated every 10 years, unless an injury prompts the need for a booster. DIF: Cognitive Level: Application REF: 76 OBJ: 1 TOP: Tetanus Booster KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk 11. When a 70-year-old male patient taking corticosteroids for rheumatoid arthritis asks the nurse if he should take the vaccination to prevent shingles, the nurse’s most helpful response would be: a. “No. Persons with impaired immune systems should not take that vaccine.” b. “Yes. It would be a good idea to protect yourself from shingles.” c. “No. That vaccine is only effective in about 10% of the cases.” d. “Yes. The vaccine is very inexpensive and very effective.” ANS: A The shingles vaccine should not be given to anyone with an impaired immune system. Corticosteroids impair the immune system. The vaccine is very expensive and is only effective in about 50% of the cases. DIF: Cognitive Level: Analysis REF: 76 OBJ: 1 TOP: Shingles Vaccine KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. OBJ: 9 Test Bank 4-5 12. The home health nurse suggests to the 82-year-old man that he should wear a Medic Alert bracelet to notify emergency personnel about his: a. artificial leg. b. congestive heart failure. c. pacemaker. d. eye prosthesis. ANS: C Such health information as pacemakers, heparin therapy, and drug allergies should be made available to emergency workers. DIF: Cognitive Level: Application REF: 77 OBJ: 1 TOP: Medic Alert Bracelets KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk 13. The nurse suggests to the caregiver of a cognitively impaired patient that to assist in maintenance of personal hygiene, the caregiver might try to: a. give the patient a sponge bath every 3 days. b. establish a consistent daily schedule of meals, hygiene, and rest. c. verbally remind the patient to bathe. d. set out personal hygiene materials for easy access. ANS: B A consistent daily schedule is helpful in setting a pattern every day and a time for self-care activities. DIF: Cognitive Level: Application REF: 80 OBJ: 4 TOP: Cognitive Impairment KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 14. When the home health nurse observes that there is still about half of the month’s supply of Glucophage medication in the bottle at the end of the month, the nurse should ask: a. “Do you know what inadequately treated diabetes can do?” b. “Have you told your physician you are not taking your prescription?” c. “Are you trying to make the medication stretch for 2 months?” d. “Why are you being so noncompliant?” ANS: C Many older adults with limited finances and limited access to a pharmacy will take less of a prescribed drug to conserve money. DIF: Cognitive Level: Application REF: 81 OBJ: 5 TOP: Limited Access KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 15. In addition to supervision of medication protocols and nutrition needs, the presence of the caregiver provides a(n): a. assurance of safety. Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-6 b. service for deep housecleaning. c. source of motivation. d. source of care that is free of charge. ANS: C A caregiver can be a potent motivational source for adhering to health maintenance practices. The presence of a caregiver does not guarantee safety and housecleaning. Although many caregivers are family members and do not charge for providing care, other caregivers do require a fee. DIF: Cognitive Level: Comprehension REF: 81 OBJ: 7 TOP: Caregiver Assistance KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 16. The caregiver who provides daily meals and attends to the daily needs of the older adult is classified as the _____ caregiver. a. basic b. organizing c. primary d. designated ANS: C The caregiver responsible for the day-to-day needs of the older adult is classified as the primary caregiver. DIF: Cognitive Level: Comprehension REF: 81 OBJ: 10 TOP: Caregiver Classifications KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 17. The RN case worker reminds the patient who is the recipient of home health care that the unlicensed home health aide may not: a. transfer the patient into a bathtub. b. measure or dispense medication. c. contact family members independently. d. accompany the patient outside the home. ANS: B Unlicensed persons are not allowed to dispense drugs in any setting. DIF: Cognitive Level: Knowledge REF: 83 OBJ: 11 TOP: Home Health Aides KEY: Nursing Process Step: Planning MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 18. Because unpaid caregivers are so significant to the successful health maintenance of the older adult, the licensed home health coordinator should: a. tell them to call the agency if they need any further assistance. b. leave them entirely on their own so as not to interfere with the care they provide. c. critique care to improve its effectiveness. d. be generous with positive feedback. Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-7 ANS: D The recognition of a job well done and morale boosting are essential to the unpaid, frequently overworked, and frustrated caregiver. DIF: Cognitive Level: Comprehension REF: 82 OBJ: 10 TOP: Nonpaid Caregivers KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 19. In counseling an older adult about exercising, the nurse suggests that activities such as walking or swimming for as little as ____ minutes a day is beneficial. a. 15 b. 30 c. 45 d. 60 ANS: B As little as 30 minutes preserves muscle mass and keeps joints flexible. DIF: Cognitive Level: Knowledge REF: 75 OBJ: 1 TOP: Exercise KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 20. The home health nurse reminds the older adult to add to the health maintenance of his teeth the practice of: a. a dental appointment every 2 years. b. using a fluoride toothpaste. c. thorough flossing every week. d. use of an electric toothbrush. ANS: B The use of fluoride toothpaste, daily brushing and flossing, and annual dental care will enhance dental health. An electric toothbrush is not necessary. DIF: Cognitive Level: Knowledge REF: 77 OBJ: 1 TOP: Dental Health KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 21. When the 84-year-old male complains of dry mouth, the nurse suggests that he: a. keep hard candy in his mouth to stimulate salivation. b. drink iced cola drinks several times daily for hydration. c. wash his mouth with an astringent mouth wash. d. limit alcohol intake. ANS: D Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-8 The reduction of alcohol will help eliminate dry mouth. Excessive use of hard candies, caffeinated drinks like colas, and astringent mouth washes will increase the discomfort from dry mouth. DIF: Cognitive Level: Application REF: 78 OBJ: 1 TOP: Dry Mouth KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation MULTIPLE RESPONSE 1. The nurse lists recommended health practices for older adults, which includes __________. (Select all that apply.) a. compliance with dietary restrictions b. performance of regular exercise daily c. cessation of smoking d. arrangement for regular medical examinations e. annual psychological testing ANS: A, B, C, D Psychological testing is not part of the recommended health practices. All of the other options listed are recommended health-seeking behaviors. DIF: Cognitive Level: Knowledge REF: 85, Box 4-6 OBJ: 1 TOP: Recommended Health Practices KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. The nurse stresses to the older adult female that even a small amount of daily exercise can __________. (Select all that apply.) a. build muscle mass b. control weight c. retard bone loss d. control the blood glucose level e. promote a sense of well-being ANS: B, C, D, E Regular mild exercise will maintain, not build, muscle mass; control weight and glucose levels; retard bone loss; and promote a sense of well-being. DIF: Cognitive Level: Application REF: 75 OBJ: 1 TOP: Exercise Benefits KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. a. b. The nurse makes a list of the health evaluations that should be conducted during an annual physical examination for the older female adult, which includes __________. (Select all that apply.) measurement of height and weight lipid study Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-9 c. electrocardiography d. rectal examination e. mammography ANS: A, B, D, E Electrocardiography is not a routine part of a physical examination. DIF: Cognitive Level: Comprehension REF: 76 OBJ: 1 TOP: Physical Examinations KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 4. When assessing for ineffective health maintenance, the nurse should assess __________. (Select all that apply.) a. willingness to follow a health maintenance plan b. possible conflict between a health maintenance plan and culture c. the presence of prohibited items such as sweets, alcohol, and cigarettes d. the family’s perception of effectiveness of a health maintenance plan e. the level of cognitive impairment ANS: A, B, C, E It is the patient’s, not the family’s, perception that the nurse needs to assess. All the other options listed would be a significant barrier to compliance. DIF: Cognitive Level: Comprehension REF: 85 OBJ: 6 TOP: Assessing for Noncompliance KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 5. The 80-year-old woman tells the home health nurse, “I can only eat cereal because I just can’t make those dentures work!” The nurse’s most helpful suggestion would be to __________. (Select all that apply.) a. take only tiny bites of food b. chew slowly c. use a dental adhesive d. select soft, nonsticky foods (e.g., ground meat, boiled carrots) e. purée all food ANS: A, B, C, D Puréeing food does not address the inability to eat with dentures. DIF: Cognitive Level: Comprehension REF: 78 OBJ: 7 TOP: Impaired Nutrition Related to Dentures KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 6. The nurse assesses factors in a 76-year-old patient’s history that might interfere with willingness to participate in health maintenance activities, which includes __________. (Select all that apply.) Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 4-10 a. a belief that diminished health is part of aging b. loss of a spouse 3 months ago c. having a physical examination every year d. living in an assisted living facility and not driving e. having no family ANS: A, B, E Belief that age is synonymous with declining health, loss of spouse, and no close family are all impediments to learning new health-seeking behaviors. DIF: Cognitive Level: Comprehension REF: 80 OBJ: 7 TOP: Perceptions of Aging KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Wold: Basic Geriatric Nursing, 5th Edition Chapter 01: Trends and Issues Test Bank MULTIPLE CHOICE 1. The nurse explains that in the late 1960s, health care focus was aimed at the older adult because: a. disability was viewed as unavoidable. b. complications from disease increased mortality. c. older adults’ needs are similar to those of all adults. d. preventive health care practices increased longevity. ANS: D Increased preventive health care practices, disease control, and focus on wellness helped people live longer. DIF: Cognitive Level: Comprehension REF: 2 OBJ: 2 TOP: Aging Trends KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 2. The nurse clarifies that in the terminology defining specific age groups, the term aged refers to persons who are: a. 55 to 64 years of age. b. 65 to 74 years of age. c. 75 to 84 years of age. d. 85 and older. ANS: C The term aged refers to persons who are 75 to 84 years of age. DIF: Cognitive Level: Comprehension REF: 2, Table 1-1 TOP: Age Categories KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 3. The nurse cautions that “ageism” is a mindset that influences persons to: a. discriminate against persons solely on the basis of age. b. fear aging. c. be culturally sensitive to concerns of aging. d. focus on resources for the older adult. ANS: A Ageism is a negative belief pattern that influences persons to discriminate against persons solely on the basis of age and can lead to destructive behaviors toward the older adult. DIF: Cognitive Level: Comprehension REF: 5 OBJ: 3 TOP: Ageism KEY: Nursing Process Step: Implementation Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. OBJ: 1 Test Bank 1-2 MSC: NCLEX:PsychosocialIntegrity:PsychosocialAdaptation 4. The nurse points out that the most beneficial legislation that has influenced health care for the older adult is: a. Medicare and Medicaid. b. elimination of the mandatory retirement age. c. the Americans with Disabilities Act. d. the Drug Benefit Program. ANS: A The broadest sweeping legislation beneficial to the older adult is Medicare and Medicaid. DIF: Cognitive Level: Application REF: 16 OBJ: 6 TOP: Legislation KEY: Nursing Process Step: Implementation MSC: NCLEX:N/A 5. The nurse clarifies that a housing option for the older adult that offers the privacy of an apartment with restaurant-style meals and some medical and personal care services is the: a. government-subsidized housing. b. long-term care facility. c. assisted-living center. d. group housing plan. ANS: C Assisted-living arrangements offer the privacy of an apartment or condominium with meals prepared and served, limited medical care, and a variety of personal services. DIF: Cognitive Level: Application REF: 14 OBJ: 9 TOP: Housing Options KEY: Nursing Process Step: Implementation MSC: NCLEX:PhysiologicalIntegrity:PhysiologicalAdaptation 6. The 75-year-old man who has been hospitalized following a severe case of pneumonia is concerned about his mounting hospital bill and asks if his Medicare coverage will pay for his care. The nurse’s most helpful response is “Yes. Medicare: a. pays 100% of all medical costs for persons older than 65.” b. Part B pays hospital costs and physician fees.” c. Part A pays for inpatient hospital costs.” d. Part D pays 80% of the charges made by physicians.” ANS: C Medicare Part A pays inpatient hospital costs, Part B pays 80% of physician’s charges, and Part D helps defray prescription drug costs. DIF: Cognitive Level: Application REF: 16 OBJ: 6 TOP: Medicare Provisions KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 1-3 7. The daughter of a patient who has been diagnosed with terminal cancer asks which documents are required to allow her to make health care decisions for her parent. The nurse’s most informative response is: a. “Advance directives indicate the degree of intervention desired by the patient.” b. “A ‘Do Not Resuscitate’ document signed by the patient transfers authority to the next of kin.” c. “A durable power of attorney for health care transfers decision-making authority for health care to a designated person.” d. “A living will transfers authority to the physician.” ANS: C A durable power of attorney for health care transfers the authority for decision making to a designated person. DIF: Cognitive Level: Application REF: 19 OBJ: 11 TOP: Advance Directives KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 8. The daughter of a resident in a long-term care facility is frustrated with her 80-year-old mother’s refusal to eat. The nurse explains that the refusal to eat is a behavior that is an: a. effort to maintain a portion of independence and self direction. b. indication of approaching Alzheimer disease. c. effort to gain attention. d. indication of the dislike of the institutional food. ANS: A Loss of independence and control is a significant issue for the older adult. Some residents will exercise whatever control they may retain. DIF: Cognitive Level: Application REF: 21 OBJ: 11 TOP: Loss of Independence KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 9. The nurse clarifies that the conditions of a living will go into effect when: a. the patient declares that desire in writing. b. a family member indicates the desire for curative therapy to cease. c. two physicians agree in writing that the criteria in the living will have been met. d. the physician and a family member agree that the criteria in the living will have been met. ANS: C Two physicians must agree in writing that the criteria of the living will have been met before the document can go into effect. DIF: Cognitive Level: Application REF: 19 OBJ: 11 TOP: Living Wills KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 1-4 10. In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce hospital costs by: a. classifying various diagnoses as ineligible for hospitalization. b. allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis. c. specifying particular physicians to treat specified diagnoses. d. using frequency of a particular diagnosis to set a payment schedule. ANS: B DRGs set up a system of preset hospitalization time and payment on the basis of the admitting diagnosis. DIF: Cognitive Level: Comprehension REF: 16 OBJ: 6 TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 11. When discussing extended care with a patient who has had a hip replacement and needs physical therapy, the nurse would recommend a(n): a. basic care facility. b. skilled care facility. c. subacute care facility. d. assisted-living residence. ANS: B Skilled care facilities offer not only basic care but also services from trained licensed professionals such as nurses, physical therapists, speech therapists, and occupational therapists. DIF: Cognitive Level: Application REF: 16 OBJ: 9 TOP: Extended-Care Facilities KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 12. The 80-year-old woman who is recovering from a stroke is being sent to an extended- care facility. She is concerned about the expense. The nurse can allay anxiety by explaining that Medicare will cover extended-care facility costs: a. for a period of 30 days. b. for a period of 45 days for physical therapy. c. for a period of 100 days for needed skilled care. d. until she is able to be discharged home. ANS: C Medicare will cover extended-care costs for 100 days while skilled care is being applied to the resident. After 100 days, the resident must revert to private pay or ancillary long-term care insurance. DIF: Cognitive Level: Application REF: 16 OBJ: 8 TOP: Extended Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 1-5 13. The senior citizen political action group that uses volunteers and lobbyists to advance the interests of older adults is the: a. American Association of Retired Persons (AARP). b. National Council of Senior Citizens (NCSC). c. National Alliance of Senior Citizens (NASC). d. Gray Panthers. ANS: A The AARP uses volunteers and lobbyists to advance the interests and welfare of older adults. DIF: Cognitive Level: Knowledge REF: 12 OBJ: 7 TOP: Political Action Groups KEY: Nursing Process Step: N/A MSC: NCLEX:N/A 14. The nurse gives an example of the caregiver who is guilty of elder abuse as the: a. daughter who uses her mother’s Social Security money to purchase her mother’s medication. b. son who puts an alarm on the front door to prevent his mother from wandering out of the house. c. wife who allows her mentally competent husband to refuse to take a bath for a week. d. frail spouse who is unable to bathe or change the clothes of her physically dependent husband. ANS: D Unintentional abuse or neglect can occur when the caregiver lacks the stamina to meet care needs. Even though physically unable, the frail wife is guilty of elder abuse. The wife should seek assistance to prevent neglect. DIF: Cognitive Level: Analysis REF: 22 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 15. The nurse cautions that the most frequent response to elder abuse by the abused older adult is: a. anger. b. physical retaliation. c. notification of authorities. d. nothing at all. ANS: D Fear of retaliation or abandonment keeps most abused elders silent. DIF: Cognitive Level: Application REF: 25-26 OBJ: 14 TOP: Response to Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 16. Many nurses today do not seek careers in gerontology because: Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 1-6 a. the physical work is too difficult. b. their technological skills are not used. c. there is not enough challenge. d. there are limited options for employment. ANS: B Many nurses feel that their technical skills will not be used in the care of the older adult. There are many employment options that offer challenge and fulfillment. DIF: Cognitive Level: Application REF: 5 OBJ: 2 TOP: Employment Options KEY: Nursing Process Step: N/A MSC: NCLEX:N/A 17. The nurse clarifies that the term “baby boomers” refers to persons who: a. entered school in 1945. b. served in the military in World War II. c. were born between 1946 and 1964. d. were eligible for Social Security benefits in 2000. ANS: C Baby boomers are those born between 1946 and 1964. The impact of the retirement of this cohort is unprecedented in terms of the impact on society. DIF: Cognitive Level: Comprehension REF: 8 OBJ: 5 TOP: Baby boomers KEY: Nursing Process Step: Implementation MSC: NCLEX:PsychosocialIntegrity:PsychosocialAdaptation 18. Restraining an older adult in a recliner to prevent wandering is an example of: a. physical abuse. b. neglect. c. emotional abuse. d. self-neglect. ANS: A Physical abuse is any action that causes physical pain or injury. Inappropriate use of drugs, force-feeding, physical restraints, or punishment of any kind are examples of physical abuse. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX:N/A 19. Nonprovision of medical care because of lack of finances is an example of: a. physical abuse. b. neglect. c. emotional abuse. d. self-neglect. ANS: B Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 1-7 Neglect is a passive form of abuse in which caregivers fail to provide for the needs of the older person under their care. Failure to provide necessary medical care may constitute neglect because with no means of going to the doctor or pharmacy, the older person may suffer or even die. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX:N/A 20. Health care workers eating a resident’s candy without permission is an example of: a. physical abuse. b. neglect. c. emotional abuse. d. self-neglect. ANS: C Emotional abuse is more subtle and difficult to recognize than physical abuse or neglect. It often includes behaviors such as isolating, ignoring, or depersonalizing older adults. Health care workers eating a resident’s candy without permission is an ignorant behavior that can be depersonalizing. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX:N/A MULTIPLE RESPONSE 1. The nurse is aware that a person’s attitude about aging is influenced mainly by his or her __________. (Select all that apply.) a. life experiences b. income level c. level of education d. current age e. occupation ANS: A, D A person’s current age and life experiences are the main influences on his or her attitude relative to aging. DIF: Cognitive Level: Comprehension REF: 4 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: Planning MSC: NCLEX:PsychosocialIntegrity:PsychosocialAdaptation 2. Gerontology encompasses application to __________. (Select all that apply.) a. appropriate housing b. health care c. public education d. business ventures e. government-sponsored pensions Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 1-8 ANS: A, B, C, D Gerontological concerns extend and influence provision of appropriate housing, health care, public education, business ventures, and political stands relative to the welfare of the older adult. DIF: Cognitive Level: Application REF: 2 OBJ: 1 TOP: Gerontology KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. Medicare Part C allows eligible persons to receive Medicare benefits via the services of private insurance companies through the services of a __________. (Select all that apply.) a. health maintenance organization (HMO) b. preferred provider organization (PPO) c. provider-sponsored organization (PSO) d. private fee for service organization (PFFS) e. medical service organization (MSO) ANS: A, B, C, D Medicare Part C allows benefits via the services of managed care organizations. Medical service organization is not one of them. DIF: Cognitive Level: Comprehension REF: 17 OBJ: 6 TOP: Medicare Part C KEY: Nursing Process Step: N/A MSC: NCLEX:N/A 4. The nurse is aware that a family’s emotional response to an aging loved one’s attempts to cope with diminishing abilities and increased care needs would include __________. (Select all that apply.) a. grief b. anger c. frustration d. loss e. resentment ANS: A, B, C, D As the family witnesses the decline of a loved one and attempts to respond to the increasing care needs, the emotional responses are varied and changing. The responses include grief, anger, frustration, loss, and confusion. DIF: Cognitive Level: Application REF: 21 OBJ: 11 TOP: Impact of Aging on the Family KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 5. The nurse outlines the characteristics of the typical caregiver for an aging family member as __________. (Select all that apply.) a. 32 years of age b. female c. having full-time employment Test Bank 1-9 d. having a care recipient older than 70 e. giving care for an average of 18 years ANS: B, C, D, E The average age of the caregiver is 46. DIF: Cognitive Level: Application REF: 20 TOP: Characteristics of Family Caregiver KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 6. The nurse reminds a family that indicators of self-neglect in the aging person include __________. (Select all that apply.) a. misbalanced check book b. reduced personal hygiene c. increased alcohol consumption d. irritability e. loss of weight ANS: A, B, C, E Indicators may be to manage personal finances, reduced hygiene, substance abuse, and loss of weight due to inability to obtain adequate food. Irritability is not a consistent characteristic. DIF: Cognitive Level: Application REF: 22 OBJ: 11 TOP: Self-Neglect KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 7. The nurse reminds a group of prospective caregivers that elder abuse may take the form of __________. (Select all that apply.) a. causing physical harm b. misappropriation of finances c. psychological intimidation d. emotional depersonalization e. abandonment ANS: A, B, C, D, E Elder abuse may take the form of physical injury, misusing the older person’s finances for personal gain, psychological intimidation, and depersonalization and abandonment. DIF: Cognitive Level: Application REF: 25-26 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk 8. The nurse explains that research done by the National Institute on Aging found that __________. (Select all that apply.) a. older patients receive less information regarding health management than younger patients Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. OBJ: 11 Test Bank 1-10 b. information on lifestyle changes were directed at younger people c. older patients were denied timely appointments for evaluation of acute illnesses d. rehabilitation programs offered limited services to the older adult e. older patients receive less evaluation and fewer treatment options for acute illnesses ANS: A, B, D, E The study showed there was less information on health management and lifestyle changes. Rehabilitation programs were limited in their service to the older adult, and only 47% of physicians interviewed felt the older patient received the same evaluation for acute illnesses. DIF: Cognitive Level: Application REF: 5 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 9. The Nursing Competence in Aging initiative advocates enhancing nurses’ __________. (Select all that apply.) a. knowledge in gerontics b. skills in geriatrics c. opportunities for employment d. political sensitivity for the older adult e. attitudes related to the older adult ANS: A, B, E The Nursing Competence in Aging initiative advocates for all nurses greater knowledge, skills, and broader attitudes toward the older adult. DIF: Cognitive Level: Comprehension REF: 5 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: N/A MSC: NCLEX:N/A COMPLETION 1. The nurse clarifies that the term that refers to the promotion of high-level functioning and supportive care to older adults is __________. ANS: gerontics DIF: Cognitive Level: Comprehension REF: 2 OBJ: 10 TOP: Gerontics KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 2. The nurse reminds a patient who was born in 1965 that eligibility for full Social Security benefits for persons of this age is now the age of __________. ANS: 67 DIF: Cognitive Level: Knowledge REF: 3 OBJ: 2 TOP: Change of Social Security Benefits Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc. Test Bank 1-11 KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 3. The nurse clarifies that the point at which a person on Medicaid Part D must assume full cost of medication is called the __________ __________. ANS: donut hole The “donut hole” is the point at which the insured has used up the $2830 worth of coinsurance for drugs and must pay the full cost of medication until the amount of out-of- pocket expenses reaches $4550. DIF: Cognitive Level: Comprehension REF: 17 OBJ: 6 TOP: Donut Hole KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care