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:-
>>>Less9than91%9of9RNs9are9certified9in9gerontological9nursing.9Geriatric9medicine9faces9s
imilar9challenges9with9about970009prepared9geriatricians,919for9every925469older9Americans
;9and9this9number9is9falling9with9the9trend9predicted9to9be9less9than950009by920409(IOM,920
08).9By920409the9number9of9older9adults9in9the9world9will9be9at9least91.39billion.9Other9prof
essions9such9as9social9work,9physical9therapy,9and9psychiatry9have9similar9shortages.9It9is9es
timated9that9by920309nearly939million9additional9health9care9professionals9and9direct9care9w
orkers9will9be9needed9to9meet9the9care9needs9of9a9growing9older9adult9population.9Healthy9
People920309has9addressed9this9concern..
DIF: Cognitive9Level:9Understanding
TOPIC:9 Integrated9Process:9Teaching/Learning9MSC:9 Patient9Need
s:9Health9Promotion9and9Maintenance
3. Best9practice9recommendations9for9nursing9education9in9relation9to9gerontology9include9whic
h9of9the9following?9(Choose9all9that9apply.)
a. Provision9of9a9“stand-alone”9course9in9gerontological9nursing
b. Integration9of9gerontological9content9throughout9the9curriculum
c. Replacement9of9acute9care9pediatric9clinical9experiences9with9gerontologica
l9clinical9experiences
d. Recruitment9of9nursing9attendants9with9Master9and9Doctoral9degrees9and9
a9specialty9in9gerontology9to9faculty9roles
e. Requiring9all9undergraduate9nursing9students9to9obtain9gerontological9certificatio
n9as9a9requirement9for9graduation
ACCURATE9ANSWER:-A,9B,9D
REASONING:->>>Best9practices9include9providing9a9stand-
alone9gerontological9nursing9course9as9well9as9integrating9gerontology9throughout9the9curricu
lum.9Recruitment9of9nursing9attendants9with9a9specialty9in9gerontology9and9a9Master9or9Doct
oral9degree9to9faculty9roles9is9a9critical9step9in9making9sure9that9the9next9generation9of9nursin
g9attendants9is9prepared9to9care9for9older9adults.9Best9practices9do9not9recommend9removing9
pediatric9clinical9experiences9and9replacing9them9with9gerontological9experiences.9Nursing9c
ertification9is9only9available9to9practicing9nursing9attendants9who9meet9specific9education9an
d9practice9requirements.9It9is9not9applicable9to9nursing9students.
DIF: Cognitive9Level:9Understanding
TOPIC:9 Integrated9Process:9Teaching/Learning9MSC:9 Patient9Need
s:9Health9Promotion9and9Maintenance
4. What9are9the9current9initiatives9being9implemented9to9enhance9the9specialty9of9gerontologic
al9nursing?9(Choose9all9that9apply.)
a. Mandating9of9a9minimum9of9a9Baccalaureate9degree9in9nursing9in9order9to9care9f
or9older9adults
b. Geriatric9Nursing9Leadership9Academy9(GNLA)9project
c. Promotion9of9geriatric9nursing9to9excellence9to9the9nursing9community
d. Requiring9a9nursing9certification9specifically9required9to9long-term9care
e. Offering9scholarships9for9study9and9research9in9geriatric9nursing
ACCURATE9ANSWER:-B,9C,9E
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:-
>>>Less9than91%9of9RNs9are9certified9in9gerontological9nursing.9Geriatric9medicine9faces9s
imilar9challenges9with9about970009prepared9geriatricians,919for9every925469older9Americans
;9and9this9number9is9falling9with9the9trend9predicted9to9be9less9than950009by920409(IOM,920
08).9By920409the9number9of9older9adults9in9the9world9will9be9at9least91.39billion.9Other9prof
essions9such9as9social9work,9physical9therapy,9and9psychiatry9have9similar9shortages.9It9is9es
timated9that9by920309nearly939million9additional9health9care9professionals9and9direct9care9w
orkers9will9be9needed9to9meet9the9care9needs9of9a9growing9older9adult9population.9Healthy9
People920309has9addressed9this9concern..
DIF: Cognitive9Level:9Understanding
TOPIC:9 Integrated9Process:9Teaching/Learning9MSC:9 Patient9Need
s:9Health9Promotion9and9Maintenance
3. Best9practice9recommendations9for9nursing9education9in9relation9to9gerontology9include9whic
h9of9the9following?9(Choose9all9that9apply.)
a. Provision9of9a9“stand-alone”9course9in9gerontological9nursing
b. Integration9of9gerontological9content9throughout9the9curriculum
c. Replacement9of9acute9care9pediatric9clinical9experiences9with9gerontologica
l9clinical9experiences
d. Recruitment9of9nursing9attendants9with9Master9and9Doctoral9degrees9and9
a9specialty9in9gerontology9to9faculty9roles
e. Requiring9all9undergraduate9nursing9students9to9obtain9gerontological9certificatio
n9as9a9requirement9for9graduation
ACCURATE9ANSWER:-A,9B,9D
REASONING:->>>Best9practices9include9providing9a9stand-
alone9gerontological9nursing9course9as9well9as9integrating9gerontology9throughout9the9curricu
lum.9Recruitment9of9nursing9attendants9with9a9specialty9in9gerontology9and9a9Master9or9Doct
oral9degree9to9faculty9roles9is9a9critical9step9in9making9sure9that9the9next9generation9of9nursin
g9attendants9is9prepared9to9care9for9older9adults.9Best9practices9do9not9recommend9removing9
pediatric9clinical9experiences9and9replacing9them9with9gerontological9experiences.9Nursing9c
ertification9is9only9available9to9practicing9nursing9attendants9who9meet9specific9education9an
d9practice9requirements.9It9is9not9applicable9to9nursing9students.
DIF: Cognitive9Level:9Understanding
TOPIC:9 Integrated9Process:9Teaching/Learning9MSC:9 Patient9Need
s:9Health9Promotion9and9Maintenance
4. What9are9the9current9initiatives9being9implemented9to9enhance9the9specialty9of9gerontologic
al9nursing?9(Choose9all9that9apply.)
a. Mandating9of9a9minimum9of9a9Baccalaureate9degree9in9nursing9in9order9to9care9f
or9older9adults
b. Geriatric9Nursing9Leadership9Academy9(GNLA)9project
c. Promotion9of9geriatric9nursing9to9excellence9to9the9nursing9community
d. Requiring9a9nursing9certification9specifically9required9to9long-term9care
e. Offering9scholarships9for9study9and9research9in9geriatric9nursing
ACCURATE9ANSWER:-B,9C,9E
