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