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