TOWARD HEALTH AGING:
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Human Needs and Nursing Responses 11thedition
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TABLE OF CONTENT i i
All Chapters (1-35) Covered.
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PART 1 Foundations for Clinical Judgment to Promote Healthy Aging
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1 Gerontological Nursing Across the Continuum
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of Care 2 Aging, Health, and Wellness in a
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Global Community 3 Theories of Aging
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4 Providing Cross-Cultural Care i i
5 Economics and Health Care in Late i i i i i
Life 6 Promoting Excellence in Long-
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Term Care PART 2 Foundations for
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Taking Action
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7 Therapeutic Communication With Older
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Adults 8 Cognitive Health and Learning
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9 Recognizing and Analyzing Cues to Maximize
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Outcomes 10 Using Laboratory Data in Clinical
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Judgment
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11 Safe Medication Use i i
PART 3 Clinical Judgment to Promote Wellness and Function
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12 Visual Health i
13 Auditory Health i
14 Healthy Skin i
15 Nutritional Health i
16 Hydration and Oral i i
Health 17 Elimination
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18 Sleep
19 Activity and Exercise i i
20 Falls and Fall Risk i i i
Reduction 21 Safe and Secure
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Environments
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PART 4 Clinical Judgment to Promote Wellness for Persons With
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Chronic Illnesses
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22 Living Well With Chronic
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Illness 23 Vascular Disorders
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24 Respiratory Disorders i
25 NeurocognitiveDisorders i
26 Care of Individuals With Neurocognitive
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Disorders 27 Endocrine and Immune Disorders
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28 Common Musculoskeletal
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Disorders 29 Pain and Comfort
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30 Mental Health i
, 35 Spiritual Health, Meaning, and Self-Actualization
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PART 5 Clinical Judgment to Promote Healthy
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Chapter 01: Gerontological Nursing Across the Continuum of
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Aging With Older Adults and Families
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Care
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31 Ethics, Decision Making, and i i i
Touhy: Toward Healthy Aging, 11th Edition
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Mistreatment 32 Relationships, Roles,
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and Life Transitions 33 Intimacy and
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Sexual Health
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MULTIPLE iCHOICE
34 Loss, Death, and Palliative Care
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1. When idid iserious iand iwell-controlled iresearch istudies ion iaging ifirst ibecome
i available?
a. Only iin ithe ipast i60 iyears.
b. Since ithe iturn iof ithe i20th icentury.
c. Following ithe iGreat iDepression.
d. Since ithe iyear i2000.
ACCURATE
ANSWER:-A
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REASONING:->>>Only iin ithe ipast i60 iyears ihave iserious iand icarefully icontrolled
iresearch i studies iflourished. iBefore ithat, ianecdotal ievidence iwas iused ito iillustrate
iissues iassumed ito ibe i universal, imaking iall ithe iremaining ioptions iincorrect.
DIF: Cognitive iLevel: iRemembering TOPIC: i i Integrated
iProcess: i Teaching/Learning iMSC: i Patient iNeeds: iHealth
iPromotion iand iMaintenance
2. The i son i of i a i nursing i home i resident i asks i a i nursing i attendant: i “What i is
ithe i significance i of i being icertified i in igerontology? iI isee ithat iyou iare, ibut inot
iall iof ithe inursing iattendants iare.” i What iresponse ibest ianswers ithe ifamily
imember’s iquestion?
a. “National icertification ias ia igerontological inursing iattendant iis ia
iway ito i demonstrate ispecial iknowledge iin icaring ifor iolder
iadults.”
b. “National icertification iin igerontology iis irequired ifor iall inursing
iattendants iwho i have iworked iin ithis isetting ifor i2 ior imore iyears.”
c. “National icertification iis ionly iavailable ito inursing iattendants
iwho ihave ia i Baccalaureate idegree iin inursing.”
d. “Only iadvanced ipractice inursing iattendants, ilike inursing
iattendant i practitioners, iare icertified iin igerontology.”
ACCURATE
ANSWER:-A
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REASONING:->>>National icertification iis ia iway ito idemonstrate ispecial iexpertise
iin icaring i for iolder iadults. iIt iis inot irequired ifor ipractice iin iany isetting iacross ithe
icontinuum iof icare, iand i it iis inot iexclusive ito inursing iattendants iwith
iBaccalaureate idegrees. iThere iis iboth ia igeneralist i and ia ispecialist igerontological
inursing icertification. iThe igeneralist ifunctions iin ia ivariety iof i settings iproviding
icare ito iolder iadults iand itheir ifamilies. iThe ispecialist ihas iadvanced
i gerontological ieducation iat ia imaster’s ilevel.
DIF: Cognitive iLevel: iUnderstanding
, TOPIC: i i Integrated iProcess: iCommunication iand
iDocumentation i MSC: i Patient iNeeds: iManagement iof ACCURATE iANSWER:-A
iCare REASONING:->>>The igoal iof iNICHE iis ito iimprove ioutcomes ifor ihospitalized
iolder iadults. i Although ioption iD iis ia igood i outcome ifor ihospitalized iolder
3. The imajor igoal iof ithe iNICHE i(Nursing iattendants iImproving iCare ifor iadults, iit iis inot ione iof ithe imajor i goals iof iNICHE, iwhich iare ibroader. iOptions iB
Healthsystem iElders)
i i program iincludes iwhich iof ithe ifollowing?
iand iC iare inot igoals ithat iwould iimprove icare i for iolder iadults ibut iwould ibe
a. Improve ioutcomes ifor ihospitalized iolder iadults.
inegative ioutcomes ithemselves.
b. Increase ithe inumber iof iolder iadults icared ifor iin ihospitals.
c. Increase ithe inumber iof iiatrogenic icomplications ithat ioccur iin
DIF: Cognitive iLevel: iUnderstanding TOPIC: i i Integrated
hospitalized iolder i adults.
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iProcess: i Teaching/Learning iMSC: i Patient iNeeds: iHealth
d. Decrease i30-day ireadmission irates ifor ihospitalized iolder iadults. iPromotion iand iMaintenance
MULTIPLE iRESPONSE
1. What iis ithe iimpact iof ithe iHospital iReadmission iReduction iProgram i(HRRP)
on iavoidable i readmissions? i(Choose iall ithat iapply.)
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a. Readmission irates ifor ithe iselected iconditions ihave idropped inationwide.
b. Many ihospitals ihave iinstituted isystem-wide iinterventions ito iprevent ireadmissions.
c. Hospitals iare ikeeping ihospital ipatients ilonger ito iavoid ireadmissions.
d. Potentially iavoidable ihospitalizations iamong inursing ihome iresidents iis iincreasing.
e. Hospitals ihave ia ifinancial iincentive ito idevelop iprograms ito ireduce ireadmissions.
ACCURATE iANSWER:-A, iB, iE
REASONING:->>>The iHospital iReadmission iReduction iProgram i(HRRP) iwas
iestablished ias ia i provision iin ithe iAffordable iCare iAct i(ACA) irequiring iMedicare
ito ireduce ipayments ito i hospitals iwith irelatively ihigh ireadmission irates ifor
iselected iconditions ifor ihospital ipatients iin i traditional iMedicare. iSince ithe
iHRRP, ireadmission irates ifor ithe iselected iconditions ihave i dropped inationwide
ibut iestimates iare ithat iin i2018, iabout i80% iof ihospitals ievaluated iby i CMS iwill iface
ipenalties itotaling i$564 imillion i(Advisory iBoard, i2017). iAdditionally, ithe iHRRP
i has ibeen ithe iimpetus ifor imany ihospitals ito iinstitute isystem-wide iinterventions ito
iprevent i readmissions ithat ihave ialso icontributed ito ithe idecline iin ireadmission
irates. iThe irate iof i potentially iavoidable ihospitalizations iamong iSNF iresidents ihas
ifallen iby inearly ia ithird iin i recent iyears ias ia iresult iof imany iquality iimprovement
iinitiatives.
DIF: Cognitive iLevel: iUnderstanding TOPIC: i i Integrated
iProcess: i Teaching/Learning iMSC: i Patient iNeeds: iHealth
iPromotion iand iMaintenance
2. Which iof ithe ifollowing iare itrue istatements iabout ithe icurrent ihealth icare iworkforce?
(Choose iall
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a. Approximately i10% iof iregistered inursing iattendants i(RNs) iare
certified iin
i i gerontological inursing.
b. The inumber iof igeriatricians iis iexpected ito iincrease iabout i50% iover
the inext i 25 iyears.
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c. The iprofessions iof isocial iwork, iphysical itherapy, iand ipsychiatry iare
demonstrating i the isame itrends ias inursing.
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d. The iworld’s iolder ipopulation iis iexpected ito igrow ito iat ileast i1.3 ibillion iin
the inext i 20 iyears.
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e. It iis ianticipated ithat ithere iwill ibe ia ineed ifor iapproximately
, REASONING:->>>Less ithan i1% iof iRNs iare icertified iin igerontological inursing.
i3million i additional idirect icare iand iprofessional ihealth icare iGeriatric i medicine ifaces isimilar ichallenges iwith iabout i7000 iprepared
iworkers iby ithe iyear i 2030. igeriatricians, i1 ifor ievery i2546 i older iAmericans; iand ithis inumber iis ifalling iwith
ithe itrend ipredicted ito ibe iless ithan i5000 iby i 2040 i(IOM, i2008). iBy i2040 ithe inumber
ACCURATE iANSWER:-C, iD, iE
iof iolder iadults iin ithe iworld iwill ibe iat ileast i1.3 i billion. iOther iprofessions isuch ias
isocial iwork, iphysical itherapy, iand ipsychiatry ihave isimilar i shortages. iIt iis
iestimated ithat iby i2030 inearly i3 imillion iadditional ihealth icare iprofessionals i and
idirect icare iworkers iwill ibe ineeded ito imeet ithe icare ineeds iof ia igrowing iolder
iadult i population. iHealthy iPeople i2030 ihas iaddressed ithis iconcern..
DIF: Cognitive iLevel: iUnderstanding TOPIC: i i Integrated
iProcess: i Teaching/Learning iMSC: i Patient iNeeds: iHealth
iPromotion iand iMaintenance
3. Best ipractice irecommendations ifor inursing ieducation iin irelation ito igerontology
iinclude iwhich iof i the ifollowing? i(Choose iall ithat iapply.)
a. Provision iof ia i“stand-alone” icourse iin igerontological inursing
b. Integration iof igerontological icontent ithroughout ithe icurriculum
c. Replacement iof iacute icare ipediatric iclinical iexperiences iwith
gerontological
i i clinical iexperiences
d. Recruitment iof inursing iattendants iwith iMaster iand iDoctoral
degrees iand ia i specialty iin igerontology ito ifaculty iroles
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e. Requiring iall iundergraduate inursing istudents ito iobtain igerontological
certification i as ia irequirement ifor igraduation
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ACCURATE iANSWER:-A, iB, iD
REASONING:->>>Best ipractices iinclude iproviding ia istand-alone igerontological
inursing icourse i as iwell ias iintegrating igerontology ithroughout ithe icurriculum.
iRecruitment iof inursing iattendants i with ia ispecialty iin igerontology iand ia iMaster
ior iDoctoral idegree ito ifaculty iroles iis ia icritical i step iin imaking isure ithat ithe inext
igeneration iof inursing iattendants iis iprepared ito icare ifor i i older iadults. iBest
ipractices ido inot irecommend iremoving ipediatric iclinical iexperiences iand
i replacing ithem iwith igerontological iexperiences. iNursing icertification iis ionly
iavailable ito i practicing inursing iattendants iwho imeet ispecific ieducation iand
ipractice irequirements. iIt iis inot i applicable ito inursing istudents.
DIF: Cognitive iLevel: iUnderstanding TOPIC: i i Integrated
iProcess: i Teaching/Learning iMSC: i Patient iNeeds: iHealth
iPromotion iand iMaintenance
4. What iare ithe icurrent iinitiatives ibeing iimplemented ito ienhance ithe ispecialty iof
gerontological
i i nursing? i(Choose iall ithat iapply.)
a. Mandating iof ia iminimum iof ia iBaccalaureate idegree iin inursing iin iorder ito
icare ifor i older iadults
b. Geriatric iNursing iLeadership iAcademy i(GNLA) iproject
c. Promotion iof igeriatric inursing ito iexcellence ito ithe inursing icommunity
d. Requiring ia inursing icertification ispecifically irequired ito ilong-term icare
e. Offering ischolarships ifor istudy iand iresearch iin igeriatric inursing
ACCURATE iANSWER:-B, iC, iE