Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 3rd Edition

TEST BANK
Ebersole and Hess' Gerontological Nursing and Healthy Aging in Canada

Veronique Boscart
3RD Edition




TEST BANK

,Chapter 01: Introduction to Healthy Aging
Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 3rd
Edition


MULTIPLE CHOICE

1. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this
man’s wellness?
a. Wellness can only be achieved with aggressive medical interventions.
b. Wellness is not a real option for this client because he is terminally ill.
c. Wellness is defined as the absence of disease.
d. Nursing interventions can help empower a client to achieve a higher level of
wellness.
ANS: D
Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse
can foster wellness in his or her clients. Wellness is defined by the individual and is
multidimensional. It is not just the absence of disease. A wellness perspective is based on the
belief that every person has an optimal level of health independent of his or her situation or
functional level. Even in the presence of chronic illness or while dying, a movement toward
wellness is possible if emphasis of care is placed on the promotion of well-being in a
supportive environment.

PTS: 1 DIF: Apply REF: p. 7 TOP: Nursing Process: Diagnosis
MSC: Health Promotion and Maintenance
2. In differentiating between health and wellness in health care, which of the following
statements is true?
a. Health is a broad term encompassing attitudes and behaviors.
b. The concept of illness prevention was never considered by previous generations.
c. Wellness and self-actualization develop through learning and growth.
d. Wellness is impossible when one’s health is compromised.
ANS: A
Health is a broad term that encompasses attitudes and behaviors; holistically, health includes
wellness, which involves one’s whole being. The concept of illness prevention was never
considered by previous generations; throughout history, basic self-care requirements have
been recognized. Wellness and self-actualization develop through learning and growth—as
basic needs are met, higher level needs can be satisfied in turn, with ever-deepening richness
to life. Wellness is possible when one’s health is compromised—even with chronic illness,
with multiple disabilities, or in dying, movement toward a higher level of wellness is possible.

PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation
MSC: Health Promotion and Maintenance

3. Which racial or ethnic group has the highest life expectancy in the United States?
a. Native Americans
b. African Americans
c. Hispanic Americans
d. Asian and Pacific Island Americans

, Chapter 02: Cross-Cultural Caring and Aging
Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 3rd
Edition


MULTIPLE CHOICE

1. Which of the following is a true statement about differing health belief systems?
a. Personalistic or magicoreligious beliefs have been superseded in Western minds by
biomedical principles.
b. In most cultures, older adults are likely to treat themselves using traditional
methods before turning to biomedical professionals.
c. Ayurvedic medicine is another name for traditional Chinese medicine.
d. The belief that health depends on maintaining a balance among opposite qualities
is characteristic of a magicoreligious belief system.
ANS: B
Older adults in most cultures usually have had experience with traditional methods that have
worked as well as expected. After these treatments fail, older adults turn to the formal health
care system. Even in the United States, it is common for older adults to pray for cures or
wonder what they did to incur an illness as punishment. The Ayurvedic system is a
naturalistic health belief system practiced in India and in some neighboring countries. This
belief is characteristic of a holistic or naturalistic approach.

PTS: 1 DIF: Understand REF: p. 16-17
TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance
N R I G B.C M
2. Which of the following considU
eratiS
onsNis m
Tost likO
ely to be true when working with an
interpreter?
a. An interpreter is never needed if the nurse speaks the same language as the patient.
b. When working with interpreters, the nurse can use technical terms or metaphors.
c. A patient’s young granddaughter who speaks fluent English would make the best
interpreter because she is familiar with and loves the patient.
d. The nurse should face the patient rather than the interpreter.
ANS: D
The nurse should face the patient rather than the interpreter is a true statement; the intent is to
converse with the patient, not with a third party about the patient. Many reasons may prevent
the patient from speaking directly to a nurse. Technical terms and metaphors may be difficult
or impossible to translate. Cultural restrictions may prevent some topics from being spoken of
to a grandparent or child.

PTS: 1 DIF: Understand REF: p. 18-19
TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment

3. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and
refuses to remain in the bed. Which intervention should the nurse use to promote and maintain
his health?
a. Have the health care provider speak to him.
b. Use principles of the holistic health system.
c. Ask about his perceptions and treatment ideas.

, d. Consult with a practitioner of Chinese medicine.
ANS: C
Using the LEARN model (listen with sympathy to the patient’s perception of the problem,
explain your perception of the problem, acknowledge the differences and similarities,
recommend treatment, and negotiate agreement), the nurse gathers information from the
patient about cultural beliefs concerning health care and avoids stereotyping the patient. In the
assessment, the nurse determines what the patient believes about caregiving, decision making,
treatment, and other pertinent health-related information. Speaking with the health care
provider is premature until the assessment is complete. Unless he accepts the beliefs,
principles of the holistic health system can be potentially unsuitable and insulting for this
patient. Unless he accepts the treatments, consulting with a practitioner of Chinese medicine
can also be unsuitable and insulting for this patient.

PTS: 1 DIF: Apply REF: p. 18
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance

4. Which action should the nurse take when addressing older adults?
a. Speak in an exaggerated pitch.
b. Use a lower quality of speech.
c. Use endearing terms such as “honey.”
d. Speak clearly.
ANS: D
Some health professionals demonstrate ageism, in part because providers tend to see many
frail, older persons and fewer of those who are healthy and active. Providers should not
assume that all older adults are hearing or mentally impaired. The most appropriate action
when addressing an older aduNltUwRoSulI
dNbeGtT
oBsp.eC
akOcM
learly. Examples of unintentional ageism
in language are an exaggerated pitch, a demeaning emotional tone, and a lower quality of
speech.

PTS: 1 DIF: Apply REF: p. 15
TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance

5. The nurse prepares an older woman, who is Polish, for discharge through an interpreter and
notes that she becomes tense during the instructions about elimination. Which intervention
should the nurse implement?
a. Move on to the discussion about medication.
b. Ask the older woman how she feels about this topic.
c. Instruct the interpreter to repeat the instructions.
d. Have the older woman repeat the instructions for clarity.

ANS: B
When working with an interpreter, the nurse closely watches the older adult for nonverbal
communication and emotion regarding a specific topic and therefore validates the assessment
about the older adult’s tension before proceeding. Because the nurse notices her tension, the
nurse temporarily suspends the preparation to validate her assessment. If the nurse proceeds
and the older adult is uncomfortable discussing elimination, then important instructions can be
missed, leading to adverse effects for the older adult. Repeating the instructions can aggravate
the older adult’s discomfort. Instructing the older adult to repeat the nurse’s instruction
ignores her needs.

, PTS: 1 DIF: Apply REF: p. 18-19
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment

6. The fnurse fplans fcare ffor fan folder fAfrican fAmerican fman fwho fis ffrom fJamaica fand
fresides fin fNew fYork fCity. f Which f should fthe f nurse f include f in fplanning fcare?
a. Attribute fhis fillness fto fbreaking fa fvoodoo.
b. Help fhim fimprove fsocial frelationships.
c. Maintain fblood fpressure fbelow f120/70 fmm fHg.
d. Review fthe fprinciples fof fthe fmagicoreligious fsystem.
ANS: f C
Because fAfrican fAmericans ftend fto fbe fat frisk ffor fcardiovascular fdisease fand
fhypertension, fthe f nurse fplans fto fmaintain fthe f patient’s f blood fpressure fat for fbelow fthe
fcurrent frecommendation f by fthe f American fHeart fAssociation. fThe f nurse fcan f be
f incorrectly fassuming fthat fhe fpractices fand f believes f in fthe f magicoreligious f system. fThe
fnurse f should fassess f his f spiritual f beliefs fand fdetermine f how f much fthey f influence f his
fattitudes ftoward fWestern f health fcare. fThe f magicoreligious f system f maintains fsocial
frelationships f in fgood fcondition fto fprevent f illness; f however, f if fthe folder fadult fdoes f not
f follow fthis fcultural fpractice, fthen fthis fgoal fcan fbe funsuitable. fThe folder fadult f may
fnot fbelieve f in fthis fsystem; ftherefore, fthe f information fcan f be f irrelevant.


PTS: f 1 DIF: Apply REF: f p. f18-19 TOP: f Nursing fProcess:
fPlanning fMSC: f Safe, fEffective fCare fEnvironment

7. Which fhealth fbelief fsystem fuses ftreatments fto frepair fa fbody fpart?
a. Holistic NURSINGTB.COM
b. Biomedical
c. Personalistic
d. Magicoreligious

ANS: f B
Because fdysfunction for fa fstructural fabnormality fis fthought fto fcause fdisease, fthe
fbiomedical f system fbelieves fin frepairing fthe fstructural fabnormality. fThe fholistic fsystem
fholds fthat fhealth fis f attained fthrough fbalance. fThe fpersonalistic fsystem fuses ftreatments
fsuch fas fmeditation, ffasting, fand fpraying. fThe f magicoreligious f system f is fthe fsame fas
fthe fpersonalistic fsystem.


PTS: f f 1 DIF: Understand REF: f p. f17
TOP: f Nursing fProcess: fAssessment MSC: f Safe, fEffective fCare fEnvironment

8. A fnurse fis fcaring ffor fa fculturally fdiverse fpatient fwho fhas fmissed ffollow-up
fappointments fwith fthe fprimary f care fprovider fthree ftimes fover fthe fpast f year. fThe
fpatient fhas fa fchronic f illness fthat frequires fperiodic f monitoring fof f blood ftest fvalues.
fThe fpatient ftells fthe f nurse: f “You fdon’t funderstand—in f my fculture, fwe fdon’t fdo
fthings f like fthat. fI fcannot fbe ftroubled fwith fworrying fabout fappointments f in fthe f future;
fI fdeal fwith feach fday fas f it fcomes.” fThe f nurse funderstands fwhich fof fthe f following
fabout fthe fpatient’s fculture?
a. The fculture fdoes fnot fvalue fWestern fmedicine.
b. The fculture fhas fa fdifferent forientation fto ftime fthan fWestern fmedicine.
c. The fculture fis fan finterdependent fculture.
d. The fculture fdoes fnot fbelieve fin fpreventative fcare.

, ANS: f B
Time forientation fis fa fculturally fconstructed ffactor. fWesternized fmedical fcare fis ffuture
foriented. fConflicts fbetween ffuture foriented fWesternized fmedical fcare fand fthose fwith fa
fpresent for fpast ftime forientation f may farise. fPatients fare flikely fto fbe flabeled fas
fnoncompliant ffor ffailing fto fkeep fappointments.


PTS: f 1 DIF: Understand REF: f p. f15-17 TOP: f Nursing fProcess:
fPlanning fMSC: f Safe, fEffective fCare fEnvironment


9. A fpaper fon fculture fand fillness fwould fbe flikely fto finclude fthe fstatement fthat
a. culture fis fthe fsame fas fethnicity.
b. ethnic fgroups falways fshare fcommon fgeographic forigin fand freligion.
c. ethnicity finvolves frecognized ftraditions, fsymbols, fand fliterature.
d. most fmembers fof fan fethnic fgroup fexhibit fidentical fcultural ftraits.

ANS: f C
Ethnicity fis fa fcomplex fphenomenon fthat fincludes ftraditions, fsymbols, fliterature, ffolklore,
ffood fpreferences, fand fdress. fIt fis fa f shared f identity. fEthnicity f is f more fthan f just fculture. fIt
f is f social fdifferentiation f based fon fculture. fEven fwithin fethnic fgroups, fthere f is fconsiderable
fdiversity.


PTS: f 1 DIF: Remember REF: f p. f12 TOP: f Teaching fand
fLearning fMSC: f Psychosocial fIntegrity


10. A fhome fcare fnurse fis fcaring ffor fan folder fpatient ffrom fa fdifferent fculture fwho fis
fbedbound fand f high frisk f for fdevelopment fof fa f pressure fulcer. fThe f nurse fdiscusses fthe
fplan fof fcare fwith fthe
patient’s fdaughter, femphasizing fthe fimportance fof fturning fevery f2 fhours, fand fposts fa
fturning f clock fon fthe fwall. f When fthe f nurse freturns f later f in fthe fweek, fthe fturning
fclock fhas f been fremoved, fand fthe fpatient’s fda NuU
ghRteSr fI poGrtT
reN sBth.
atCsO
heMturns fher fmother
foccasionally. fShe fstates,
“I fam ftaking fvery fgood fcare fof fmy fmother. fYou fjust fdon’t funderstand—our fways fdo fnot
involve fdoing fthings fon fschedules.” fThe fbest fresponse fby fthe fnurse fis:
a. “You fmust ffollow fmy fguidelines fand fturn fher fevery f2 fhours, for fI fwill fnot
fbe fable fto ftake fcare fof fher.”
b. “I funderstand fthat fyou fvalue fyour fculture, fbut fculture fcannot fstop
fyou ffrom fproviding fgood fcare fto fyour f mother.”
c. ‘I funderstand fthat fyou fcare fvery fmuch ffor fyour fmother. fPerhaps fcaring ffor
fher fis ftoo fmuch f for f you.”
d. “How fcan fwe fbest fwork ftogether fto fprovide fthe fbest fcare ffor fyour fmother?”
ANS: f D
In fproviding fcross-cultural fcare, fit fis fimportant fthat fthe fnurse fwork fwith fthe fpatient fand
ffamily fand f listen fcarefully fand f find fa f way fto finclude fthe f values fand f beliefs fof fthe
fpatient f in fthe fplan fof fcare.


PTS: f f 1 DIF: Analyze REF: f p. f15
TOP: f Communication fand fDocumentation MSC: f Psychosocial fIntegrity

11. An folder fpatient flearns fthat fshe fhas fmetastatic fcancer. fThe fpatient fstates: f“I fmust fhave
fangered fGod.” fThis f is fan f example fof fwhich ftype fof f belief?
a. Biomedical
b. Magicoreligious
c. Naturalistic

, d. Ayurvedic
ANS: f B
Magicoreligious fbeliefs fview fillness fas fcaused fby factions fof fa fhigher fauthority.
fBiomedical f beliefs fview fdisease fas fa fresult fof fabnormalities fin fstructure fand ffunction
fand fdisease fcaused f by f intrusion fof fpathogens f into fthe fbody. fNaturalistic f beliefs f are
fbased fon fthe fconcepts fof f balance; f health f is f seen fas fa f sign fof f balance. f Ayurvedic
fbeliefs fare fof fthe foldest fknown fparadigm f in fthe f naturalistic f system; f illness f is fseen
fas fan f imbalance.


PTS: f f 1 DIF: Remember REF: f p. f17
TOP: f Communication fand fDocumentation MSC: f Psychosocial fIntegrity

12. The fterm fhealth fdisparity fis fdefined fas
a. the fsystematic felimination fof fthe fculture fof fanother fresulting fin fdecreased fwellness.
b. differences fin fhealth foutcomes famong fgroups.
c. the fdifference fbetween fan fexpected fincidence fand fprevalence fand fthat
fwhich factually foccurs f in fa fcomparison fpopulation fgroup.
d. the fexistence fof fmore fthan fone fgroup fwith fdiffering fvalues fand fperspective.
ANS: f B
Health fdisparities fare fdefined fas fdifferences fin fhealth foutcomes famong fgroups. fCultural
fdestructiveness f is fdefined fas fthe fsystematic felimination fof fthe fculture fof f another.
fHealth f inequities fare fdefined fas fthe fdifference fbetween fan fexpected fincidence fand
fprevalence fand fthat fwhich factually foccurs f in fa fcomparison fpopulation fgroup. fCultural
fdiversity f is fdefined f as fthe fexistence fof f more fthan fone fgroup fwith fdiffering f values fand
fperspective.


PTS: f f 1 DIF: Remember REF: f f p. f13 TOP: f Teaching fand fLearning
MSC: f Psychosocial NURSINGTB.COM
fIntegrity



MULTIPLE fRESPONSE

1. The fnurse fis fassessing fan folder fadult ffrom fa fculture fdifferent fthan fthe fnurse’s fby
fasking fquestions ffrom fthe fexplanatory fmodel ffor fculturally fsensitive fassessment.
fWhich fquestion(s) fshould fthe f nurse fask fto ffollow fthis f model? f(Select fall fthat fapply.)
a. How fcan fwe fnegotiate fto fsolve fthe fproblem?
b. What ftreatment fcan fimprove fyour fcondition?
c. Should fwe ftry fmy fplan ffirst fto fsee fif fit fhelps?
d. Can fwe fdiscuss fdifferences fin four fplans fnow?
e. How flong fhave fyou fexperienced fthe fproblem?
f. Who, fother fthan fme, fcan fmake fyou ffeel fbetter?
ANS: f B, fE, fF
Asking fabout fpotential ftherapies fis fa fquestion ffrom fthe fexplanatory fmodel fand fasks
fwhat fthe f individual f believes fwill f help fclear fup fthe fproblem. fThe f nurse fasks fabout fthe
fduration fof fthe fproblem fas fa fpart fof fapplying f the fexplanatory f model. fThe f nurse fasks
fabout fother fdisciplines fthat fthe findividual fbelieves fcan fbe ftherapeutic. fThis fquestion fis
fbased fon fthe fLEARN fmodel.


PTS: f f 1 DIF: Apply REF: f p. f14
TOP: f Nursing fProcess: fAssessment MSC: f Health fPromotion fand fMaintenance