,Chapter 1 Seeing Older Adults Through the Eyes of Wellness
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.
The nurse would use these standards to:
a. promote the practice of gerontologic nursing within the acute care setting.
b. define the concepts and dimensions of gerontologic nursing practice.
c. elevate the practice of gerontologic nursing.
d. incorporate suggested interventions from others who practice gerontologic
nursing.
ANS: D
The current publishing of the Standards and Scope of Gerontological Nursing Practice in 2010
incorporates the input of gerontologic nurses from across the United States. It was not intended
to promote gerontologic nursing practice within acute care settings, define concepts or
dimensions of gerontologic nursing practice, or elevate the practice of gerontologic nursing.
DIF: Remembering (Knowledge) REF: MCS: 2 OBJ: 1-1
TOP: N/A MSC: Safe and Effective Care Environment
2. The nurse planning care for an older adult who has recently been diagnosed with rheumatoid
arthritis views the priority criterion for continued independence to be the patients:
a. age.
b. financial status.
c. gender.
d. functional status.
ANS: D
Maintaining the functional status of older adults may avert the onset of physical frailty and
cognitive impairment, two conditions that increase the likelihood of institutionalization.
DIF: Remembering (Knowledge) REF: MCS: 8 OBJ: 1-6
,TOP: Nursing Process: Planning MSC: Physiologic Integrity
3. When attempting to minimize the effect of ageism on the practice of nursing older adults, a
nurse needs to first:
a. recognize that nurses must act as advocates for aging patients.
b. accept that this population represents a substantial portion of those requiring
nursing care.
c. self-reflect and formulate ones personal view of aging and the older patient.
d. recognize ageism as a form of bigotry shared by many Americans.
ANS: C
Ageism is an ever-increasing prejudicial view of the effects of the aging process and of the older
population as a whole. With nurses being members of a society holding such views, it is critical
that the individual nurse self-reflect on personal feelings and determine whether such feelings
will affect the nursing care that he or she provides to the aging patient. Acting as an advocate is
an important nursing role in all settings. Simply accepting a fact does not help end ageism, nor
does recognizing ageism as a form of bigotry.
DIF: Applying (Application) REF: N/A OBJ: 1-9
TOP: Teaching-Learning MSC: Safe and Effective Care Environment
4. When discussing factors that have helped to increase the number of healthy, independent older
Americans, the nurse includes the importance of:
a. increased availability of in-home care services.
b. government support of retired citizens.
c. effective antibiotic therapies.
d. the development of life-extending therapies.
ANS: C
The health and ultimate autonomy of older Americans has been positively impacted by the
development of antibiotics, better sanitation, and vaccines. These public health measures have
been more instrumental in increasing the numbers of healthy, independent older Americans than
have in-home care services, government programs, or life-extending therapies.
,DIF: Remembering (Knowledge) REF: MCS: 2 OBJ: 3-3
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
5. Based on current data, when presenting an older adults discharge teaching plan, the nurse
includes the patients:
a. nonrelated caretaker.
b. paid caregiver.
c. family member.
d. intuitional representative.
ANS: C
Less than 4% of older adults live in a formal health care environment. The majority of the
geriatric population lives at home or with family members.
DIF: Applying (Application) REF: N/A OBJ: 3-3
TOP: Nursing Process: Planning MSC: Safe and Effective Care Environment
6. A nurse working with the older adult population is most likely to assess a need for a financial
social services referral for a(n):
a. white male.
b. black female.
c. Hispanic male.
,d. Asian American female.
ANS: B
The poverty rate among older black women is substantially higher than that seen among males or
females of other ethnic groups. White males had the least poverty.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
7. Which of the following statements made by a nurse preparing to complete a health assessment
and history on an older patient reflects an understanding of the general health status of this
population?
a. Ill need to document well regarding the medications the patient is currently
prescribed.
b. I would like to understand how supportive the patients family members are.
c. Most older patients are being treated for a variety of chronic health care issues.
d. It will be interesting to see whether this patient sees herself as being healthy.
ANS: D
It is a misconception that old age is synonymous with disease and illness. The nurse should
always determine the patients sense of wellness and independence when conducting a health and
history assessment. An assessment of medication use and family support is important for any
patient. Many older adults do have chronic health conditions, but their perception is more
important than a single number.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Health Promotion
8. The nurse is caring for an older adult who has been admitted to an acute care hospital for
treatment of a fractured femur. The family expresses concern about the patients pending transfer
to a subacute care facility. What response by the nurse is best?
, a. Acute fcare ffacilities flack fthe flong-term fphysical ftherapy fsupport fyour
fdad frequires.
b. Your fdad fwill fbe fmuch fhappier fin fa fmore fserene, fprivate fenvironment.
c. The fsubacute ffacility fwill ffocus fon fhelping fyour fdad fmaintain fhis findependence.
d. Insurance, fincluding fMedicare, fwill fcover fonly fa flimited famount fof ftime fhere.
ANS: fC
The ftransfer fof fthe fpatient fto fa fsubacute ffacility fis fbased fon fthe fneed fto fmaintain fthe
fpatients f level fof ffunction fand f independence, fa ftask fthe facute fcare ffacility fis fnot fprepared
fto faddress fonce fthe fpatient fis fphysiologically f stable. fThe fpatient f may for fmay f not fbe
fhappier f in fthe f new f setting; fthe fnurse fshould fnot fmake fthis fjudgment. fIt fis ftrue fthat
finsurance fonly fpays f for fa flimited famount fof ftime f in fan f acute fcare f facility, f but fthis f is
fnot fthe fbest freason f for fthe fpatient fto ftransfer.
DIF: fApplying f(Application) fREF: fN/A fOBJ: f1-
6 fTOP: fCommunication fand fDocumentation
MSC: fHealth fPromotion fand fMaintenance
9. To fbest fassure fboth fthe fquality fof fcare fand fthe fsafety fof fthe folder fadult fpatient fwho
frequires f in- fhome funlicensed f assistive fpersonal f(UAP) fassistance, fthe fgeriatric f nurse:
a. evaluates fthe fcompetency fof fthe fUAP fstaff.
b. assumes fthe froles fof fcase fmanager fand fpatient fadvocate.
c. arranges ffor fthe fneeded fUAP fprovided fservices.
d. assesses fthe fpatient ffor ffunctional flimitations.
ANS: fA
As fmore fcare ftraditionally fprovided fby fprofessional fnurses fis fbeing ftransferred fto fUAP,
fthe fnurse f must fassume f more fresponsibility ffor feducating, ftraining, fand fevaluating fthe
fcompetency fof f UAP fstaff fto fprovide f safe, feffective fcare f for fthe folder fadult fpatient.
DIF: fApplying f(Application) fREF: fN/A fOBJ: f1-2
, TOP: fCommunication fand fDocumentation
fMSC: fSafe fand fEffective fCare
fEnvironment
10. The fnurse fworking fwith folder fadults funderstands fwhat finformation fabout
fcertification fin fgerontologic f nursing?
a. It fis fmandatory ffor fthose fin flong-term fcare fsettings.
b. It fis fvoluntary fand fshows fclinical fexpertise fin fan farea.
c. It fallows fnurses fto fbe fpaid fby fthird-party fpayers.
d. It fallows fnurses fto fadvance ftheir fcareers fin fa fjob.
ANS: fB
Certification fis fvoluntary fand fshows fthat fa fnurse fhas fadditional fknowledge fand fexpertise
f in fa fcertain farea fof fpractice. fIt fis f not fmandatory fin fspecific fcare fsettings. fIt fdoes fnot
fallow f for fthird- fparty freimbursement. fIt fmay fbe fpart fof fa fcareer f ladder fprogram, fbut
fthat fis f not ftrue fof fall fwork fsettings.
DIF: fRemembering f(Knowledge) fREF: fMCS: f2 fOBJ: f1-2
TOP: fTeaching-Learning fMSC: fSafe fEffective fCare fEnvironment
11. A fnurse fworks fin fa fgerontologic fclinic. fWhat faction fby fthe fnurse ftakes fhighest fpriority?
a. Serving fas fa fpatient fadvocate
b. Educating fpatients fabout fdiseases
c. Helping fpatients fremain findependent
d. Referring fpatients fto fhome fhealth fcare
ANS: fC
One fof fthe fchallenges fand fpriorities fof fthe fgerontologic fnurse fis fhelping fpatients fmaintain ftheir
findependence.