TEST BANK FOR HAM’S PRIMARY CARE GERIATRICS: A CASE-BASED APPROACH 7TH EDITION BY RICHARD J. HAM :ISBN10; /ISBN-13; 978-0323721684

, Chapter1. Principles of PrimaryCareofOlder Adults b b b b b b b b




MULTIPLECHOICE b




1. In2010,therevised StandardsandScopeof Gerontological NursingPracticewaspublished.The
b b b b b b b b b b b b b




nurse would use these standards to:
b b b b b b




a. promotethepractice ofgerontologic nursing withinthe acute caresetting. b b b b b b b b b b




b. definethe conceptsanddimensionsofgerontologic nursingpractice.
b b b b b b b b




c. elevatethepracticeofgerontologicnursing. b b b b b




d. incorporatesuggestedinterventionsfromotherswhopracticegerontologicnursing. b b b b b b b b




ACCURATE ANSWER:-D
b b




Reasoning:->>>Thecurrent publishingofthe Standardsand Scope of GerontologicalNursing Practice in20 b b b b b b b b b b b b b




incorporates the input of gerontologic nursing attendants from across the United States. It was not
b b b b b b b b b b b b b b




intended to promote gerontologic nursing practice withinacute care settings, define conceptsor
b b b b b b b b b b b b b




dimensions ofgerontologic nursing practice, or elevate the practice ofgerontologic nursing.
b b b b b b b b b b b b




DIFFICULT:Remembering(Knowledge)REF:msc:2OBJ:1-1 b b b b b b b




TOPIC:N/AMSC: Safe and Effective Care Environment
b b b b b b b




2. Whenattempting tominimizetheeffect ofageism onthepracticeofnursing older adults, anursing
b b b b b b b b b b b b b b b b




attendant needs to first:
b b b b




a. recognizethat nursing attendants must actasadvocatesfor aginghospital clients. b b b b b b b b b b b




b. acceptthatthis populationrepresents asubstantial portionofthose requiring nursingcare.
b b b b b b b b b b b b




c. self-reflect and formulateones personalview ofagingand theolder hospital client. b b b b b b b b b b b b




d. recognizeageismasa formofbigotryshared by many Americans. b b b b b b b b b b




ACCURATE ANSWER:-C
b b




Reasoning:->>>Ageism is anever-increasing prejudicial view ofthe effects ofthe aging process and oftheolder b b b b b b b b b b b b b b b b




population as a whole. With nursing attendants being members of a society holding such views, it is
b b b b b b b b b b b b b b b b




criticalthat the individual nursing attendant self-reflect onpersonal feelings and determine whether
b b b b b b b b b b b b b




such feelings willaffect the nursing care that he orshe providestothe aginghospital client. Acting as an
b b b b b b b b b b b b b b b b b b b b




advocate is an important nursing role in all settings. Simply accepting a fact does not help end ageism,
b b b b b b b b b b b b b b b b b b




nor does recognizing ageism as a formofbigotry.
b b b b b b b b b




DIFFICULT:Applying(Application) REF: N/AOBJ: 1-9 b b b b b b




TOPIC: Teaching-LearningMSC:SafeandEffectiveCareEnvironment
b b b b b b b




3. Whendiscussing factorsthat have helpedtoincreasethenumberofhealthy, independentolder
b b b b b b b b b b b b b




Americans, the nursing attendant includes the importance of:
b b b b b b b b




a. increasedavailabilityofin-homecareservices. b b b b b




b. government supportofretired citizens. b b b b




c. effectiveantibiotictherapies. b b




d. thedevelopmentoflife-extendingtherapies.
b b b b

,ACCURATE ANSWER:-C b




Reasoning:->>>The health and ultimate autonomy of older Americans has been positively impacted b b b b b b b b b b b




bythe development ofantibiotics, bettersanitation, and vaccines. These public healthmeasures have
b b b b b b b b b b b b b b




been more instrumental in increasing the numbers of healthy, independent olderAmericans than have
b b b b b b b b b b b b b b




in-home care services, government programs, or life-extending therapies.DIFFICULT:
b b b b b b b b b




Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
b b b b b b b




TOPIC:NursingProcess: ImplementationMSC:HealthPromotionandMaintenance b b b b b b b




4. Basedoncurrent data, whenpresenting anolder adultsdischargeteaching plan, the
b b b b b b b b b b b b




nursing attendant includes the hospital clients:
b b b b b b




a. nonrelatedcaretaker. b




b. paidnursing attendant. b b




c. familymember. b




d. intuitional representative. b




ACCURATE ANSWER:-C
b b




Reasoning:->>>Less than4%ofolder adults live ina formalhealth care environment. The majorityofthe b b b b b b b b b b b b b b b b




geriatricpopulationlivesathomeorwithfamilymembers.
b b b b b b b b




DIFFICULT: Applying (Application) REF: N/AOBJ: 3-3
b b b b b b b




TOPIC:NursingProcess:PlanningMSC:Safeand EffectiveCareEnvironment b b b b b b b b




5. The nursing attendant planning care for an older adult who has recently been diagnosed with
b b b b b b b b b b b b b b




rheumatoid arthritisviews the prioritycriterion forcontinued independence to bethe hospital
b b b b b b b b b b b b b




clients:
b




a. age.
b. financialstatus. b




c. gender.
d. functionalstatus. b




ACCURATE ANSWER:-D
b b




Reasoning:->>>Maintainingthe functionalstatusofolder adults mayavert theonset ofphysical frailtyand b b b b b b b b b b b b b b




cognitiveimpairment,two conditionsthat increasethelikelihoodofinstitutionalization.
b b b b b b b b b




DIFFICULT: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
b b b b b b b b




TOPIC: NursingProcess:PlanningMSC: Physiologic Integrity
b b b b b b




6. Anursing attendant working with the older adult population is most likelyto assess a need for a
b b b b b b b b b b b b b b b b b




financialsocial services referral for a(n):
b b b b b b




a. whitemale. b




b. blackfemale. b




c. Hispanicmale. b




d. AsianAmericanfemale. b b




ACCURATE ANSWER:-B
b b




Reasoning:->>>Thepovertyrate among older black women issubstantially higher thanthat seenamongmaor b b b b b b b b b b b b b b b




femalesofotherethnicgroups.White maleshadtheleast poverty.
b b b b b b b b b b




DIFFICULT: Applying (Application) REF: N/AOBJ: 1-4
b b b b b b b




TOPIC:NursingProcess: Assessment MSC:SafeandEffectiveCareEnvironment b b b b b b b b

, 7. Which of the following statements made by a nursing attendant preparing to complete a health
b b b b b b b b b b b b b b




assessment and historyonanolder hospital client reflects anunderstanding ofthe general health
b b b b b b b b b b b b b b b




statusofthis population?
b b b b




a. Illneed to document wellregardingthemedicationsthehospital client iscurrentlyprescribed. b b b b b b b b b b b b b




b. Iwould liketo understand howsupportivethehospital clients familymembersare.
b b b b b b b b b b b b




c. Mostolderhospital clients arebeing treatedfora varietyofchronic healthcare issues.
b b b b b b b b b b b b b b




d. Itwillbe interestingtoseewhetherthishospital client sees herselfasbeing b b b b b b b b b b b b b




healthy.ACCURATE ANSWER:-D
b b b




Reasoning:->>>It isa misconceptionthat old ageissynonymouswithillness and illness. Thenursing attendant sho b b b b b b b b b b b b b b b b




always determinethehospital clientssenseofwellnessand independencewhenconductinga healthand
b b b b b b b b b b b b b b




history assessment. An assessment of medication use and family support is important for any hospital
b b b b b b b b b b b b b b b




client. Many older adults do have chronic health conditions, but their perception is more important than
b b b b b b b b b b b b b b b b




a single number.
b b b




DIFFICULT:Applying(Application) REF: N/AOBJ: 1-4 b b b b b b




TOPIC:NursingProcess: Assessment MSC:HealthPromotion b b b b b




8. The nursing attendant is caring for an older adult who has been admitted to an acute care health
b b b b b b b b b b b b b b b b b




center for treatment of a fractured femur. The family expresses concern about the hospital
b b b b b b b b b b b b b b




clients pendingtransfer to a subacute supported care facility. What response bythe nursing
b b b b b b b b b b b b b b




attendant is best?
b b b




a. Acutecare facilities lackthe long-termphysicaltherapysupport yourdad requires. b b b b b b b b b b b




b. Yourdad willbe muchhappier inamoreserene, private environment.
b b b b b b b b b b b




c. Thesubacute facilitywillfocusonhelping yourdad maintain his independence.
b b b b b b b b b b b




d. Insurance, includingMedicare, willcoveronlya limitedamount oftimehere. b b b b b b b b b b b




ACCURATE ANSWER:-C
b b




Reasoning:->>>The transfer of the hospital client to a subacute facility is based on the need to maintain the hospital b b b b b b b b b b b b b b b b b b




clients
b




level of function and independence, a task the acute supported care facility is not prepared to address
b b b b b b b b b b b b b b b b




once the hospital client is physiologically stable. The hospital client may or may not be happier in the
b b b b b b b b b b b b b b b b b b




new setting; thenursing attendant should not make this judgment.It is truethat insurance onlypays for a
b b b b b b b b b b b b b b b b b b b




limited amount of time in an acute supported care facility, but this is not the best reason for the hospital
b b b b b b b b b b b b b b b b b b b b




client totransfer.
b b b




DIFFICULT:Applying(Application)REF:N/AOBJ: b b b b b




1-6TOPIC:Communicationand Documentation
b b b b




MSC:HealthPromotionandMaintenance b b b b




9. To best assure boththe qualityofcare andthe safetyofthe older adult hospital client who requires in-
b b b b b b b b b b b b b b b b b b b




home unlicensed assistive personal (UAP) assistance, the geriatric nursing attendant:
b b b b b b b b b b




a. evaluates the competencyofthe UAP staff. b b b b b b




b. assumestherolesofcase manager andhospital client advocate. b b b b b b b b b




c. arrangesfortheneeded UAPprovided services. b b b b b b




d. assessesthehospital client forfunctional b b b b b




limitations.ACCURATE ANSWER:-A
b b b




Reasoning:->>>As more caretraditionallyprovided byprofessional nursing attendants is beingtransferredto UAP, b b b b b b b b b b b b b




nursing attendant
b b




must assume more responsibilityfor educating, training, and evaluatingthe competencyofUAPstaffto
b b b b b b b b b b b b b b




provide safe, effective care for the older adult hospital client.
b b b b b b b b b b




DIFFICULT:Applying(Application) REF: N/AOBJ: 1-2 b b b b b b