TOWARD HEALTH AGING: Human Needs and
Nursing Responses 11TH EDITION/ALL
CHAPTERS 1-35
,Chapter 01: Gerontological Nursing Across the Continuum of Care
T T T T T T T T
Touhy: Toward Healthy Aging, 11th Edition
T T T T T T
MULTIPLE CHOICE T
1. When did serious and well-controlled research studies on aging first become available?
T T T T T T T T T T T
a. Only in the past 60 years. T T T T T
b. Since the turn of the 20th century.T T T T T T
c. Following the Great Depression. T T T
d. Since the year 2000. T T T
ACCURATE
ANSWER:-A
T
REASONING:->>>Only in the past 60 years have serious and carefully controlled research T T T T T T T T T T T
studies flourished. Before that, anecdotal evidence was used to illustrate issues assumed to
T T T T T T T T T T T T T
be universal, making all the remaining options incorrect.
T T T T T T T T
DIF: Cognitive Level: Remembering TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
2. The son of a nursing home resident asks a nursing attendant: “What is the significance of
T T T T T T T T T T T T T T T
being certified in gerontology? I see that you are, but not all of the nursing attendants are.”
T T T T T T T T T T T T T T T T T
What response best answers the family member’s question?
T T T T T T T T
a. “National certification as a gerontological nursing attendant is a way to
T T T T T T T T T T
demonstrate special knowledge in caring for older adults.”
T T T T T T T T
b. “National certification in gerontology is required for all nursing attendants who
T T T T T T T T T T
have worked in this setting for 2 or more years.”
T T T T T T T T T T
c. “National certification is only available to nursing attendants who have a
T T T T T T T T T T
Baccalaureate degree in nursing.”
T T T T
d. “Only advanced practice nursing attendants, like nursing attendant
T T T T T T T
practitioners, are certified in gerontology.”
T T T T T
ACCURATE
ANSWER:-A
T
REASONING:->>>National certification is a way to demonstrate special expertise in caring T T T T T T T T T T
for older adults. It is not required for practice in any setting across the continuum of care,
T T T T T T T T T T T T T T T T T
and it is not exclusive to nursing attendants with Baccalaureate degrees. There is both a
T T T T T T T T T T T T T T T
generalist and a specialist gerontological nursing certification. The generalist functions in a
T T T T T T T T T T T T
variety of settings providing care to older adults and their families. The specialist has
T T T T T T T T T T T T T T
advanced gerontological education at a master’s level.
T T T T T T T
DIF: Cognitive Level: Understanding T T
TOPIC: Integrated Process: Communication and Documentation
T T T T T
MSC: Patient Needs: Management of Care
T T T T T T
3. The major goal of the NICHE (Nursing attendants Improving Care for Healthsystem
T T T T T T T T T T T
Elders) program includes which of the following?
T T T T T T T
a. Improve outcomes for hospitalized older adults.
T T T T T
b. Increase the number of older adults cared for in hospitals.
T T T T T T T T T
c. Increase the number of iatrogenic complications that occur in hospitalized older
T T T T T T T T T T
adults.
T
, d. Decrease 30-day readmission rates for hospitalized older adults.
T T T T T T T
ACCURATE ANSWER:-A T
REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older T T T T T T T T T T
adults. Although option D is a good outcome for hospitalized older adults, it is not one of
T T T T T T T T T T T T T T T T T
the major goals of NICHE, which are broader. Options B and C are not goals that would
T T T T T T T T T T T T T T T T T
improve care for older adults but would be negative outcomes themselves.
T T T T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
MULTIPLE RESPONSE T
1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on
T T T T T T T T T T T
avoidable readmissions? (Choose all that apply.)
T T T T T T
a. Readmission rates for the selected conditions have dropped nationwide. T T T T T T T T
b. Many hospitals have instituted system-wide interventions to prevent readmissions.
T T T T T T T T
c. Hospitals are keeping hospital patients longer to avoid readmissions.
T T T T T T T T
d. Potentially avoidable hospitalizations among nursing home residents is increasing.
T T T T T T T T
e. Hospitals have a financial incentive to develop programs to reduce readmissions.
T T T T T T T T T T
ACCURATE ANSWER:-A, B, E T T T
REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was established T T T T T T T
as a provision in the Affordable Care Act (ACA) requiring Medicare to reduce payments to
T T T T T T T T T T T T T T T
hospitals with relatively high readmission rates for selected conditions for hospital patients
T T T T T T T T T T T T
in traditional Medicare. Since the HRRP, readmission rates for the selected conditions have
T T T T T T T T T T T T T
dropped nationwide but estimates are that in 2018, about 80% of hospitals evaluated by
T T T T T T T T T T T T T T
CMS will face penalties totaling $564 million (Advisory Board, 2017). Additionally, the
T T T T T T T T T T T T
HRRP has been the impetus for many hospitals to institute system-wide interventions to
T T T T T T T T T T T T T
prevent readmissions that have also contributed to the decline in readmission rates. The rate
T T T T T T T T T T T T T T
of potentially avoidable hospitalizations among SNF residents has fallen by nearly a third in
T T T T T T T T T T T T T T
recent years as a result of many quality improvement initiatives.
T T T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
2. Which of the following are true statements about the current health care workforce? (Choose
T T T T T T T T T T T T T
all that apply.)
T T T
a. Approximately 10% of registered nursing attendants (RNs) are certified in T T T T T T T T T
T gerontological nursing. T
b. The number of geriatricians is expected to increase about 50% over the next
T T T T T T T T T T T T
T 25 years. T
c. The professions of social work, physical therapy, and psychiatry are
T T T T T T T T T
T demonstrating the same trends as nursing. T T T T T
d. The world’s older population is expected to grow to at least 1.3 billion in the
T T T T T T T T T T T T T T
T next 20 years. T T
e. It is anticipated that there will be a need for approximately 3million
T T T T T T T T T T T
T additional direct care and professional health care workers by the year 2030.
T T T T T T T T T T T
ACCURATE ANSWER:-C, D, E T T T
, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing. Geriatric T T T T T T T T T T
medicine faces similar challenges with about 7000 prepared geriatricians, 1 for every 2546
T T T T T T T T T T T T T
older Americans; and this number is falling with the trend predicted to be less than 5000 by
T T T T T T T T T T T T T T T T T
2040 (IOM, 2008). By 2040 the number of older adults in the world will be at least 1.3
T T T T T T T T T T T T T T T T T T
billion. Other professions such as social work, physical therapy, and psychiatry have similar
T T T T T T T T T T T T T
shortages. It is estimated that by 2030 nearly 3 million additional health care professionals
T T T T T T T T T T T T T T
and direct care workers will be needed to meet the care needs of a growing older adult
T T T T T T T T T T T T T T T T T
population. Healthy People 2030 has addressed this concern..
T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
3. Best practice recommendations for nursing education in relation to gerontology include
T T T T T T T T T T
which of the following? (Choose all that apply.)
T T T T T T T T
a. Provision of a “stand-alone” course in gerontological nursing
T T T T T T T
b. Integration of gerontological content throughout the curriculum T T T T T T
c. Replacement of acute care pediatric clinical experiences with gerontological T T T T T T T T
clinical experiences
T T
d. Recruitment of nursing attendants with Master and Doctoral degrees and a T T T T T T T T T T
specialty in gerontology to faculty roles
T T T T T T
e. Requiring all undergraduate nursing students to obtain gerontological certification
T T T T T T T T
as a requirement for graduation
T T T T T
ACCURATE ANSWER:-A, B, D T T T
REASONING:->>>Best practices include providing a stand-alone gerontological nursing T T T T T T T
course as well as integrating gerontology throughout the curriculum. Recruitment of nursing
T T T T T T T T T T T T
attendants with a specialty in gerontology and a Master or Doctoral degree to faculty roles is
T T T T T T T T T T T T T T T T
a critical step in making sure that the next generation of nursing attendants is prepared to
T T T T T T T T T T T T T T T T
care for older adults. Best practices do not recommend removing pediatric clinical
T T T T T T T T T T T T
experiences and replacing them with gerontological experiences. Nursing certification is
T T T T T T T T T T
only available to practicing nursing attendants who meet specific education and practice
T T T T T T T T T T T T
requirements. It is not applicable to nursing students.
T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
4. What are the current initiatives being implemented to enhance the specialty of
T T T T T T T T T T T
Tgerontological nursing? (Choose all that apply.) T T T T T
a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care
T T T T T T T T T T T T T
for older adults
T T T
b. Geriatric Nursing Leadership Academy (GNLA) project
T T T T T
c. Promotion of geriatric nursing to excellence to the nursing community
T T T T T T T T T
d. Requiring a nursing certification specifically required to long-term care
T T T T T T T T
e. Offering scholarships for study and research in geriatric nursing
T T T T T T T T
ACCURATE ANSWER:-B, C, E T T T
Nursing Responses 11TH EDITION/ALL
CHAPTERS 1-35
,Chapter 01: Gerontological Nursing Across the Continuum of Care
T T T T T T T T
Touhy: Toward Healthy Aging, 11th Edition
T T T T T T
MULTIPLE CHOICE T
1. When did serious and well-controlled research studies on aging first become available?
T T T T T T T T T T T
a. Only in the past 60 years. T T T T T
b. Since the turn of the 20th century.T T T T T T
c. Following the Great Depression. T T T
d. Since the year 2000. T T T
ACCURATE
ANSWER:-A
T
REASONING:->>>Only in the past 60 years have serious and carefully controlled research T T T T T T T T T T T
studies flourished. Before that, anecdotal evidence was used to illustrate issues assumed to
T T T T T T T T T T T T T
be universal, making all the remaining options incorrect.
T T T T T T T T
DIF: Cognitive Level: Remembering TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
2. The son of a nursing home resident asks a nursing attendant: “What is the significance of
T T T T T T T T T T T T T T T
being certified in gerontology? I see that you are, but not all of the nursing attendants are.”
T T T T T T T T T T T T T T T T T
What response best answers the family member’s question?
T T T T T T T T
a. “National certification as a gerontological nursing attendant is a way to
T T T T T T T T T T
demonstrate special knowledge in caring for older adults.”
T T T T T T T T
b. “National certification in gerontology is required for all nursing attendants who
T T T T T T T T T T
have worked in this setting for 2 or more years.”
T T T T T T T T T T
c. “National certification is only available to nursing attendants who have a
T T T T T T T T T T
Baccalaureate degree in nursing.”
T T T T
d. “Only advanced practice nursing attendants, like nursing attendant
T T T T T T T
practitioners, are certified in gerontology.”
T T T T T
ACCURATE
ANSWER:-A
T
REASONING:->>>National certification is a way to demonstrate special expertise in caring T T T T T T T T T T
for older adults. It is not required for practice in any setting across the continuum of care,
T T T T T T T T T T T T T T T T T
and it is not exclusive to nursing attendants with Baccalaureate degrees. There is both a
T T T T T T T T T T T T T T T
generalist and a specialist gerontological nursing certification. The generalist functions in a
T T T T T T T T T T T T
variety of settings providing care to older adults and their families. The specialist has
T T T T T T T T T T T T T T
advanced gerontological education at a master’s level.
T T T T T T T
DIF: Cognitive Level: Understanding T T
TOPIC: Integrated Process: Communication and Documentation
T T T T T
MSC: Patient Needs: Management of Care
T T T T T T
3. The major goal of the NICHE (Nursing attendants Improving Care for Healthsystem
T T T T T T T T T T T
Elders) program includes which of the following?
T T T T T T T
a. Improve outcomes for hospitalized older adults.
T T T T T
b. Increase the number of older adults cared for in hospitals.
T T T T T T T T T
c. Increase the number of iatrogenic complications that occur in hospitalized older
T T T T T T T T T T
adults.
T
, d. Decrease 30-day readmission rates for hospitalized older adults.
T T T T T T T
ACCURATE ANSWER:-A T
REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older T T T T T T T T T T
adults. Although option D is a good outcome for hospitalized older adults, it is not one of
T T T T T T T T T T T T T T T T T
the major goals of NICHE, which are broader. Options B and C are not goals that would
T T T T T T T T T T T T T T T T T
improve care for older adults but would be negative outcomes themselves.
T T T T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
MULTIPLE RESPONSE T
1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on
T T T T T T T T T T T
avoidable readmissions? (Choose all that apply.)
T T T T T T
a. Readmission rates for the selected conditions have dropped nationwide. T T T T T T T T
b. Many hospitals have instituted system-wide interventions to prevent readmissions.
T T T T T T T T
c. Hospitals are keeping hospital patients longer to avoid readmissions.
T T T T T T T T
d. Potentially avoidable hospitalizations among nursing home residents is increasing.
T T T T T T T T
e. Hospitals have a financial incentive to develop programs to reduce readmissions.
T T T T T T T T T T
ACCURATE ANSWER:-A, B, E T T T
REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was established T T T T T T T
as a provision in the Affordable Care Act (ACA) requiring Medicare to reduce payments to
T T T T T T T T T T T T T T T
hospitals with relatively high readmission rates for selected conditions for hospital patients
T T T T T T T T T T T T
in traditional Medicare. Since the HRRP, readmission rates for the selected conditions have
T T T T T T T T T T T T T
dropped nationwide but estimates are that in 2018, about 80% of hospitals evaluated by
T T T T T T T T T T T T T T
CMS will face penalties totaling $564 million (Advisory Board, 2017). Additionally, the
T T T T T T T T T T T T
HRRP has been the impetus for many hospitals to institute system-wide interventions to
T T T T T T T T T T T T T
prevent readmissions that have also contributed to the decline in readmission rates. The rate
T T T T T T T T T T T T T T
of potentially avoidable hospitalizations among SNF residents has fallen by nearly a third in
T T T T T T T T T T T T T T
recent years as a result of many quality improvement initiatives.
T T T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
2. Which of the following are true statements about the current health care workforce? (Choose
T T T T T T T T T T T T T
all that apply.)
T T T
a. Approximately 10% of registered nursing attendants (RNs) are certified in T T T T T T T T T
T gerontological nursing. T
b. The number of geriatricians is expected to increase about 50% over the next
T T T T T T T T T T T T
T 25 years. T
c. The professions of social work, physical therapy, and psychiatry are
T T T T T T T T T
T demonstrating the same trends as nursing. T T T T T
d. The world’s older population is expected to grow to at least 1.3 billion in the
T T T T T T T T T T T T T T
T next 20 years. T T
e. It is anticipated that there will be a need for approximately 3million
T T T T T T T T T T T
T additional direct care and professional health care workers by the year 2030.
T T T T T T T T T T T
ACCURATE ANSWER:-C, D, E T T T
, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing. Geriatric T T T T T T T T T T
medicine faces similar challenges with about 7000 prepared geriatricians, 1 for every 2546
T T T T T T T T T T T T T
older Americans; and this number is falling with the trend predicted to be less than 5000 by
T T T T T T T T T T T T T T T T T
2040 (IOM, 2008). By 2040 the number of older adults in the world will be at least 1.3
T T T T T T T T T T T T T T T T T T
billion. Other professions such as social work, physical therapy, and psychiatry have similar
T T T T T T T T T T T T T
shortages. It is estimated that by 2030 nearly 3 million additional health care professionals
T T T T T T T T T T T T T T
and direct care workers will be needed to meet the care needs of a growing older adult
T T T T T T T T T T T T T T T T T
population. Healthy People 2030 has addressed this concern..
T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
3. Best practice recommendations for nursing education in relation to gerontology include
T T T T T T T T T T
which of the following? (Choose all that apply.)
T T T T T T T T
a. Provision of a “stand-alone” course in gerontological nursing
T T T T T T T
b. Integration of gerontological content throughout the curriculum T T T T T T
c. Replacement of acute care pediatric clinical experiences with gerontological T T T T T T T T
clinical experiences
T T
d. Recruitment of nursing attendants with Master and Doctoral degrees and a T T T T T T T T T T
specialty in gerontology to faculty roles
T T T T T T
e. Requiring all undergraduate nursing students to obtain gerontological certification
T T T T T T T T
as a requirement for graduation
T T T T T
ACCURATE ANSWER:-A, B, D T T T
REASONING:->>>Best practices include providing a stand-alone gerontological nursing T T T T T T T
course as well as integrating gerontology throughout the curriculum. Recruitment of nursing
T T T T T T T T T T T T
attendants with a specialty in gerontology and a Master or Doctoral degree to faculty roles is
T T T T T T T T T T T T T T T T
a critical step in making sure that the next generation of nursing attendants is prepared to
T T T T T T T T T T T T T T T T
care for older adults. Best practices do not recommend removing pediatric clinical
T T T T T T T T T T T T
experiences and replacing them with gerontological experiences. Nursing certification is
T T T T T T T T T T
only available to practicing nursing attendants who meet specific education and practice
T T T T T T T T T T T T
requirements. It is not applicable to nursing students.
T T T T T T T T
DIF: Cognitive Level: Understanding TOPIC: Integrated Process: T T T T
Teaching/Learning MSC: Patient Needs: Health Promotion and Maintenance
T T T T T T T T
4. What are the current initiatives being implemented to enhance the specialty of
T T T T T T T T T T T
Tgerontological nursing? (Choose all that apply.) T T T T T
a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care
T T T T T T T T T T T T T
for older adults
T T T
b. Geriatric Nursing Leadership Academy (GNLA) project
T T T T T
c. Promotion of geriatric nursing to excellence to the nursing community
T T T T T T T T T
d. Requiring a nursing certification specifically required to long-term care
T T T T T T T T
e. Offering scholarships for study and research in geriatric nursing
T T T T T T T T
ACCURATE ANSWER:-B, C, E T T T
