,Chapter 1. Principles of Primary Care of Older Adults
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MULTIPLE CHOICE vj
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.
vj vj vj vj vj vj vj vj vj vj vj vj
The nurse would use these standards to:
vj vj vj vj vj vj
a. promote the practice of gerontologic nursing within the acute care setting. vj vj vj vj vj vj vj vj vj vj
b. define the concepts and dimensions of gerontologic nursing practice.
vj vj vj vj vj vj vj vj
c. elevate the practice of gerontologic nursing.
vj vj vj vj vj
d. incorporate suggested interventions from others who practice gerontologic nursing. vj vj vj vj vj vj vj vj vj
ANS: D vj
The current publishing of the Standards and Scope of Gerontological Nursing Practice in 2010
vj vj vj vj vj vj vj vj vj vj vj vj vj
incorporates the input of gerontologic nurses from across the United States. It was not intended to p
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
romote gerontologic nursing practice within acute care settings, define concepts or dimensions of
vj vj vj vj vj vj vj vj vj vj vj vj vj
gerontologic nursing practice, or elevate the practice of gerontologic nursing.
vj vj vj vj vj vj vj vj vj
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 1-
vj vj vj vj vj vj vj
1 TOP: N/A MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj vj
2. When attempting to minimize the effect of ageism on the practice of nursing older adults, a
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
nurse needs to first: vj vj vj
a. recognize that nurses must act as advocates for aging patients. vj vj vj vj vj vj vj vj vj
b. accept that this population represents a substantial portion of those requiring nursing care.
vj vj vj vj vj vj vj vj vj vj vj vj
c. self-reflect and formulate ones personal view of aging and the older patient.
vj vj vj vj vj vj vj vj vj vj vj
d. recognize ageism as a form of bigotry shared by many Americans. A vj vj vj vj vj vj vj vj vj vj vj
NS: C vj
Ageism is an ever-increasing prejudicial view of the effects of the aging process and of the older
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
population as a whole. With nurses being members of a society holding such views, it is critical tha
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
t the individual nurse self-
vj vj vj vj
reflect on personal feelings and determine whether such feelings will affect the nursing care that h
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
e or she provides to the aging patient. Acting as an advocate is an important nursing role in all setti
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
ngs. Simply accepting a fact does not help end ageism, nor does recognizing ageism as a form of b
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
igotry.
DIF: Applying (Application) REF: N/A OBJ: 1-9
vj vj vj vj vj vj
TOP: Teaching-Learning MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj
3. When discussing factors that have helped to increase the number of healthy, independent older A
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
mericans, the nurse includes the importance of: vj vj vj vj vj vj
a. increased availability of in-home care services. vj vj vj vj vj
b. government support of retired citizens. vj vj vj vj
c. effective antibiotic therapies. vj vj
d. the development of life-extending therapies.
vj vj vj vj
,ANS: C vj
The health and ultimate autonomy of older Americans has been positively impacted by the develo
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
pment of antibiotics, better sanitation, and vaccines. These public health measures have been mor
vj vj vj vj vj vj vj vj vj vj vj vj vj
e instrumental in increasing the numbers of healthy, independent older Americans than have in-
vj vj vj vj vj vj vj vj vj vj vj vj vj
home care services, government programs, or life-extending therapies.
vj vj vj vj vj vj vj
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
vj vj vj vj vj vj vj
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
vj vj vj vj vj vj vj vj
4. Based on current data, when presenting an older adults discharge teaching plan, the nurse in
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
cludes the patients: vj vj
a. nonrelated caretaker. vj
b. paid caregiver. vj
c. family member. vj
d. intuitional representative. vj vj
ANS: C vj
Less than 4% of older adults live in a formal health care environment. The majority of the
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
geriatric population lives at home or with family members. DI
vj vj vj vj vj vj vj vj vj
F: Applying (Application) REF: N/A OBJ: 3-3
vj vj vj vj vj vj
TOP: Nursing Process: Planning MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj vj vj
5. The nurse planning care for an older adult who has recently been diagnosed with rheumatoid ar
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
thritis views the priority criterion for continued independence to be the patients:
vj vj vj vj vj vj vj vj vj vj vj
a. age.
b. financial status. vj
c. gender.
d. functional status. vj vj
ANS: D vj
Maintaining the functional status of older adults may avert the onset of physical frailty and
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
cognitive impairment, two conditions that increase the likelihood of institutionalization. DI
vj vj vj vj vj vj vj vj vj vj
F: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
vj vj vj vj vj vj vj
TOP: Nursing Process: Planning MSC: Physiologic Integrity
vj vj vj vj vj vj
6. A nurse working with the older adult population is most likely to assess a need for a financial so
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
cial services referral for a(n):
vj vj vj vj
a. white male. vj
b. black female. vj
c. Hispanic male. vj
d. Asian American female. vj vj vj
ANS: B vj
The poverty rate among older black women is substantially higher than that seen among males or
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
females of other ethnic groups. White males had the least poverty. D
vj vj vj vj vj vj vj vj vj vj vj
IF: Applying (Application) REF: N/A OBJ: 1-4
vj vj vj vj vj vj
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj vj vj
, 7. Which of the following statements made by a nurse preparing to complete a health assessment an
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
d history on an older patient reflects an understanding of the general health status of this populatio
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
n?
a. Ill need to document well regarding the medications the patient is currently prescribed. vj vj vj vj vj vj vj vj vj vj vj vj
b. I would like to understand how supportive the patients family members are.
vj vj vj vj vj vj vj vj vj vj vj
c. Most older patients are being treated for a variety of chronic health care issues.
vj vj vj vj vj vj vj vj vj vj vj vj vj
d. It will be interesting to see whether this patient sees herself as being healthy. A vj vj vj vj vj vj vj vj vj vj vj vj vj vj
NS: D vj
It is a misconception that old age is synonymous with disease and illness. The nurse should
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
always determine the patients sense of wellness and independence when conducting a health and hi
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
story assessment. An assessment of medication use and family support is important for any patient
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
. Many older adults do have chronic health conditions, but their perception is more important than
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
a single number.
vj vj
DIF: Applying (Application) REF: N/A OBJ: 1-4
vj vj vj vj vj vj
TOP: Nursing Process: Assessment MSC: Health Promotion
vj vj vj vj vj vj
8. The nurse is caring for an older adult who has been admitted to an acute care hospital for treatm
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
ent of a fractured femur. The family expresses concern about the patients pending transfer to a sub
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
acute care facility. What response by the nurse is best?
vj vj vj vj vj vj vj vj vj
a. Acute care facilities lack the long-term physical therapy support your dad requires. vj vj vj vj vj vj vj vj vj vj vj
b. Your dad will be much happier in a more serene, private environment.
vj vj vj vj vj vj vj vj vj vj vj
c. The subacute facility will focus on helping your dad maintain his independence.
vj vj vj vj vj vj vj vj vj vj vj
d. Insurance, including Medicare, will cover only a limited amount of time here. A vj vj vj vj vj vj vj vj vj vj vj vj
NS: C vj
The transfer of the patient to a subacute facility is based on the need to maintain the patients
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
level of function and independence, a task the acute care facility is not prepared to address once th
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
e patient is physiologically stable. The patient may or may not be happier in the new setting; the n
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
urse should not make this judgment. It is true that insurance only pays for a limited amount of time
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
in an acute care facility, but this is not the best reason for the patient to transfer.
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
DIF: Applying (Application) REF: N/A OBJ: 1-
vj vj vj vj vj vj
6 TOP: Communication and Documentation
vj vj vj vj
MSC: Health Promotion and Maintenance vj vj vj vj
9. To best assure both the quality of care and the safety of the older adult patient who requires in-
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
home unlicensed assistive personal (UAP) assistance, the geriatric nurse:
vj vj vj vj vj vj vj vj vj
a. evaluates the competency of the UAP staff. vj vj vj vj vj vj
b. assumes the roles of case manager and patient advocate. vj vj vj vj vj vj vj vj
c. arranges for the needed UAP provided services. vj vj vj vj vj vj
d. assesses the patient for functional limitations. vj vj vj vj vj vj
ANS: A vj
As more care traditionally provided by professional nurses is being transferred to UAP, the nurse
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
must assume more responsibility for educating, training, and evaluating the competency of UAP st
vj vj vj vj vj vj vj vj vj vj vj vj vj
aff to provide safe, effective care for the older adult patient.
vj vj vj vj vj vj vj vj vj vj
DIF: Applying (Application) REF: N/A OBJ: 1-2
vj vj vj vj vj vj
vj vj vj vj vj vj vj vj
MULTIPLE CHOICE vj
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.
vj vj vj vj vj vj vj vj vj vj vj vj
The nurse would use these standards to:
vj vj vj vj vj vj
a. promote the practice of gerontologic nursing within the acute care setting. vj vj vj vj vj vj vj vj vj vj
b. define the concepts and dimensions of gerontologic nursing practice.
vj vj vj vj vj vj vj vj
c. elevate the practice of gerontologic nursing.
vj vj vj vj vj
d. incorporate suggested interventions from others who practice gerontologic nursing. vj vj vj vj vj vj vj vj vj
ANS: D vj
The current publishing of the Standards and Scope of Gerontological Nursing Practice in 2010
vj vj vj vj vj vj vj vj vj vj vj vj vj
incorporates the input of gerontologic nurses from across the United States. It was not intended to p
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
romote gerontologic nursing practice within acute care settings, define concepts or dimensions of
vj vj vj vj vj vj vj vj vj vj vj vj vj
gerontologic nursing practice, or elevate the practice of gerontologic nursing.
vj vj vj vj vj vj vj vj vj
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 1-
vj vj vj vj vj vj vj
1 TOP: N/A MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj vj
2. When attempting to minimize the effect of ageism on the practice of nursing older adults, a
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
nurse needs to first: vj vj vj
a. recognize that nurses must act as advocates for aging patients. vj vj vj vj vj vj vj vj vj
b. accept that this population represents a substantial portion of those requiring nursing care.
vj vj vj vj vj vj vj vj vj vj vj vj
c. self-reflect and formulate ones personal view of aging and the older patient.
vj vj vj vj vj vj vj vj vj vj vj
d. recognize ageism as a form of bigotry shared by many Americans. A vj vj vj vj vj vj vj vj vj vj vj
NS: C vj
Ageism is an ever-increasing prejudicial view of the effects of the aging process and of the older
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
population as a whole. With nurses being members of a society holding such views, it is critical tha
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
t the individual nurse self-
vj vj vj vj
reflect on personal feelings and determine whether such feelings will affect the nursing care that h
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
e or she provides to the aging patient. Acting as an advocate is an important nursing role in all setti
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
ngs. Simply accepting a fact does not help end ageism, nor does recognizing ageism as a form of b
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
igotry.
DIF: Applying (Application) REF: N/A OBJ: 1-9
vj vj vj vj vj vj
TOP: Teaching-Learning MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj
3. When discussing factors that have helped to increase the number of healthy, independent older A
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
mericans, the nurse includes the importance of: vj vj vj vj vj vj
a. increased availability of in-home care services. vj vj vj vj vj
b. government support of retired citizens. vj vj vj vj
c. effective antibiotic therapies. vj vj
d. the development of life-extending therapies.
vj vj vj vj
,ANS: C vj
The health and ultimate autonomy of older Americans has been positively impacted by the develo
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
pment of antibiotics, better sanitation, and vaccines. These public health measures have been mor
vj vj vj vj vj vj vj vj vj vj vj vj vj
e instrumental in increasing the numbers of healthy, independent older Americans than have in-
vj vj vj vj vj vj vj vj vj vj vj vj vj
home care services, government programs, or life-extending therapies.
vj vj vj vj vj vj vj
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
vj vj vj vj vj vj vj
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
vj vj vj vj vj vj vj vj
4. Based on current data, when presenting an older adults discharge teaching plan, the nurse in
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
cludes the patients: vj vj
a. nonrelated caretaker. vj
b. paid caregiver. vj
c. family member. vj
d. intuitional representative. vj vj
ANS: C vj
Less than 4% of older adults live in a formal health care environment. The majority of the
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
geriatric population lives at home or with family members. DI
vj vj vj vj vj vj vj vj vj
F: Applying (Application) REF: N/A OBJ: 3-3
vj vj vj vj vj vj
TOP: Nursing Process: Planning MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj vj vj
5. The nurse planning care for an older adult who has recently been diagnosed with rheumatoid ar
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
thritis views the priority criterion for continued independence to be the patients:
vj vj vj vj vj vj vj vj vj vj vj
a. age.
b. financial status. vj
c. gender.
d. functional status. vj vj
ANS: D vj
Maintaining the functional status of older adults may avert the onset of physical frailty and
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
cognitive impairment, two conditions that increase the likelihood of institutionalization. DI
vj vj vj vj vj vj vj vj vj vj
F: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
vj vj vj vj vj vj vj
TOP: Nursing Process: Planning MSC: Physiologic Integrity
vj vj vj vj vj vj
6. A nurse working with the older adult population is most likely to assess a need for a financial so
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
cial services referral for a(n):
vj vj vj vj
a. white male. vj
b. black female. vj
c. Hispanic male. vj
d. Asian American female. vj vj vj
ANS: B vj
The poverty rate among older black women is substantially higher than that seen among males or
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
females of other ethnic groups. White males had the least poverty. D
vj vj vj vj vj vj vj vj vj vj vj
IF: Applying (Application) REF: N/A OBJ: 1-4
vj vj vj vj vj vj
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
vj vj vj vj vj vj vj vj vj
, 7. Which of the following statements made by a nurse preparing to complete a health assessment an
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
d history on an older patient reflects an understanding of the general health status of this populatio
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
n?
a. Ill need to document well regarding the medications the patient is currently prescribed. vj vj vj vj vj vj vj vj vj vj vj vj
b. I would like to understand how supportive the patients family members are.
vj vj vj vj vj vj vj vj vj vj vj
c. Most older patients are being treated for a variety of chronic health care issues.
vj vj vj vj vj vj vj vj vj vj vj vj vj
d. It will be interesting to see whether this patient sees herself as being healthy. A vj vj vj vj vj vj vj vj vj vj vj vj vj vj
NS: D vj
It is a misconception that old age is synonymous with disease and illness. The nurse should
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
always determine the patients sense of wellness and independence when conducting a health and hi
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
story assessment. An assessment of medication use and family support is important for any patient
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
. Many older adults do have chronic health conditions, but their perception is more important than
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
a single number.
vj vj
DIF: Applying (Application) REF: N/A OBJ: 1-4
vj vj vj vj vj vj
TOP: Nursing Process: Assessment MSC: Health Promotion
vj vj vj vj vj vj
8. The nurse is caring for an older adult who has been admitted to an acute care hospital for treatm
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
ent of a fractured femur. The family expresses concern about the patients pending transfer to a sub
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
acute care facility. What response by the nurse is best?
vj vj vj vj vj vj vj vj vj
a. Acute care facilities lack the long-term physical therapy support your dad requires. vj vj vj vj vj vj vj vj vj vj vj
b. Your dad will be much happier in a more serene, private environment.
vj vj vj vj vj vj vj vj vj vj vj
c. The subacute facility will focus on helping your dad maintain his independence.
vj vj vj vj vj vj vj vj vj vj vj
d. Insurance, including Medicare, will cover only a limited amount of time here. A vj vj vj vj vj vj vj vj vj vj vj vj
NS: C vj
The transfer of the patient to a subacute facility is based on the need to maintain the patients
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
level of function and independence, a task the acute care facility is not prepared to address once th
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
e patient is physiologically stable. The patient may or may not be happier in the new setting; the n
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
urse should not make this judgment. It is true that insurance only pays for a limited amount of time
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
in an acute care facility, but this is not the best reason for the patient to transfer.
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
DIF: Applying (Application) REF: N/A OBJ: 1-
vj vj vj vj vj vj
6 TOP: Communication and Documentation
vj vj vj vj
MSC: Health Promotion and Maintenance vj vj vj vj
9. To best assure both the quality of care and the safety of the older adult patient who requires in-
vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj vj
home unlicensed assistive personal (UAP) assistance, the geriatric nurse:
vj vj vj vj vj vj vj vj vj
a. evaluates the competency of the UAP staff. vj vj vj vj vj vj
b. assumes the roles of case manager and patient advocate. vj vj vj vj vj vj vj vj
c. arranges for the needed UAP provided services. vj vj vj vj vj vj
d. assesses the patient for functional limitations. vj vj vj vj vj vj
ANS: A vj
As more care traditionally provided by professional nurses is being transferred to UAP, the nurse
vj vj vj vj vj vj vj vj vj vj vj vj vj vj
must assume more responsibility for educating, training, and evaluating the competency of UAP st
vj vj vj vj vj vj vj vj vj vj vj vj vj
aff to provide safe, effective care for the older adult patient.
vj vj vj vj vj vj vj vj vj vj
DIF: Applying (Application) REF: N/A OBJ: 1-2
vj vj vj vj vj vj
