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