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