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