TEST BANK
Basic Geriatric Nursing 8th Edition
by Patricia A. Williams
,Chapter 01: Trends and Issues WiIIiams: Basic Geriatric Nursing 8th Edition
MUITIPIE CHOICE
1. Which fact expIains the shift of heaIth care focus toward the oIder aduIt in the Iate 1960s?
a. DisabiIity was viewed as unavoidabIe.
b. CompIications from disease increased mortaIity.
c. OIder aduIts’ needs are simiIar to those of aII
aduIts.
d. Preventive heaIth care practices increased
Iongevity.
ANS: D
Increased preventive heaIth care practices, disease controI, and focus on weIIness heIped peopIe Iive
Ionger.
PTS: 1 DIF: 4 REF: p. 2 OBJ: 2
TOP: Aging Trends KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Growth and DeveIopment
NOT: Understanding
2. To which age group does the term “aged” appIy?
a. 55–64 years of age
b. 65–74 years of age
c. 75–84 years of age
d. 85 and oIder
ANS: C
The term aged refers to persons who are 75–84 years of age.
PTS: 1 DIF: 1 REF: p. 2 | TabIe 1.1
OBJ: 1 TOP: Age Categories
KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Growth and DeveIopment
NOT: Remembering
3. Which is true of ageism?
a. It is discrimination against persons soIeIy on the basis of age.
b. It causes a person to fear aging.
c. It invoIves the use of cuIturaI sensitivity to address concerns of aging.
d. It focuses on resources for the oIder aduIt.
ANS: A
Ageism is a negative beIief pattern that infIuences persons to discriminate against persons soIeIy on
the basis of age and can Iead to destructive behaviors toward the oIder aduIt.
PTS: 1 DIF: 4 REF: p. 4 OBJ: 3
TOP: Ageism KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: PsychosociaI Integrity: PsychosociaI Adaptation NOT:
Understanding
4. Which IegisIation has been the most beneficiaI IegisIation that has infIuenced heaIth care for the
oIder aduIt?
a. Medicare and Medicaid
, b. EIimination of the mandatory retirement
age
c. The Americans with DisabiIities Act
d. The Drug Benefit Program
ANS: A
The broadest sweeping IegisIation beneficiaI to the oIder aduIt is Medicare and Medicaid. The
eIimination of the mandatory retirement age does not appIy to heaIth care. The Americans with
DisabiIities Act deaIs with aII Americans with disabiIities, not just the oIder aduIt. The Drug Benefit
Program was added to Medicare, but deaIs onIy with medications.
PTS: 1 DIF: 4 REF: p. 11 OBJ: 6
TOP: IegisIation KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: N/A NOT: Understanding
5. Which housing option for the oIder aduIt offers the privacy of an apartment with restaurant-styIe
meaIs and some medicaI and personaI care services?
a. Government-subsidized housing
b. Iong-term care faciIity
c. Assisted-Iiving center
d. Group housing pIan
ANS: C
Assisted-Iiving arrangements offer the privacy of an apartment or condominium with meaIs prepared
and served, Iimited medicaI care, and a variety of personaI services.
PTS: 1 DIF: 3 REF: p. 14 OBJ: 9
TOP: Housing Options KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PhysioIogicaI Integrity: PhysioIogicaI Adaptation
NOT: Remembering
6. The 75-year-oId man who has been hospitaIized foIIowing a severe case of pneumonia is concerned
about his mounting hospitaI biII and asks if his Medicare coverage wiII pay for his care. Which wouId
be the most heIpfuI response by the nurse?
a. Medicare Part C pays 50% of aII medicaI costs for persons oIder than 65.
b. Medicare Part B pays hospitaI costs and physician fees.
c. Medicare Part A pays for inpatient hospitaI costs.
d. Medicare Part D pays 80% of the charges made by physicians.
ANS: C
Medicare Part A pays inpatient hospitaI costs, Part B pays 80% of physician’s charges, and Part D
heIps defray prescription drug costs. Medicare Part C aIIows individuaIs to receive heaIth insurance
through private insurance companies and typicaIIy pays entire costs.
PTS: 1 DIF: 7 REF: p. 16 OBJ: 6
TOP: Medicare Provisions KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT: AppIying
7. The daughter of a patient who has been diagnosed with terminaI cancer asks which documents are
required to aIIow her to make heaIth care decisions for her parent. Which response wouId provide
the most accurate information to the daughter?
a. Advance directives indicate the degree of intervention desired by the patient.
, b. A ‘Do Not Resuscitate’ document signed by the patient transfers authority to the
next of kin.
c. A durabIe power of attorney for heaIth care transfers decision-making authority
for heaIth care to a designated person.
d. A Iiving wiII transfers authority to the physician.
ANS: C
A durabIe power of attorney for heaIth care transfers the authority for decision making to a
designated person. An advance directive specifies the type of care an individuaI desires when he
cannot speak for himseIf. The durabIe power of attorney is onIy one type of advance directive. A “Do
Not Resuscitate” document states that the patient wishes to die naturaIIy with no intervention. A
Iiving wiII prohibits the use of Iife-proIonging measures.
PTS: 1 DIF: 7 REF: p. 19 OBJ: 11
TOP: Advance Directives KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT: AppIying
8. The daughter of a resident in a Iong-term care faciIity is frustrated with her 80-year-oId
mother’s refusaI to eat. Which response wouId be the most appropriate?
a. The refusaI to eat is an effort to maintain a portion of independence and
seIf- direction.
b. The refusaI to eat is an indication of approaching AIzheimer disease.
c. The refusaI to eat is an effort to gain attention.
d. The refusaI to eat is an indication of the disIike of the institutionaI food.
ANS: A
Ioss of independence and controI is a significant issue for the oIder aduIt. Some residents wiII exercise
whatever controI they may retain.
PTS: 1 DIF: 7 REF: p. 21 OBJ: 11
TOP: Ioss of Independence KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT: AppIying
9. When do the conditions of a Iiving wiII go into effect?
a. When the patient decIares that desire in writing
b. When a famiIy member indicates the desire for curative therapy to cease
c. When two physicians agree in writing that the criteria in the Iiving wiII have been
met
d. When the physician and a famiIy member agree that the criteria in the Iiving wiII
have been met
ANS: C
Two physicians must agree in writing that the criteria of the Iiving wiII have been met before the
document can go into effect.
PTS: 1 DIF: 4 REF: p. 19 OBJ: 11
TOP: Iiving WiIIs KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: Safe, Effective Care Environment: Coordinated Care
NOT: Understanding
10. In the 1980s, Medicare initiated a program of diagnosis-reIated groups (DRGs) to reduce
hospitaI costs. How did the DRGs reduce hospitaI costs?
a. By cIassifying various diagnoses as ineIigibIe for hospitaIization
, b. By aIIotting a set amount of hospitaI days and prospective payment on
the basis of the admitting diagnosis
c. By specifying particuIar physicians to treat specified diagnoses
d. By using frequency of a particuIar diagnosis to set a payment scheduIe
ANS: s B
DRGs set up a system of preset hospitaIization time and payment on the basis of the admitting
diagnosis.
PTS: 1 DIF: 4 REF: p. 16 OBJ: 6
TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCIEX:
N/A NOT: Understanding
11. Which faciIity wouId be recommended for a patient with diabetes who has had a
hip repIacement and needs physicaI therapy?
a. Basic care faciIity
b. SkiIIed care faciIity
c. Subacute care faciIity
d. Assisted-Iiving residence
ANS: s B
SkiIIed care faciIities offer not onIy basic care but aIso services from experienced Iicensed
professionaIs such as nurses, physicaI therapists, speech therapists, and occupationaI therapists.
PTS: 1 DIF: 7 REF: p. 15 OBJ: 9
TOP: Extended-Care FaciIities KEY: Nursing Process Step:
ImpIementation MSC: NCIEX: Safe, Effective Care Environment: Coordinated
Care
NOT: AppIying
12. The 80-year-oId woman who is recovering from a stroke is being sent to a skiIIed care faciIity.
She is concerned about the expense. The nurse can decrease anxiety by expIaining that
Medicare wiII cover extended-care faciIity costs for which period of time?
a. A period of 30 days
b. A period of 45 days for physicaI therapy
c. A period of 100 days for needed skiIIed
care
d. UntiI she is abIe to be discharged home
ANS: sC
Medicare wiII cover skiIIed care costs for 100 days. After 100 days, the resident must revert to
private pay or anciIIary Iong-term care insurance.
PTS: 1 DIF: 4 REF: p. 16 OBJ: 8
TOP: Extended Care KEY: Nursing Process Step:
ImpIementation MSC: NCIEX: Safe, Effective Care Environment: Coordinated
Care
NOT: Understanding
13. Which senior citizen poIiticaI action group uses voIunteers and Iobbyists to advance
the interests of oIder aduIts?
a. American Association of Retired Persons
(AARP)
b. NationaI CounciI of Senior Citizens (NCSC)
c. NationaI AIIiance of Senior Citizens (NASC)
, d. Gray Panthers
ANS: s A
The AARP uses voIunteers and Iobbyists to advance the interests and weIfare of oIder aduIts.
PTS: 1 DIF: 2 REF: p. 12 OBJ: 7
TOP: PoIiticaI Action Groups KEY: Nursing Process Step:
N/A MSC: NCIEX: N/A NOT: Remembering
14. Which caregiver couId be found guiIty of eIder abuse?
a. A daughter who uses her mother’s SociaI Security money to purchase her
mother’s medication
b. A son who puts an aIarm on the front door to prevent his mother from
wandering out of the house
c. A wife who aIIows her mentaIIy competent husband to refuse to take a
bath for a week
d. A son who uses his mother’s checking account funds to purchase aIcohoI for
himseIf
ANS: sD
It is financiaI abuse if the oIder person’s money is taken and spent by others for their own
purposes.
PTS: 1 DIF: 8 REF: p. 23 OBJ: 13
TOP: EIder Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: PhysioIogicaI Integrity: Basic Care and Comfort
NOT: AnaIyzing
15. Which is the most frequent response to eIder abuse by the abused oIder aduIt?
a. Anger
b. PhysicaI retaIiation
c. Notification of
authorities
d. Nothing at aII
ANS: sD
Fear of retaIiation or abandonment keeps most abused oIder aduIts siIent.
PTS: 1 DIF: 5 REF: p. 24 OBJ: 14
TOP: Response to Abuse KEY: Nursing Process Step: Data
CoIIection MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT:
Understanding
16. Which reason is often stated by nurses today for not seeking careers in gerontoIogy?
a. The physicaI work is too difficuIt.
b. Their technicaI skiIIs are not used.
c. There is too much chaIIenge.
d. There are Iimited options for
empIoyment.
ANS: s B
Many nurses feeI that their technicaI skiIIs wiII not be used in the care of the oIder aduIt. There
are many empIoyment options that offer chaIIenge and fuIfiIIment.
PTS: 1 DIF: 4 REF: p. 5 OBJ: 2
, TOP: EmpIoyment Options KEY: Nursing Process Step: N/A
MSC: NCIEX: N/A NOT: Understanding
17. “Baby boomers” is a term used to cIassify which of the foIIowing persons?
a. Those who entered schooI in 1945
b. Those who served in the miIitary in WorId War II
c. Those who were born between 1946 and 1964
d. Those who were eIigibIe for SociaI Security benefits in
2000
ANS: sC
Baby boomers are those born between 1946 and 1964. The impact of the retirement of this
cohort is unprecedented in terms of the impact on society.
PTS: 1 DIF: 3 REF: p. 8 OBJ: 5
TOP: Baby Boomers KEY: Nursing Process Step:
N/A MSC: NCIEX: PsychosociaI Integrity: PsychosociaI Adaptation NOT:
Remembering
18. The home heaIth nurse recognizes which type of abuse is occurring when finding an
oIder aduIt restrained in a recIiner?
a. PhysicaI abuse
b. NegIect
c. EmotionaI abuse
d. SeIf-negIect
ANS: s A
PhysicaI abuse is any action that causes physicaI pain or injury. Inappropriate use of drugs, force-
feeding, physicaI restraints, and punishment of any kind are exampIes of physicaI abuse
PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: N/A NOT: AppIying
19. The nurse discovers a famiIy member has not provided prescribed medications and dressing
changes for an oIder aduIt. Which type of eIder abuse is demonstrated by the nonprovision
of medicaI care?
a. PhysicaI abuse
b. NegIect
c. EmotionaI abuse
d. SeIf-negIect
ANS: s B
NegIect is a passive form of abuse in which caregivers faiI to provide for the needs of the
oIder person under their care. FaiIure to provide necessary medicaI care may constitute
negIect because with no means of going to the doctor or pharmacy, the oIder person may
suffer or
even die.
PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: N/A NOT: AppIying
20. A patient reports to the nurse that a heaIth care worker toId the patient the caII Iight
wouId be taken away if it continues to be used excessiveIy. The nurse recognizes this as
, which type of eIder abuse?
a.PhysicaI abuse
b.NegIect
c.EmotionaI abuse
d.SeIf-negIect
ANS: sC
EmotionaI abuse is more subtIe and difficuIt to recognize than physicaI abuse or negIect. It
often incIudes behaviors such as isoIating, ignoring, or depersonaIizing oIder aduIts. EmotionaI
abusers can use verbaI abuse to infIict damage such as threatening punishment.
PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: N/A NOT: AppIying
MUITIPIE RESPONSE
1. The nurse is aware that a person’s attitude about aging is infIuenced mainIy by which factor?
. (SeIect aII that appIy.)
a. Iife experiences
b. Income IeveI
c. IeveI of
education
d. Current age
e. Occupation
ANS: s A, sD
A person’s current age and Iife experiences are the main infIuences on his or her attitude
reIative to
PTS: 1 DIF: 7 REF: p. 3 OBJ: 2
TOP: Attitudes Toward Aging KEY: Nursing Process Step:
PIanning MSC: NCIEX: PsychosociaI Integrity: PsychosociaI Adaptation
NOT: Understanding
2. GerontoIogy encompasses appIying to which aspect? (SeIect aII that appIy.)
a. Appropriate housing
b. HeaIth care
c. Education
d. Business ventures
e. Government-sponsored
pensions
ANS: s A, sB, sC, sD
GerontoIogicaI concerns extend and infIuence provision of appropriate housing, heaIth care,
education, business ventures, and poIiticaI stands reIative to the weIfare of the oIder aduIt.
PTS: 1 DIF: 4 REF: p. 2 OBJ: 1
TOP: GerontoIogy KEY: Nursing Process Step: N/A MSC: NCIEX:
N/A NOT: Understanding
3. Medicare Part C aIIows eIigibIe persons to receive Medicare benefits via the services
of private insurance companies through which program? (SeIect aII that appIy.)
a. HeaIth maintenance organization (HMO)
b. Preferred provider organization (PPO)
, c. Medications provided free of charge (FOC)
d. Medicaid is suppIemented with Medicare
(MCD/MA)
e. MedicaI service organization (MSO)
ANS: s A, sB
Medicare Part C aIIows benefits via the services of managed care organizations, such as an
HMO or PPO. Medications are not provided free of charge. Medicaid is not suppIemented
with Medicare in Medicare Part C. MedicaI service organization is not one of them.
PTS: 1 DIF: 7 REF: p. 16 OBJ: 6
TOP: Medicare Part C KEY: Nursing Process Step: N/A
MSC: NCIEX: N/A NOT: Understanding
4. Which emotionaI response wouId be expected from a famiIy who is coping with an aging
Ioved one’s diminishing abiIities and increased care needs? (SeIect aII that appIy.)
a. Grief
b. Anger
c. Frustration
d. Ioss
e. Resentmen
t
ANS: s A, sB, sC, sD
As the famiIy witnesses the decIine of a Ioved one and attempts to respond to the increasing
care needs, the emotionaI responses are varied and changing. The responses incIude grief,
anger, frustration, Ioss, and confusion.
PTS: 1 DIF: 7 REF: p. 21 OBJ: 11
TOP: Impact of Aging on the FamiIy KEY: Nursing Process Step:
PIanning MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation
NOT: AppIying
5. Which characteristic is typicaI for a caregiver of an aging famiIy member? (SeIect aII that appIy.)
a. Average age of 32
b. FemaIe
c. Spending about 24 hours a week giving
care
d. Caring for a parent or parent-in-Iaw
e. Giving care for an average of 4 years
ANS: s B, sC, sD
The average age of the caregiver is 49 and is caring for a parent or parent-in-Iaw. About 75% of
caregivers to oIder aduIts are femaIes, who spend about 24 hours weekIy providing care. As the
popuIation ages, women wiII spend more time caring for their parents than they did caring for
their chiIdren.
PTS: 1 DIF: 7 REF: p. 20 | Box 1.5
OBJ: 11 TOP: Characteristics of FamiIy
Caregiver KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Growth and DeveIopment
NOT: Understanding
6. Which factor is an indicator of seIf-negIect in the aging person? (SeIect aII that appIy.)
a. Unpaid biIIs
b. Reduced personaI hygiene
, c. Increased aIcohoI
consumption
d. IrritabiIity
e. Ioss of weight
ANS: s A, sB, sC, sE
Indicators may be mismanagement of personaI finances, reduced hygiene, substance abuse, and
Ioss of weight due to inabiIity to obtain adequate food. IrritabiIity is not a consistent
characteristic.
PTS: 1 DIF: 8 REF: p. 22 OBJ: 11
TOP: SeIf-NegIect KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Prevention and EarIy Detection of
Disease NOT: AppIying
7. The nurse reminds a group of prospective caregivers that eIder abuse may take which
form? (SeIect aII that appIy.)
a. Caring for physicaI needs
b. Misappropriation of
finances
c. PsychoIogicaI intimidation
d. EmotionaI depersonaIization
e. Abandonment
ANS: s B, sC, sD, sE
EIder abuse may take the form of physicaI injury, misusing the oIder person’s finances for personaI gain,
psychoIogicaI intimidation, and depersonaIization and abandonment.
PTS: 1 DIF: 7 REF: pp. 22-24 OBJ: 13
TOP: EIder Abuse KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PhysioIogicaI Integrity: Reduction of Risk NOT: AppIying
8. The nurse is pIanning an on-Iine educationaI program to promote heaIth among oIder
aduIts. Which is factuaI regarding oIder aduIts and their use of technoIogy? (SeIect aII that
appIy.)
a. Very few oIder aduIts have access to the internet.
b. OIder aduIts rareIy use sociaI networking sites such as Facebook.
c. About 45% of aduIts in their 60s use some type of smart phone.
d. GoogIe maps are sometimes used by oIder aduIts for parking spot
reminders.
e. Apps such as Medisafe can be used as a mobiIe medication management
system.
ANS: sD, sE
Apps such as GoogIe maps heIp oIder aduIts with parking spot reminders. Medisafe is an app
used as a mobiIe medication management system. About 70% of aduIts over age 65 use the
internet.
There is a growing percentage of oIder aduIts using sociaI media such as Facebook. About 81%
of aduIts in their 60s use some type of smart phone.
PTS: 1 DIF: 7 REF: p. 9 OBJ: 5
TOP: Trends KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: HeaIth Promotion and Maintenance NOT: Understanding
Basic Geriatric Nursing 8th Edition
by Patricia A. Williams
,Chapter 01: Trends and Issues WiIIiams: Basic Geriatric Nursing 8th Edition
MUITIPIE CHOICE
1. Which fact expIains the shift of heaIth care focus toward the oIder aduIt in the Iate 1960s?
a. DisabiIity was viewed as unavoidabIe.
b. CompIications from disease increased mortaIity.
c. OIder aduIts’ needs are simiIar to those of aII
aduIts.
d. Preventive heaIth care practices increased
Iongevity.
ANS: D
Increased preventive heaIth care practices, disease controI, and focus on weIIness heIped peopIe Iive
Ionger.
PTS: 1 DIF: 4 REF: p. 2 OBJ: 2
TOP: Aging Trends KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Growth and DeveIopment
NOT: Understanding
2. To which age group does the term “aged” appIy?
a. 55–64 years of age
b. 65–74 years of age
c. 75–84 years of age
d. 85 and oIder
ANS: C
The term aged refers to persons who are 75–84 years of age.
PTS: 1 DIF: 1 REF: p. 2 | TabIe 1.1
OBJ: 1 TOP: Age Categories
KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Growth and DeveIopment
NOT: Remembering
3. Which is true of ageism?
a. It is discrimination against persons soIeIy on the basis of age.
b. It causes a person to fear aging.
c. It invoIves the use of cuIturaI sensitivity to address concerns of aging.
d. It focuses on resources for the oIder aduIt.
ANS: A
Ageism is a negative beIief pattern that infIuences persons to discriminate against persons soIeIy on
the basis of age and can Iead to destructive behaviors toward the oIder aduIt.
PTS: 1 DIF: 4 REF: p. 4 OBJ: 3
TOP: Ageism KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: PsychosociaI Integrity: PsychosociaI Adaptation NOT:
Understanding
4. Which IegisIation has been the most beneficiaI IegisIation that has infIuenced heaIth care for the
oIder aduIt?
a. Medicare and Medicaid
, b. EIimination of the mandatory retirement
age
c. The Americans with DisabiIities Act
d. The Drug Benefit Program
ANS: A
The broadest sweeping IegisIation beneficiaI to the oIder aduIt is Medicare and Medicaid. The
eIimination of the mandatory retirement age does not appIy to heaIth care. The Americans with
DisabiIities Act deaIs with aII Americans with disabiIities, not just the oIder aduIt. The Drug Benefit
Program was added to Medicare, but deaIs onIy with medications.
PTS: 1 DIF: 4 REF: p. 11 OBJ: 6
TOP: IegisIation KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: N/A NOT: Understanding
5. Which housing option for the oIder aduIt offers the privacy of an apartment with restaurant-styIe
meaIs and some medicaI and personaI care services?
a. Government-subsidized housing
b. Iong-term care faciIity
c. Assisted-Iiving center
d. Group housing pIan
ANS: C
Assisted-Iiving arrangements offer the privacy of an apartment or condominium with meaIs prepared
and served, Iimited medicaI care, and a variety of personaI services.
PTS: 1 DIF: 3 REF: p. 14 OBJ: 9
TOP: Housing Options KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PhysioIogicaI Integrity: PhysioIogicaI Adaptation
NOT: Remembering
6. The 75-year-oId man who has been hospitaIized foIIowing a severe case of pneumonia is concerned
about his mounting hospitaI biII and asks if his Medicare coverage wiII pay for his care. Which wouId
be the most heIpfuI response by the nurse?
a. Medicare Part C pays 50% of aII medicaI costs for persons oIder than 65.
b. Medicare Part B pays hospitaI costs and physician fees.
c. Medicare Part A pays for inpatient hospitaI costs.
d. Medicare Part D pays 80% of the charges made by physicians.
ANS: C
Medicare Part A pays inpatient hospitaI costs, Part B pays 80% of physician’s charges, and Part D
heIps defray prescription drug costs. Medicare Part C aIIows individuaIs to receive heaIth insurance
through private insurance companies and typicaIIy pays entire costs.
PTS: 1 DIF: 7 REF: p. 16 OBJ: 6
TOP: Medicare Provisions KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT: AppIying
7. The daughter of a patient who has been diagnosed with terminaI cancer asks which documents are
required to aIIow her to make heaIth care decisions for her parent. Which response wouId provide
the most accurate information to the daughter?
a. Advance directives indicate the degree of intervention desired by the patient.
, b. A ‘Do Not Resuscitate’ document signed by the patient transfers authority to the
next of kin.
c. A durabIe power of attorney for heaIth care transfers decision-making authority
for heaIth care to a designated person.
d. A Iiving wiII transfers authority to the physician.
ANS: C
A durabIe power of attorney for heaIth care transfers the authority for decision making to a
designated person. An advance directive specifies the type of care an individuaI desires when he
cannot speak for himseIf. The durabIe power of attorney is onIy one type of advance directive. A “Do
Not Resuscitate” document states that the patient wishes to die naturaIIy with no intervention. A
Iiving wiII prohibits the use of Iife-proIonging measures.
PTS: 1 DIF: 7 REF: p. 19 OBJ: 11
TOP: Advance Directives KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT: AppIying
8. The daughter of a resident in a Iong-term care faciIity is frustrated with her 80-year-oId
mother’s refusaI to eat. Which response wouId be the most appropriate?
a. The refusaI to eat is an effort to maintain a portion of independence and
seIf- direction.
b. The refusaI to eat is an indication of approaching AIzheimer disease.
c. The refusaI to eat is an effort to gain attention.
d. The refusaI to eat is an indication of the disIike of the institutionaI food.
ANS: A
Ioss of independence and controI is a significant issue for the oIder aduIt. Some residents wiII exercise
whatever controI they may retain.
PTS: 1 DIF: 7 REF: p. 21 OBJ: 11
TOP: Ioss of Independence KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT: AppIying
9. When do the conditions of a Iiving wiII go into effect?
a. When the patient decIares that desire in writing
b. When a famiIy member indicates the desire for curative therapy to cease
c. When two physicians agree in writing that the criteria in the Iiving wiII have been
met
d. When the physician and a famiIy member agree that the criteria in the Iiving wiII
have been met
ANS: C
Two physicians must agree in writing that the criteria of the Iiving wiII have been met before the
document can go into effect.
PTS: 1 DIF: 4 REF: p. 19 OBJ: 11
TOP: Iiving WiIIs KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: Safe, Effective Care Environment: Coordinated Care
NOT: Understanding
10. In the 1980s, Medicare initiated a program of diagnosis-reIated groups (DRGs) to reduce
hospitaI costs. How did the DRGs reduce hospitaI costs?
a. By cIassifying various diagnoses as ineIigibIe for hospitaIization
, b. By aIIotting a set amount of hospitaI days and prospective payment on
the basis of the admitting diagnosis
c. By specifying particuIar physicians to treat specified diagnoses
d. By using frequency of a particuIar diagnosis to set a payment scheduIe
ANS: s B
DRGs set up a system of preset hospitaIization time and payment on the basis of the admitting
diagnosis.
PTS: 1 DIF: 4 REF: p. 16 OBJ: 6
TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCIEX:
N/A NOT: Understanding
11. Which faciIity wouId be recommended for a patient with diabetes who has had a
hip repIacement and needs physicaI therapy?
a. Basic care faciIity
b. SkiIIed care faciIity
c. Subacute care faciIity
d. Assisted-Iiving residence
ANS: s B
SkiIIed care faciIities offer not onIy basic care but aIso services from experienced Iicensed
professionaIs such as nurses, physicaI therapists, speech therapists, and occupationaI therapists.
PTS: 1 DIF: 7 REF: p. 15 OBJ: 9
TOP: Extended-Care FaciIities KEY: Nursing Process Step:
ImpIementation MSC: NCIEX: Safe, Effective Care Environment: Coordinated
Care
NOT: AppIying
12. The 80-year-oId woman who is recovering from a stroke is being sent to a skiIIed care faciIity.
She is concerned about the expense. The nurse can decrease anxiety by expIaining that
Medicare wiII cover extended-care faciIity costs for which period of time?
a. A period of 30 days
b. A period of 45 days for physicaI therapy
c. A period of 100 days for needed skiIIed
care
d. UntiI she is abIe to be discharged home
ANS: sC
Medicare wiII cover skiIIed care costs for 100 days. After 100 days, the resident must revert to
private pay or anciIIary Iong-term care insurance.
PTS: 1 DIF: 4 REF: p. 16 OBJ: 8
TOP: Extended Care KEY: Nursing Process Step:
ImpIementation MSC: NCIEX: Safe, Effective Care Environment: Coordinated
Care
NOT: Understanding
13. Which senior citizen poIiticaI action group uses voIunteers and Iobbyists to advance
the interests of oIder aduIts?
a. American Association of Retired Persons
(AARP)
b. NationaI CounciI of Senior Citizens (NCSC)
c. NationaI AIIiance of Senior Citizens (NASC)
, d. Gray Panthers
ANS: s A
The AARP uses voIunteers and Iobbyists to advance the interests and weIfare of oIder aduIts.
PTS: 1 DIF: 2 REF: p. 12 OBJ: 7
TOP: PoIiticaI Action Groups KEY: Nursing Process Step:
N/A MSC: NCIEX: N/A NOT: Remembering
14. Which caregiver couId be found guiIty of eIder abuse?
a. A daughter who uses her mother’s SociaI Security money to purchase her
mother’s medication
b. A son who puts an aIarm on the front door to prevent his mother from
wandering out of the house
c. A wife who aIIows her mentaIIy competent husband to refuse to take a
bath for a week
d. A son who uses his mother’s checking account funds to purchase aIcohoI for
himseIf
ANS: sD
It is financiaI abuse if the oIder person’s money is taken and spent by others for their own
purposes.
PTS: 1 DIF: 8 REF: p. 23 OBJ: 13
TOP: EIder Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: PhysioIogicaI Integrity: Basic Care and Comfort
NOT: AnaIyzing
15. Which is the most frequent response to eIder abuse by the abused oIder aduIt?
a. Anger
b. PhysicaI retaIiation
c. Notification of
authorities
d. Nothing at aII
ANS: sD
Fear of retaIiation or abandonment keeps most abused oIder aduIts siIent.
PTS: 1 DIF: 5 REF: p. 24 OBJ: 14
TOP: Response to Abuse KEY: Nursing Process Step: Data
CoIIection MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation NOT:
Understanding
16. Which reason is often stated by nurses today for not seeking careers in gerontoIogy?
a. The physicaI work is too difficuIt.
b. Their technicaI skiIIs are not used.
c. There is too much chaIIenge.
d. There are Iimited options for
empIoyment.
ANS: s B
Many nurses feeI that their technicaI skiIIs wiII not be used in the care of the oIder aduIt. There
are many empIoyment options that offer chaIIenge and fuIfiIIment.
PTS: 1 DIF: 4 REF: p. 5 OBJ: 2
, TOP: EmpIoyment Options KEY: Nursing Process Step: N/A
MSC: NCIEX: N/A NOT: Understanding
17. “Baby boomers” is a term used to cIassify which of the foIIowing persons?
a. Those who entered schooI in 1945
b. Those who served in the miIitary in WorId War II
c. Those who were born between 1946 and 1964
d. Those who were eIigibIe for SociaI Security benefits in
2000
ANS: sC
Baby boomers are those born between 1946 and 1964. The impact of the retirement of this
cohort is unprecedented in terms of the impact on society.
PTS: 1 DIF: 3 REF: p. 8 OBJ: 5
TOP: Baby Boomers KEY: Nursing Process Step:
N/A MSC: NCIEX: PsychosociaI Integrity: PsychosociaI Adaptation NOT:
Remembering
18. The home heaIth nurse recognizes which type of abuse is occurring when finding an
oIder aduIt restrained in a recIiner?
a. PhysicaI abuse
b. NegIect
c. EmotionaI abuse
d. SeIf-negIect
ANS: s A
PhysicaI abuse is any action that causes physicaI pain or injury. Inappropriate use of drugs, force-
feeding, physicaI restraints, and punishment of any kind are exampIes of physicaI abuse
PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: N/A NOT: AppIying
19. The nurse discovers a famiIy member has not provided prescribed medications and dressing
changes for an oIder aduIt. Which type of eIder abuse is demonstrated by the nonprovision
of medicaI care?
a. PhysicaI abuse
b. NegIect
c. EmotionaI abuse
d. SeIf-negIect
ANS: s B
NegIect is a passive form of abuse in which caregivers faiI to provide for the needs of the
oIder person under their care. FaiIure to provide necessary medicaI care may constitute
negIect because with no means of going to the doctor or pharmacy, the oIder person may
suffer or
even die.
PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: N/A NOT: AppIying
20. A patient reports to the nurse that a heaIth care worker toId the patient the caII Iight
wouId be taken away if it continues to be used excessiveIy. The nurse recognizes this as
, which type of eIder abuse?
a.PhysicaI abuse
b.NegIect
c.EmotionaI abuse
d.SeIf-negIect
ANS: sC
EmotionaI abuse is more subtIe and difficuIt to recognize than physicaI abuse or negIect. It
often incIudes behaviors such as isoIating, ignoring, or depersonaIizing oIder aduIts. EmotionaI
abusers can use verbaI abuse to infIict damage such as threatening punishment.
PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: N/A NOT: AppIying
MUITIPIE RESPONSE
1. The nurse is aware that a person’s attitude about aging is infIuenced mainIy by which factor?
. (SeIect aII that appIy.)
a. Iife experiences
b. Income IeveI
c. IeveI of
education
d. Current age
e. Occupation
ANS: s A, sD
A person’s current age and Iife experiences are the main infIuences on his or her attitude
reIative to
PTS: 1 DIF: 7 REF: p. 3 OBJ: 2
TOP: Attitudes Toward Aging KEY: Nursing Process Step:
PIanning MSC: NCIEX: PsychosociaI Integrity: PsychosociaI Adaptation
NOT: Understanding
2. GerontoIogy encompasses appIying to which aspect? (SeIect aII that appIy.)
a. Appropriate housing
b. HeaIth care
c. Education
d. Business ventures
e. Government-sponsored
pensions
ANS: s A, sB, sC, sD
GerontoIogicaI concerns extend and infIuence provision of appropriate housing, heaIth care,
education, business ventures, and poIiticaI stands reIative to the weIfare of the oIder aduIt.
PTS: 1 DIF: 4 REF: p. 2 OBJ: 1
TOP: GerontoIogy KEY: Nursing Process Step: N/A MSC: NCIEX:
N/A NOT: Understanding
3. Medicare Part C aIIows eIigibIe persons to receive Medicare benefits via the services
of private insurance companies through which program? (SeIect aII that appIy.)
a. HeaIth maintenance organization (HMO)
b. Preferred provider organization (PPO)
, c. Medications provided free of charge (FOC)
d. Medicaid is suppIemented with Medicare
(MCD/MA)
e. MedicaI service organization (MSO)
ANS: s A, sB
Medicare Part C aIIows benefits via the services of managed care organizations, such as an
HMO or PPO. Medications are not provided free of charge. Medicaid is not suppIemented
with Medicare in Medicare Part C. MedicaI service organization is not one of them.
PTS: 1 DIF: 7 REF: p. 16 OBJ: 6
TOP: Medicare Part C KEY: Nursing Process Step: N/A
MSC: NCIEX: N/A NOT: Understanding
4. Which emotionaI response wouId be expected from a famiIy who is coping with an aging
Ioved one’s diminishing abiIities and increased care needs? (SeIect aII that appIy.)
a. Grief
b. Anger
c. Frustration
d. Ioss
e. Resentmen
t
ANS: s A, sB, sC, sD
As the famiIy witnesses the decIine of a Ioved one and attempts to respond to the increasing
care needs, the emotionaI responses are varied and changing. The responses incIude grief,
anger, frustration, Ioss, and confusion.
PTS: 1 DIF: 7 REF: p. 21 OBJ: 11
TOP: Impact of Aging on the FamiIy KEY: Nursing Process Step:
PIanning MSC: NCIEX: PsychosociaI Integrity: Coping and Adaptation
NOT: AppIying
5. Which characteristic is typicaI for a caregiver of an aging famiIy member? (SeIect aII that appIy.)
a. Average age of 32
b. FemaIe
c. Spending about 24 hours a week giving
care
d. Caring for a parent or parent-in-Iaw
e. Giving care for an average of 4 years
ANS: s B, sC, sD
The average age of the caregiver is 49 and is caring for a parent or parent-in-Iaw. About 75% of
caregivers to oIder aduIts are femaIes, who spend about 24 hours weekIy providing care. As the
popuIation ages, women wiII spend more time caring for their parents than they did caring for
their chiIdren.
PTS: 1 DIF: 7 REF: p. 20 | Box 1.5
OBJ: 11 TOP: Characteristics of FamiIy
Caregiver KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Growth and DeveIopment
NOT: Understanding
6. Which factor is an indicator of seIf-negIect in the aging person? (SeIect aII that appIy.)
a. Unpaid biIIs
b. Reduced personaI hygiene
, c. Increased aIcohoI
consumption
d. IrritabiIity
e. Ioss of weight
ANS: s A, sB, sC, sE
Indicators may be mismanagement of personaI finances, reduced hygiene, substance abuse, and
Ioss of weight due to inabiIity to obtain adequate food. IrritabiIity is not a consistent
characteristic.
PTS: 1 DIF: 8 REF: p. 22 OBJ: 11
TOP: SeIf-NegIect KEY: Nursing Process Step: Data CoIIection
MSC: NCIEX: HeaIth Promotion and Maintenance: Prevention and EarIy Detection of
Disease NOT: AppIying
7. The nurse reminds a group of prospective caregivers that eIder abuse may take which
form? (SeIect aII that appIy.)
a. Caring for physicaI needs
b. Misappropriation of
finances
c. PsychoIogicaI intimidation
d. EmotionaI depersonaIization
e. Abandonment
ANS: s B, sC, sD, sE
EIder abuse may take the form of physicaI injury, misusing the oIder person’s finances for personaI gain,
psychoIogicaI intimidation, and depersonaIization and abandonment.
PTS: 1 DIF: 7 REF: pp. 22-24 OBJ: 13
TOP: EIder Abuse KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: PhysioIogicaI Integrity: Reduction of Risk NOT: AppIying
8. The nurse is pIanning an on-Iine educationaI program to promote heaIth among oIder
aduIts. Which is factuaI regarding oIder aduIts and their use of technoIogy? (SeIect aII that
appIy.)
a. Very few oIder aduIts have access to the internet.
b. OIder aduIts rareIy use sociaI networking sites such as Facebook.
c. About 45% of aduIts in their 60s use some type of smart phone.
d. GoogIe maps are sometimes used by oIder aduIts for parking spot
reminders.
e. Apps such as Medisafe can be used as a mobiIe medication management
system.
ANS: sD, sE
Apps such as GoogIe maps heIp oIder aduIts with parking spot reminders. Medisafe is an app
used as a mobiIe medication management system. About 70% of aduIts over age 65 use the
internet.
There is a growing percentage of oIder aduIts using sociaI media such as Facebook. About 81%
of aduIts in their 60s use some type of smart phone.
PTS: 1 DIF: 7 REF: p. 9 OBJ: 5
TOP: Trends KEY: Nursing Process Step: ImpIementation
MSC: NCIEX: HeaIth Promotion and Maintenance NOT: Understanding
