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