TEST BANK for HAM'S PRIMARY CARE GERIATRICS- A CASE
n n n n n n n n
BASED APPROACH 7TH EDITION /COMPLETE GUIDE
n n n n n n
, Chapter 1. Principles of Primary Care of Older Adults n n n n n n n n
MULTIPLE CHOICE n
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.The
n n n n n n n n n n n n n
nurse would use these standards to:
n n n n n n
a. promote the practice of gerontologic nursing within the acute care setting. n n n n n n n n n n
b. define the concepts and dimensions of gerontologic nursing practice.
n n n n n n n n
c. elevate the practice of gerontologic nursing. n n n n n
d. incorporate suggested interventions fromothers who practice gerontologic nursing. n n n n n n n n
ACCURATE ANSWER:-D
n n
Reasoning:->>>The current publishing of the Standards and Scope of Gerontological Nursing Practice in 20 n n n n n n n n n n n n n
incorporates the input of gerontologic nursing attendants from across the United States. It was not
n n n n n n n n n n n n n n
intended to promote gerontologic nursing practice within acute care settings, define concepts or
n n n n n n n n n n n n n
dimensions of gerontologic nursing practice, or elevate the practice of gerontologic nursing.
n n n n n n n n n n n n
DIFFICULT: Remembering (Knowledge) REF: msc: 2 OBJ: 1- n n n n n n n
1TOPIC:N/A MSC: Safe and Effective Care Environment
n n n n n n n
2. When attempting to minimize the effect of ageism on the practice of nursing older adults, a
n n n n n n n n n n n n n n n
nursing attendant needs to first:
n n n n n
a. recognize that nursing attendants must act as advocates for aging hospital clients. n n n n n n n n n n n
b. accept that this population represents a substantial portion ofthose requiring nursing care.
n n n n n n n n n n n n
c. self-reflect and formulate ones personal view ofaging and the older hospital client.n n n n n n n n n n n n
d. recognize ageism as a form ofbigotry shared by many Americans. n n n n n n n n n n
ACCURATE ANSWER:-C
n n
Reasoning:->>>Ageism is an ever-increasing prejudicial view of the effects of the aging process and of theolder n n n n n n n n n n n n n n n n
population as a whole. With nursing attendants being members of a society holding such views, it is
n n n n n n n n n n n n n n n n
critical that the individual nursing attendant self-reflect on personal feelings and determine whether
n n n n n n n n n n n n n
such feelings will affect the nursing care that he or she provides to the aging hospital client. Acting as
n n n n n n n n n n n n n n n n n n n
anadvocate is an important nursing role in all settings. Simply accepting a fact does not help end
n n n n n n n n n n n n n n n n n n
ageism, nor does recognizing ageism as a form of bigotry.
n n n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-9 n n n n n n
TOPIC: Teaching-Learning MSC: Safe and Effective Care Environment
n n n n n n n
3. When discussing factors that have helped to increase the number of healthy, independent older
n n n n n n n n n n n n n
Americans, the nursing attendant includes the importance of:
n n n n n n n n
a. increased availability of in-home care services. n n n n n
b. government support ofretired citizens. n n n n
c. effective antibiotic therapies. n n
d. the development of life-extending therapies.
n n n n
,ACCURATE ANSWER:-C n
Reasoning:->>>The health and ultimate autonomy of older Americans has been positively n n n n n n n n n n
impacted by the development of antibiotics, better sanitation, and vaccines. These public health
n n n n n n n n n n n n n
measures have been more instrumental in increasing the numbers of healthy, independent older
n n n n n n n n n n n n n
Americans than have in-home care services, government programs, or life-extending therapies.
n n n n n n n n n n n
DIFFICULT: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
n n n n n n n n
TOPIC:Nursing Process: Implementation MSC: Health Promotion and Maintenance n n n n n n n
4. Based on current data, when presenting an older adults discharge teaching plan, the
n n n n n n n n n n n n
nursing attendant includes the hospital clients:
n n n n n n
a. nonrelated caretaker. n
b. paid nursing attendant. n n
c. family member. n
d. intuitional representative. n
ACCURATE ANSWER:-C
n n
Reasoning:->>>Less than 4% of older adults live in a formal health care environment. The majority of the n n n n n n n n n n n n n n n n
geriatric population lives at home or with family members.
n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 3-3
n n n n n n n
TOPIC:Nursing Process: Planning MSC: Safe and Effective Care Environment n n n n n n n n
5. The nursing attendant planning care for an older adult who has recently been diagnosed with
n n n n n n n n n n n n n n
rheumatoid arthritis views the priority criterion for continued independence to be the hospital
n n n n n n n n n n n n n
clients:
n
a. age.
b. financial status. n
c. gender.
d. functional status. n
ACCURATE ANSWER:-D
n n
Reasoning:->>>Maintaining the functional status of older adults may avert the onset of physical frailty and n n n n n n n n n n n n n n
cognitive impairment, two conditions that increase the likelihood ofinstitutionalization.
n n n n n n n n n
DIFFICULT: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
n n n n n n n n
TOPIC: Nursing Process: Planning MSC: Physiologic Integrity
n n n n n n
6. A nursing attendant working with the older adult population is most likelyto assess a need
n n n n n n n n n n n n n n n
for afinancial social services referral for a(n):
n n n n n n n n
a. white male. n
b. black female. n
c. Hispanic male. n
d. AsianAmerican female. n n
ACCURATE ANSWER:-B
n n
Reasoning:->>>The povertyrate among older black women is substantially higher than that seen among maor n n n n n n n n n n n n n n n
females ofother ethnic groups. White males had the least poverty.
n n n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-4
n n n n n n n
TOPIC:Nursing Process: Assessment MSC: Safe and Effective Care Environment n n n n n n n n
, 7. Which of the following statements made by a nursing attendant preparing to complete a health
n n n n n n n n n n n n n n
assessment and history on an older hospital client reflects an understanding of the general health
n n n n n n n n n n n n n n n
statusof this population?
n n n n
a. Ill need to document well regarding the medications the hospital client is currently prescribed. n n n n n n n n n n n n n
b. I would like to understand how supportive the hospital clients family members are.
n n n n n n n n n n n n
c. Most older hospital clients are being treated for a variety of chronic health care issues.
n n n n n n n n n n n n n n
d. It will be interesting to see whether this hospital client sees herself as being n n n n n n n n n n n n n
healthy.ACCURATE ANSWER:-D
n n n
Reasoning:->>>It is a misconception that old age is synonymous with illness and illness. The nursing attendant n n n n n n n n n n n n n n n
sho
n
always determine the hospital clients sense of wellness and independence when conducting a health
n n n n n n n n n n n n n
andhistory assessment. An assessment of medication use and family support is important for any
n n n n n n n n n n n n n n n
hospital client. Many older adults do have chronic health conditions, but their perception is more
n n n n n n n n n n n n n n n
important than a single number.
n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-4 n n n n n n
TOPIC:Nursing Process: Assessment MSC: Health Promotion n n n n n
8. The nursing attendant is caring for an older adult who has been admitted to an acute care
n n n n n n n n n n n n n n n n
healthcenter for treatment of a fractured femur. The family expresses concern about the
n n n n n n n n n n n n n n
hospital clients pending transfer to a subacute supported care facility. What response by the
n n n n n n n n n n n n n n
nursing attendant is best?
n n n n
a. Acute care facilities lack the long-term physical therapy support your dad requires. n n n n n n n n n n n
b. Your dad will be much happier in a more serene, private environment.
n n n n n n n n n n n
c. The subacute facility will focus on helping your dad maintain his independence.
n n n n n n n n n n n
d. Insurance, including Medicare, will cover only a limited amount oftime here. n n n n n n n n n n n
ACCURATE ANSWER:-C
n n
Reasoning:->>>The transfer of the hospital client to a subacute facility is based on the need to maintain the n n n n n n n n n n n n n n n n n
hospital clients
n n
level of function and independence, a task the acute supported care facility is not prepared to address
n n n n n n n n n n n n n n n n
once the hospital client is physiologically stable. The hospital client may or may not be happier in
n n n n n n n n n n n n n n n n n
the new setting; the nursing attendant should not make this judgment. It is true that insurance only
n n n n n n n n n n n n n n n n n
pays for a limited amountof time in an acute supported care facility, but this is not the best reason for
n n n n n n n n n n n n n n n n n n n n n
the hospital client to transfer.
n n n n n
DIFFICULT: Applying (Application) REF: N/AOBJ: n n n n n
1-6TOPIC:Communication and Documentation
n n n n
MSC: Health Promotion and Maintenance
n n n n
9. To best assure both the quality of care and the safety ofthe older adult hospital client who requires
n n n n n n n n n n n n n n n n n n
in-home unlicensed assistive personal (UAP) assistance, the geriatric nursing attendant:
n n n n n n n n n n n
a. evaluates the competency of the UAP staff. n n n n n n
b. assumes the roles of case manager and hospital client advocate. n n n n n n n n n
c. arranges for the needed UAP provided services. n n n n n n
d. assessesthehospital client for functional n n n n n
limitations.ACCURATE ANSWER:-A
n n n
Reasoning:->>>As more care traditionally provided by professional nursing attendants is being transferred to n n n n n n n n n n n n
UAP,nursing attendant
n n n
must assume more responsibility for educating, training, and evaluating the competencyof UAPstaff
n n n n n n n n n n n n n
to provide safe, effective care for the older adult hospital client.
n n n n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-2 n n n n n n
n n n n n n n n
BASED APPROACH 7TH EDITION /COMPLETE GUIDE
n n n n n n
, Chapter 1. Principles of Primary Care of Older Adults n n n n n n n n
MULTIPLE CHOICE n
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.The
n n n n n n n n n n n n n
nurse would use these standards to:
n n n n n n
a. promote the practice of gerontologic nursing within the acute care setting. n n n n n n n n n n
b. define the concepts and dimensions of gerontologic nursing practice.
n n n n n n n n
c. elevate the practice of gerontologic nursing. n n n n n
d. incorporate suggested interventions fromothers who practice gerontologic nursing. n n n n n n n n
ACCURATE ANSWER:-D
n n
Reasoning:->>>The current publishing of the Standards and Scope of Gerontological Nursing Practice in 20 n n n n n n n n n n n n n
incorporates the input of gerontologic nursing attendants from across the United States. It was not
n n n n n n n n n n n n n n
intended to promote gerontologic nursing practice within acute care settings, define concepts or
n n n n n n n n n n n n n
dimensions of gerontologic nursing practice, or elevate the practice of gerontologic nursing.
n n n n n n n n n n n n
DIFFICULT: Remembering (Knowledge) REF: msc: 2 OBJ: 1- n n n n n n n
1TOPIC:N/A MSC: Safe and Effective Care Environment
n n n n n n n
2. When attempting to minimize the effect of ageism on the practice of nursing older adults, a
n n n n n n n n n n n n n n n
nursing attendant needs to first:
n n n n n
a. recognize that nursing attendants must act as advocates for aging hospital clients. n n n n n n n n n n n
b. accept that this population represents a substantial portion ofthose requiring nursing care.
n n n n n n n n n n n n
c. self-reflect and formulate ones personal view ofaging and the older hospital client.n n n n n n n n n n n n
d. recognize ageism as a form ofbigotry shared by many Americans. n n n n n n n n n n
ACCURATE ANSWER:-C
n n
Reasoning:->>>Ageism is an ever-increasing prejudicial view of the effects of the aging process and of theolder n n n n n n n n n n n n n n n n
population as a whole. With nursing attendants being members of a society holding such views, it is
n n n n n n n n n n n n n n n n
critical that the individual nursing attendant self-reflect on personal feelings and determine whether
n n n n n n n n n n n n n
such feelings will affect the nursing care that he or she provides to the aging hospital client. Acting as
n n n n n n n n n n n n n n n n n n n
anadvocate is an important nursing role in all settings. Simply accepting a fact does not help end
n n n n n n n n n n n n n n n n n n
ageism, nor does recognizing ageism as a form of bigotry.
n n n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-9 n n n n n n
TOPIC: Teaching-Learning MSC: Safe and Effective Care Environment
n n n n n n n
3. When discussing factors that have helped to increase the number of healthy, independent older
n n n n n n n n n n n n n
Americans, the nursing attendant includes the importance of:
n n n n n n n n
a. increased availability of in-home care services. n n n n n
b. government support ofretired citizens. n n n n
c. effective antibiotic therapies. n n
d. the development of life-extending therapies.
n n n n
,ACCURATE ANSWER:-C n
Reasoning:->>>The health and ultimate autonomy of older Americans has been positively n n n n n n n n n n
impacted by the development of antibiotics, better sanitation, and vaccines. These public health
n n n n n n n n n n n n n
measures have been more instrumental in increasing the numbers of healthy, independent older
n n n n n n n n n n n n n
Americans than have in-home care services, government programs, or life-extending therapies.
n n n n n n n n n n n
DIFFICULT: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
n n n n n n n n
TOPIC:Nursing Process: Implementation MSC: Health Promotion and Maintenance n n n n n n n
4. Based on current data, when presenting an older adults discharge teaching plan, the
n n n n n n n n n n n n
nursing attendant includes the hospital clients:
n n n n n n
a. nonrelated caretaker. n
b. paid nursing attendant. n n
c. family member. n
d. intuitional representative. n
ACCURATE ANSWER:-C
n n
Reasoning:->>>Less than 4% of older adults live in a formal health care environment. The majority of the n n n n n n n n n n n n n n n n
geriatric population lives at home or with family members.
n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 3-3
n n n n n n n
TOPIC:Nursing Process: Planning MSC: Safe and Effective Care Environment n n n n n n n n
5. The nursing attendant planning care for an older adult who has recently been diagnosed with
n n n n n n n n n n n n n n
rheumatoid arthritis views the priority criterion for continued independence to be the hospital
n n n n n n n n n n n n n
clients:
n
a. age.
b. financial status. n
c. gender.
d. functional status. n
ACCURATE ANSWER:-D
n n
Reasoning:->>>Maintaining the functional status of older adults may avert the onset of physical frailty and n n n n n n n n n n n n n n
cognitive impairment, two conditions that increase the likelihood ofinstitutionalization.
n n n n n n n n n
DIFFICULT: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
n n n n n n n n
TOPIC: Nursing Process: Planning MSC: Physiologic Integrity
n n n n n n
6. A nursing attendant working with the older adult population is most likelyto assess a need
n n n n n n n n n n n n n n n
for afinancial social services referral for a(n):
n n n n n n n n
a. white male. n
b. black female. n
c. Hispanic male. n
d. AsianAmerican female. n n
ACCURATE ANSWER:-B
n n
Reasoning:->>>The povertyrate among older black women is substantially higher than that seen among maor n n n n n n n n n n n n n n n
females ofother ethnic groups. White males had the least poverty.
n n n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-4
n n n n n n n
TOPIC:Nursing Process: Assessment MSC: Safe and Effective Care Environment n n n n n n n n
, 7. Which of the following statements made by a nursing attendant preparing to complete a health
n n n n n n n n n n n n n n
assessment and history on an older hospital client reflects an understanding of the general health
n n n n n n n n n n n n n n n
statusof this population?
n n n n
a. Ill need to document well regarding the medications the hospital client is currently prescribed. n n n n n n n n n n n n n
b. I would like to understand how supportive the hospital clients family members are.
n n n n n n n n n n n n
c. Most older hospital clients are being treated for a variety of chronic health care issues.
n n n n n n n n n n n n n n
d. It will be interesting to see whether this hospital client sees herself as being n n n n n n n n n n n n n
healthy.ACCURATE ANSWER:-D
n n n
Reasoning:->>>It is a misconception that old age is synonymous with illness and illness. The nursing attendant n n n n n n n n n n n n n n n
sho
n
always determine the hospital clients sense of wellness and independence when conducting a health
n n n n n n n n n n n n n
andhistory assessment. An assessment of medication use and family support is important for any
n n n n n n n n n n n n n n n
hospital client. Many older adults do have chronic health conditions, but their perception is more
n n n n n n n n n n n n n n n
important than a single number.
n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-4 n n n n n n
TOPIC:Nursing Process: Assessment MSC: Health Promotion n n n n n
8. The nursing attendant is caring for an older adult who has been admitted to an acute care
n n n n n n n n n n n n n n n n
healthcenter for treatment of a fractured femur. The family expresses concern about the
n n n n n n n n n n n n n n
hospital clients pending transfer to a subacute supported care facility. What response by the
n n n n n n n n n n n n n n
nursing attendant is best?
n n n n
a. Acute care facilities lack the long-term physical therapy support your dad requires. n n n n n n n n n n n
b. Your dad will be much happier in a more serene, private environment.
n n n n n n n n n n n
c. The subacute facility will focus on helping your dad maintain his independence.
n n n n n n n n n n n
d. Insurance, including Medicare, will cover only a limited amount oftime here. n n n n n n n n n n n
ACCURATE ANSWER:-C
n n
Reasoning:->>>The transfer of the hospital client to a subacute facility is based on the need to maintain the n n n n n n n n n n n n n n n n n
hospital clients
n n
level of function and independence, a task the acute supported care facility is not prepared to address
n n n n n n n n n n n n n n n n
once the hospital client is physiologically stable. The hospital client may or may not be happier in
n n n n n n n n n n n n n n n n n
the new setting; the nursing attendant should not make this judgment. It is true that insurance only
n n n n n n n n n n n n n n n n n
pays for a limited amountof time in an acute supported care facility, but this is not the best reason for
n n n n n n n n n n n n n n n n n n n n n
the hospital client to transfer.
n n n n n
DIFFICULT: Applying (Application) REF: N/AOBJ: n n n n n
1-6TOPIC:Communication and Documentation
n n n n
MSC: Health Promotion and Maintenance
n n n n
9. To best assure both the quality of care and the safety ofthe older adult hospital client who requires
n n n n n n n n n n n n n n n n n n
in-home unlicensed assistive personal (UAP) assistance, the geriatric nursing attendant:
n n n n n n n n n n n
a. evaluates the competency of the UAP staff. n n n n n n
b. assumes the roles of case manager and hospital client advocate. n n n n n n n n n
c. arranges for the needed UAP provided services. n n n n n n
d. assessesthehospital client for functional n n n n n
limitations.ACCURATE ANSWER:-A
n n n
Reasoning:->>>As more care traditionally provided by professional nursing attendants is being transferred to n n n n n n n n n n n n
UAP,nursing attendant
n n n
must assume more responsibility for educating, training, and evaluating the competencyof UAPstaff
n n n n n n n n n n n n n
to provide safe, effective care for the older adult hospital client.
n n n n n n n n n n n
DIFFICULT: Applying (Application) REF: N/A OBJ: 1-2 n n n n n n
