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Chapter 01: Overview of Gerontologic NursingMeiner: Gerontologic Nursing, 5th EditionMULTIPLE CHOICE 1.In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published. The nurse would use these standards
to:
a.p romote the practice of gerontologic nursing within the acute care setting.
- define
the concepts and dimensions of gerontologic nursing practice.c.elevate the practice of gerontologic nursing.d.incorporate suggested interventions from others who practice gerontologic nursing.
ANS:
D The current publishing of the Standards and Scope of Gerontological Nursing Practice in 2010 incorporates the input of gerontologic nurses from across the United States. It was not intended to promote gerontologic nursing practice within acute care settings, define concepts or dimensions of gerontologic nursing practice, or elevate the practice of gerontologic nursing.
DIF:
Remembering (Knowledge) REF: Page 2 OBJ: 1-1
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N/A MSC: Safe and Effective Care Environment
- When
- accept
attempting to minimize the effect of ageism on the practice of nursing older adults, a nurse needs to first: a.r ecognize that nurses must act as advocates for aging patients.
that this population represents a substantial portion of those requiring nursing care.c.self-reflect and formulate one’s personal view of aging and the older patient.d.recognize ageism as a form of bigotry shared by many Americans.
ANS:
C Ageism is an ever-increasing prejudicial view of the effects of the aging process and of the older population as a whole. With nurses being members of a society holding such views, it is critical that the individual nurse self-reflect on personal feelings and determine whether such feelings will affect the nursing care that he or she provides to the aging patient. Acting as an advocate is an important nursing role in all settings. Simply accepting a fact does not help end ageism, nor does recognizing ageism as a form of bigotry.
DIF:
Applying (Application) REF: N/A OBJ: 1-9
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Teaching-Learning MSC: Safe and Effective Care Environment
3.When discussing factors that have helped to increase the number of healthy, independent older Americans, the nurse includes
the importance of:
a.i ncreased availability of in-home care services.
- government
support of retired citizens.c.effective antibiotic therapies.d.the development of life-extending therapies.
ANS:
C The health and ultimate autonomy of older Americans has been positively impacted by the development of antibiotics, better sanitation, and vaccines. These public health measures have been more instrumental in increasing the numbers of healthy, independent older Americans than have in-home care services, government programs, or life-extending therapies.
DIF:
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Nursing Process: Implementation MSC: Health Promotion and Maintenance
- Based
- paid
- intuitional
on current data, when presenting an older adult’s discharge teaching plan, the nurse includes the patient’s: a.n onrelated caretaker.
caregiver.c.family member.
representative. Test Bank for Gerontologic Nursing, 5e Sue Meiner, Jennifer Yeager 1 / 4
ANS:
C Le ss than 4% of older adults live in a formal health care environment. The majority of the geriatric population lives at home or with family members.D
IF:
Applying (Application) REF: N/A OBJ: 3-3 TO
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Nursing Process: Planning MSC: Safe and Effective Care Environment 5.The nurse planning care for an older adult who has recently been diagnosed with rheumatoid arthritis views the priority criterion
for continued independence to be the patient’s:
a.age.b.financial status.c .gender.d.functional status.A
NS:
D Ma intaining the functional status of older adults may avert the onset of physical frailty and cognitive impairment, two c onditions that increase the likelihood of institutionalization.D
IF:
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Nursing Process: Planning MSC: Physiologic Integrity 6.A nurse working with the older adult population is most likely to assess a need for a financial social service’s referral for
a(n):
a.white male.b.bl ack female.c .Hispanic male.d.A sian American female.A
NS:
B The poverty rate among older black women is substantially higher than that seen among males or females of other ethnic gr oups.White males had the least poverty.D
IF:
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Nursing Process: Assessment MSC: Safe and Effective Care Environment 7.W hich of the following statements made by a nurse preparing to complete a health assessment and history on an older patient reflects an understanding of the general health status of this population?a.“I’ll need to document well regarding the medications the patient is currently prescribed.” b.“ I would like to understand how supportive the patient’s family members are.” c .“Most older patients are being treated for a variety of chronic health care issues.” d.“ It will be interesting to see whether this patient sees herself as being healthy.” A
NS:
D I t is a misconception that old age is synonymous with disease and illness. The nurse should always determine the patient’s se nse of wellness and independence when conducting a health and history assessment. An assessment of medication use and f amily support is important for any patient. Many older adults do have chronic health conditions, but their perception is more i mportant than a single number.D
IF:
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Nursing Process: Assessment MSC: Health Promotion 8.The nurse is caring for an older adult who has been admitted to an acute care hospital for treatment of a fractured femur.The family expresses concern about the patient’s pending transfer to a subacute care facility. What response by the nurse is best?a.“Acute care facilities lack the long-term physical therapy support your dad requires.” b.“ Your dad will be much happier in a more serene, private environment.” c .“The subacute facility will focus on helping your dad maintain his independence.” 2 / 4
d.“Insurance, including Medicare, will cover only a limited amount of time here.” A
NS:
C The transfer of the patient to a subacute facility is based on the need to maintain the patient’s level of function and i ndependence, a task the acute care facility is not prepared to address once the patient is physiologically stable. The patient m ay or may not be happier in the new setting; the nurse should not make this judgment. It is true that insurance only pays for a limited amount of time in an acute care facility, but this is not the best reason for the patient to
transfer.D
IF:
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Communication and Documentation MS
C:
Health Promotion and Maintenance 9.To best assure both the quality of care and the safety of the older adult patient who requires in-home unlicensed assistive personal
(UAP) assistance, the geriatric nurse:
a.evaluates the competency of the UAP staff.b.a ssumes the roles of case manager and patient advocate.c .arranges for the needed UAP provided services.d.a ssesses the patient for functional limitations.A
NS:
A A s more care traditionally provided by professional nurses is being transferred to UAP, the nurse must assume more r esponsibility for educating, training, and evaluating the competency of UAP staff to provide safe, effective care for the older a dult patient.D
IF:
Applying (Application) REF: N/A OBJ: 1-2 TO
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Communication and Documentation MS
C:
Safe and Effective Care Environment 10.The nurse working with older adults understands what information about certification in gerontologic nursing?a.It is mandatory for those in long-term care settings.b.I t is voluntary and shows clinical expertise in an area.c .It allows nurses to be paid by third-party payers.d.I t allows nurses to advance their careers in a job.A
NS:
B C ertification is voluntary and shows that a nurse has additional knowledge and expertise in a certain area of practice. It is not m andatory in specific care settings. It does not allow for third-party reimbursement. It may be part of a career ladder pr ogram, but that is not true of all work settings.D
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Teaching-Learning MSC: Safe Effective
Care Environment 11.A nurse works in a gerontologic clinic. What action by the nurse takes highest priority?a.Serving as a patient advocate b.Educ ating patients about diseases c .Helping patients remain independent d.R eferring patients to home health care A
NS:
C O ne of the challenges and priorities of the gerontologic nurse is helping patients maintain their independence.D
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Nursing Process: Implementation MSC: Health Promotion 12.A nurse is caring for an older patient in the emergency department. What information about the patient will be most helpful in creating a plan of care?a.Baseline physical and cognitive functioning b.Li ving conditions and family support 3 / 4
c.Medications and current medical problems d.R esults of the Mini Mental State examination A
NS:
A The nurse is encouraged to view older patients as individuals and consider their baseline physical and cognitive functional st atus as a standard by which to compare the patient’s current status. The other information is also important, but the basis of i ndividualized care begins with the patient’s strengths and weaknesses.D
IF:
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Nursing Process: Assessment MSC: Health Promotion 13.The faculty member explains to students that many older Americans continue to work past the “retirement age.” What best explains this trend?a.Feeling healthier longer b.C hanging financial outlook c .Becoming bored in retirement d.A desire to give back A
NS:
B A s financial situations may have declined as a result of many economic factors, more older adults work past their “retirement a ge.” The other options may be reasons for some to continue working, but financial necessity is the reason the majority c ontinue to do so.D
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Teaching-Learning MSC: Health Promotion
14.W hat information does the faculty member teach students about Medicare?a.Covers anyone with end stage renal disease b.P art A covers some prescription costs c .Part B covers inpatient hospital costs d.P art D eliminates the drug “donut hole” A
NS:
A A lthough Medicare is primarily for those over the age of 65, it does cover people of any age with end-stage kidney disease.P art A covers hospital costs. Part B is medical insurance. The “donut hole“ was fixed by the Affordable Care Act.D
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Teaching-Learning MSC: Health Promotion
15.A nursing manager notes that many older patients are admitted to the nursing unit for acute problems. What action can the manager take to most benefit this population?a.Provide mandatory education on the needs of the older patient.b.P rovide restorative therapy programs designed for this group.c .Ensure staffing numbers are adequate for dependent patients.d.Enc ourage all nurses to obtain gerontologic certification.A
NS:
B Ma ny older adults need acute care for sudden illness and injury but live in a state of functional decline, which could possibly be prevented by establishing a restorative therapy program. The other actions will help the older patients cared for in the unit, but only to limited degrees.D
IF:
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Nursing Process: Implementation MSC: Physiologic Integrity: Reduction of Risk Potential 16.The dean of a new nursing program wishes to ensure graduates are prepared to care for older patients. What document should guide the dean in designing the curriculum?a.The Nurse Practice Act for that state
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