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