Test Bank - for Toward Healthy Aging: Human Needs and Nursing Response 11th Edition

Test Bank - for Toward Healthy Aging: Human
Needs and Nursing Response 11th Edition

,Chapter 01: Gerontological Nursing Across the Continuum of Care
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Touhy: Toward Healthy Aging, 11th Edition
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MULTIPLE CHOICE b-g




1. When did serious and well-controlled research studies on aging first become available?
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a. Only in the past 60 years. b-g b-g b-g b-g b-g




b. Since the turn of the 20th century. b-g b-g b-g b-g b-g b-g




c. Following the Great Depression. b-g b-g b-g




d. Since the year 2000. b-g b-g b-g




ACCURATE ANSWER:- b-g b-




A g




REASONING:->>>Only in the past 60 years have serious and carefully controlled research b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




studies flourished. Before that, anecdotal evidence was used to illustrate issues assumed to be
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universal, making all the remaining options incorrect.
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DIF: Cognitive Level: Remembering TOPIC: Integrated Process: b-g b-g b - g b-g b-




Teaching/Learning MSC: Patient Needs: Health Promotion and
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Maintenance
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2. The son of a nursing home resident asks a nursing attendant: ―What is the significance of
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being certified in gerontology? I see that you are, but not all of the nursing attendants are.‖
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What response best answers the family member‘s question?
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a. ―National certification as a gerontological nursing attendant is a way to b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




demonstrate special knowledge in caring for older adults.‖
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b. ―National certification in gerontology is required for all nursing attendants who b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




have worked in this setting for 2 or more years.‖
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c. ―National certification is only available to nursing attendants who have a b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




Baccalaureate degree in nursing.‖
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d. ―Only advanced practice nursing attendants, like nursing attendant
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practitioners, are certified in gerontology.‖
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ACCURATE ANSWER:- b-g b-




A g




REASONING:->>>National certification is a way to demonstrate special expertise in caring b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




for older adults. It is not required for practice in any setting across the continuum of care, and
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it is not exclusive to nursing attendants with Baccalaureate degrees. There is both a generalist
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and a specialist gerontological nursing certification. The generalist functions in a variety of
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settings providing care to older adults and their families. The specialist has advanced
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gerontological education at a master‘s level.
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DIF: Cognitive Level: Understanding b-g b-g




TOPIC: Integrated Process: Communication and Documentation
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MSC: Patient Needs: Management of Care
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3. The major goal of the NICHE (Nursing attendants Improving Care for Healthsystem
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Elders) program includes which of the following?
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a. Improve outcomes for hospitalized older adults. b-g b-g b-g b-g b-g




b. Increase the number of older adults cared for in hospitals. b-g b-g b-g b-g b-g b-g b-g b-g b-g



c. Increase the number of iatrogenic complications that occur in hospitalized older
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adults. g

, d. Decrease 30-day readmission rates for hospitalized older adults. b-g b-g b-g b-g b-g b-g b-g




ACCURATE ANSWER:-A b-g




REASONING:->>>The goal of NICHE is to improve outcomes for hospitalized older adults. b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




Although option D is a good outcome for hospitalized older adults, it is not one of the
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major goals of NICHE, which are broader. Options B and C are not goals that would
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improve care for older adults but would be negative outcomes themselves.
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: b-g b-g b - g b-g b-




Teaching/Learning MSC: Patient Needs: Health Promotion and
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Maintenance
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MULTIPLE RESPONSE b-g




1. What is the impact of the Hospital Readmission Reduction Program (HRRP) on avoidable
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readmissions? (Choose all that apply.)
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a. Readmission rates for the selected conditions have dropped nationwide. b-g b-g b-g b-g b-g b-g b-g b-g




b. Many hospitals have instituted system-wide interventions to prevent readmissions.
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c. Hospitals are keeping hospital patients longer to avoid readmissions. b-g b-g b-g b-g b-g b-g b-g b-g




d. Potentially avoidable hospitalizations among nursing home residents is increasing. b-g b-g b-g b-g b-g b-g b-g b-g




e. Hospitals have a financial incentive to develop programs to reduce readmissions. b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g




ACCURATE ANSWER:-A, B, E b-g b-g b-g




REASONING:->>>The Hospital Readmission Reduction Program (HRRP) was established b-g b-g b-g b-g b-g b-g b-g b-




as a provision in the Affordable Care Act (ACA) requiring Medicare to reduce payments to
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hospitals with relatively high readmission rates for selected conditions for hospital patients
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in traditional Medicare. Since the HRRP, readmission rates for the selected conditions have
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dropped nationwide but estimates are that in 2018, about 80% of hospitals evaluated by
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CMS will face penalties totaling $564 million (Advisory Board, 2017). Additionally, the
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HRRP has been the impetus for many hospitals to institute system-wide interventions to
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prevent readmissions that have also contributed to the decline in readmission rates. The rate
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of potentially avoidable hospitalizations among SNF residents has fallen by nearly a third in
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recent years as a result of many quality improvement initiatives.
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: b-g b-g b - g b-g b-




Teaching/Learning MSC: Patient Needs: Health Promotion and
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Maintenance
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2. Which of the following are true statements about the current health care workforce? (Choose
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all that apply.)
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a. Approximately 10% of registered nursing attendants (RNs) are certified in b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




gerontological nursing.
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b. The number of geriatricians is expected to increase about 50% over the next 25
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years. g




c. The professions of social work, physical therapy, and psychiatry are demonstrating
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the same trends as nursing.
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d. The world‘s older population is expected to grow to at least 1.3 billion in the next
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20 years. g b-g




e. It is anticipated that there will be a need for approximately 3million additional
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direct care and professional health care workers by the year 2030.
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ACCURATE ANSWER:-C, D, E b-g b-g b-g

, REASONING:->>>Less than 1% of RNs are certified in gerontological nursing. Geriatric b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




medicine faces similar challenges with about 7000 prepared geriatricians, 1 for every 2546
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older Americans; and this number is falling with the trend predicted to be less than 5000
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by 2040 (IOM, 2008). By 2040 the number of older adults in the world will be at least 1.3
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billion. Other professions such as social work, physical therapy, and psychiatry have similar
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shortages. It is estimated that by 2030 nearly 3 million additional health care professionals
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and direct care workers will be needed to meet the care needs of a growing older adult
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population. Healthy People 2030 has addressed this concern..
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: b-g b-g b - g b-g b-




Teaching/Learning MSC: Patient Needs: Health Promotion and
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Maintenance
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3. Best practice recommendations for nursing education in relation to gerontology include which
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of the following? (Choose all that apply.)
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a. Provision of a ―stand-alone‖ course in gerontological nursing b-g b-g b-g b-g b-g b-g b-g




b. Integration of gerontological content throughout the curriculum b-g b-g b-g b-g b-g b-g




c. Replacement of acute care pediatric clinical experiences with gerontological b-g b-g b-g b-g b-g b-g b-g b-g b-




clinical experiences
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d. Recruitment of nursing attendants with Master and Doctoral degrees and a b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




specialty in gerontology to faculty roles
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e. Requiring all undergraduate nursing students to obtain gerontological certificationb-g b-g b-g b-g b-g b-g b-g b-g b-




as a requirement for graduation
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ACCURATE ANSWER:-A, B, D b-g b-g b-g




REASONING:->>>Best practices include providing a stand-alone gerontological nursing b-g b-g b-g b-g b-g b-g b-g b-




course as well as integrating gerontology throughout the curriculum. Recruitment of nursing
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attendants with a specialty in gerontology and a Master or Doctoral degree to faculty roles is a
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critical step in making sure that the next generation of nursing attendants is prepared to care
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for older adults. Best practices do not recommend removing pediatric clinical experiences and
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replacing them with gerontological experiences. Nursing certification is only available to
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practicing nursing attendants who meet specific education and practice requirements. It is
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not applicable to nursing students.
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DIF: Cognitive Level: Understanding TOPIC: Integrated Process: b-g b-g b - g b-g b-



Teaching/Learning MSC: Patient Needs: Health Promotion and
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Maintenance
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4. What are the current initiatives being implemented to enhance the specialty of gerontological
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nursing? (Choose all that apply.)
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a. Mandating of a minimum of a Baccalaureate degree in nursing in order to care for b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




older adults g b-g




b. Geriatric Nursing Leadership Academy (GNLA) project b-g b-g b-g b-g b-g




c. Promotion of geriatric nursing to excellence to the nursing community b-g b-g b-g b-g b-g b-g b-g b-g b-g




d. Requiring a nursing certification specifically required to long-term care b-g b-g b-g b-g b-g b-g b-g b-g




e. Offering scholarships for study and research in geriatric nursing b-g b-g b-g b-g b-g b-g b-g b-g




ACCURATE ANSWER:-B, C, E b-g b-g b-g