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