Exam (elaborations) Ebersole and Hess' Gerontological Nursing : Gerontological Exam Guide

Chapter 01: Introduction to Healthy Aging
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Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 3rd
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Edition
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MULTIPLE CHOICE vr




1. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this
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man’s wellness?
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a. Wellness can only be achieved with aggressive medical interventions. vr vr vr vr vr vr vr vr




b. Wellness is not a real option for this client because he is terminally ill. vr vr vr vr vr vr vr vr vr vr vr vr vr




c. Wellness is defined as the absence of disease. vr vr vr vr vr vr vr




d. Nursing interventions can help empower a client to achieve a higher level of vr vr vr vr vr vr vr vr vr vr vr vr




wellness. vr




ANS: D v r




Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse
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can foster wellness in his or her clients. Wellness is defined by the individual and is
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multidimensional. It is not just the absence of disease. A wellness perspective is based on the
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belief that every person has an optimal level of health independent of his or her situation or
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functional level. Even in the presence of chronic illness or while dying, a movement toward
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wellness is possible if emphasis of care is placed on the promotion of well-being in a supportive
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environment.
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PTS: 1 DIF: Apply REF: p. 7
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DiagnosisMSC: Health Promotion and Maintenance
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2. In differentiating between health and wellness in health care, which of the following
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statements is true?
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a. Health is a broad term encompassing attitudes and behaviors. vr vr vr vr vr vr vr vr




b. The concept of illness prevention was never considered by previous generations.
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c. Wellness and self-actualization develop through learning and growth. vr vr vr vr vr vr vr




d. Wellness is impossible when one’s health is compromised. vr vr vr vr vr vr vr




ANS: A v r




Health is a broad term that encompasses attitudes and behaviors; holistically, health includes
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wellness, which involves one’s whole being. The concept of illness prevention was never
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considered by previous generations; throughout history, basic self-care requirements have been
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recognized. Wellness and self-actualization develop through learning and growth—as basic
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needs are met, higher level needs can be satisfied in turn, with ever-deepening richness to life.
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Wellness is possible when one’s health is compromised—even with chronic illness, with
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multiple disabilities, or in dying, movement toward a higher level of wellness is possible.
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PTS: 1 DIF: Understand REF: p. 7
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EvaluationMSC: Health Promotion and Maintenance
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3. Which racial or ethnic group has the highest life expectancy in the United States?
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a. Native Americans vr




b. African Americans vr




c. Hispanic Americans vr




d. Asian and Pacific Island Americans vr vr vr vr

, Chapter 02: Cross-Cultural Caring and Aging
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Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 3rd
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Edition
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MULTIPLE CHOICE vr




1. Which of the following is a true statement about differing health belief systems?
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a. Personalistic or magicoreligious beliefs have been superseded in Western minds by vr vr vr vr vr vr vr vr vr vr




biomedical principles.
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b. In most cultures, older adults are likely to treat themselves using traditional
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methods before turning to biomedical professionals.
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c. Ayurvedic medicine is another name for traditional Chinese medicine. vr vr vr vr vr vr vr vr




d. The belief that health depends on maintaining a balance among opposite qualitiesis
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characteristic of a magicoreligious belief system.
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ANS: B v r




Older adults in most cultures usually have had experience with traditional methods that have
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worked as well as expected. After these treatments fail, older adults turn to the formal health
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care system. Even in the United States, it is common for older adults to pray for cures or
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wonder what they did to incur an illness as punishment. The Ayurvedic system is a
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naturalistic health belief system practiced in India and in some neighboring countries. This
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belief is characteristic of a holistic or naturalistic approach.
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PTS: 1 DIF: Understand
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TOP: Nursing Process: Assessment v r vr vr MSC: Health Promotion and Maintenance v r vr vr vr




2. Which of the following considU
eratiS
onsNis m
Tost likO
vr ely to be true when working with an
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N R I G B.C M vr vr vr vr vr vr vr vr




vr interpreter?
a. An interpreter is never needed if the nurse speaks the same language as the patient.
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b. When working with interpreters, the nurse can use technical terms or metaphors.
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c. A patient’s young granddaughter who speaks fluent English would make the best
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interpreter because she is familiar with and loves the patient.
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d. The nurse should face the patient rather than the interpreter.
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ANS: D v r




The nurse should face the patient rather than the interpreter is a true statement; the intent is to
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converse with the patient, not with a third party about the patient. Many reasons may prevent the
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patient from speaking directly to a nurse. Technical terms and metaphors may be difficult or
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impossible to translate. Cultural restrictions may prevent some topics from being spoken ofto a
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grandparent or child.
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PTS: 1 DIF: Understand REF: p. 18-19
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TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment
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3. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and
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refuses to remain in the bed. Which intervention should the nurse use to promote and maintain
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his health?
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a. Have the health care provider speak to him. vr vr vr vr vr vr vr




b. Use principles of the holistic health system. vr vr vr vr vr vr




c. Ask about his perceptions and treatment ideas. vr vr vr vr vr vr

, d. Consult with a practitioner of Chinese medicine. vr vr vr vr vr vr




ANS: C v r




Using the LEARN model (listen with sympathy to the patient’s perception of the problem,
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explain your perception of the problem, acknowledge the differences and similarities,
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recommend treatment, and negotiate agreement), the nurse gathers information from the
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patient about cultural beliefs concerning health care and avoids stereotyping the patient. In the
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assessment, the nurse determines what the patient believes about caregiving, decision making,
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treatment, and other pertinent health-related information. Speaking with the health care
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provider is premature until the assessment is complete. Unless he accepts the beliefs, principles
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of the holistic health system can be potentially unsuitable and insulting for this patient. Unless
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he accepts the treatments, consulting with a practitioner of Chinese medicine can also be
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unsuitable and insulting for this patient.
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PTS: 1 DIF: Apply
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TOP: Nursing Process: Implementation
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4. Which action should the nurse take when addressing older adults?
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a. Speak in an exaggerated pitch. vr vr vr vr




b. Use a lower quality of speech. vr vr vr vr vr




c. Use endearing terms such as “honey.” vr vr vr vr vr




d. Speak clearly. vr




ANS: D v r




Some health professionals demonstrate ageism, in part because providers tend to see many
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frail, older persons and fewer of those who are healthy and active. Providers should not
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assume that all older adults are hearing or mentally impaired. The most appropriate action
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when addressing an older aduNltUwRoS
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dNbeGtT
oBsp.eC
akOcM
learly. Examples of unintentional ageism in vr vr vr vr vr vr vr vr




language are an exaggerated pitch, a demeaning emotional tone, and a lower quality of
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speech.

PTS: 1 DIF: Apply
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TOP: Nursing Process: Assessment v r vr vr MSC: Health Promotion and Maintenance v r vr vr vr




5. The nurse prepares an older woman, who is Polish, for discharge through an interpreter and
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notes that she becomes tense during the instructions about elimination. Which intervention
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should the nurse implement?
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a. Move on to the discussion about medication. vr vr vr vr vr vr




b. Ask the older woman how she feels about this topic. vr vr vr vr vr vr vr vr vr




c. Instruct the interpreter to repeat the instructions. vr vr vr vr vr vr




d. Have the older woman repeat the instructions for clarity. vr vr vr vr vr vr vr vr




ANS: B v r




When working with an interpreter, the nurse closely watches the older adult for nonverbal
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communication and emotion regarding a specific topic and therefore validates the assessment
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about the older adult’s tension before proceeding. Because the nurse notices her tension, the
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nurse temporarily suspends the preparation to validate her assessment. If the nurse proceeds and
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the older adult is uncomfortable discussing elimination, then important instructions can be
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missed, leading to adverse effects for the older adult. Repeating the instructions can aggravate
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the older adult’s discomfort. Instructing the older adult to repeat the nurse’s instruction ignores
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her needs.
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, PTS: 1 DIF: Apply
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TOP: Communication and Documentation
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MSC: Safe, Effective Care Environment
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6. The nurse plans care for an older African American man who is from Jamaica and resides in
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New York City. Which should the nurse include in planning care?
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a. Attribute his illness to breaking a voodoo. vr vr vr vr vr vr




b. Help him improve social relationships. vr vr vr vr




c. Maintain blood pressure below 120/70 mm Hg. vr vr vr vr vr vr




d. Review the principles of the magicoreligious system. vr vr vr vr vr vr




ANS: C v r




Because African Americans tend to be at risk for cardiovascular disease and hypertension, the
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nurse plans to maintain the patient’s blood pressure at or below the current recommendation by
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the American Heart Association. The nurse can be incorrectly assuming that he practices and
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believes in the magicoreligious system. The nurse should assess his spiritual beliefs and
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determine how much they influence his attitudes toward Western health care. The
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magicoreligious system maintains social relationships in good condition to prevent illness;
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however, if the older adult does not follow this cultural practice, then this goal can be
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unsuitable. The older adult may not believe in this system; therefore, the information can be
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irrelevant.
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PTS: 1 DIF: Apply
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PlanningMSC: Safe, Effective Care Environment
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7. Which health belief system uses treatments to repair a body part?
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a. Holistic NURSINGTB.COM
b. Biomedical
c. Personalistic
d. Magicoreligious

ANS: B v r




Because dysfunction or a structural abnormality is thought to cause disease, the biomedical
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system believes in repairing the structural abnormality. The holistic system holds that health is
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attained through balance. The personalistic system uses treatments such as meditation, fasting,
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and praying. The magicoreligious system is the same as the personalistic system.
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PTS: 1 DIF: Understand
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TOP: Nursing Process: Assessment v r vr vr MSC: Safe, Effective Care Environment v r vr vr vr




8. A nurse is caring for a culturally diverse patient who has missed follow-up appointments with
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the primary care provider three times over the past year. The patient has a chronic illness that
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requires periodic monitoring of blood test values. The patient tells the nurse: “You don’t
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understand—in my culture, we don’t do things like that. I cannot be troubled with worrying
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about appointments in the future; I deal with each day as it comes.” The nurse understands
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which of the following about the patient’s culture?
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a. The culture does not value Western medicine. vr vr vr vr vr vr




b. The culture has a different orientation to time than Western medicine.
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c. The culture is an interdependent culture. vr vr vr vr vr




d. The culture does not believe in preventative care.
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