GERONTOLOGICAL NURSING10TH EDITION BY CHARLOTTE ELIOPOULOS TEST BANK ALL CHAPTERS COVERED.

MULTIPLE RESPONSE 1. The nurses list of age-related illnesses thought to cause the accumulation of free radicals includes . (Select all that apply.) a. arthritis b. colon cancer c. osteoporosis d. diabetes e. atherosclerosis ANS: A, D, E Cancer and osteoporosis are not considered to be diseases that accumulate free radicals. DIF: Cognitive Level: Application REF: 29 OBJ: 2 TOP: Free Radical Influence KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. The nurse emphasizes that the relatively new theory that correlates restricted caloric intake to slowing of the aging process would probably extend the life span of the person, provided that the person .(Select all that apply.) a. consistently eats high-nutrient, low-calorie foods b. maintains a regular exercise program c. consumes 2000 to 3000 mL of fluid a day d. supports the diet with adequate fat-soluble vitamins e. eats only organically grown foods ANS: A, B This new theory encourages high-nutrient, low-calorie foods combined with regular exercise to delay the aging process. DIF: Cognitive Level: Application REF: 30 OBJ: 2 TOP: Calorie Restriction Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. The nurse points out that the positive outcomes from a life review, according to Erikson, would include . (Select all that apply.) a. wisdom and integrated self-image b. comparing self with others c. understanding self and relationships d. seeking anothers opinion of his or her achievement e. acceptance of self ANS: A, C, E Acceptance of self and understanding self and relationships with accumulated wisdom is the goal of Erikson. Seeking the opinion of others suggests that the older adult is experiencing doubt and gloom, which are negative outcomes according to Erikson. DIF: Cognitive Level: Application REF: 30 OBJ: 2 TOP: Eriksons Developmental Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 4. When a patient asks what can be done to neutralize the free radicals in his system, the nurse responds that antioxidant therapy is thought to inhibit free radicals. Antioxidants include . (Select all that apply.) a. fruits b. vegetables c. organ meat d. folic acid e. vitamin D ANS: A, B, D Antioxidants can be obtained largely from fruits and vegetables. Organ meat and vitamin D are not antioxidants. Chapter 3 Diversity MULTIPLE CHOICE 1. A postmenopausal black woman who has been experiencing uterine bleeding tells the nurse, I expect Ill need a total hysterectomy because when my sister had this problem thats what she had done. The nurse recognizes that this woman belongs to a cultural subgroup whose health care beliefs are most influenced by the: a. biomedical model. b. magico-religious model. c. balance/harmony model. d. personal experience. ANS: A The patient shows a tendency to identify with the biomedical model, which views the body as a functioning machine. When a part gives out or is functioning abnormally, traditional Western medical treatment is sought and expected. The magico-religious models believe that health is a reward from a higher power. The balance/harmony models state that illness is the result of a state of imbalance in body energies. Personal experience influences all of these models. DIF: Understanding (Comprehension) REF: Page 91 OBJ: 5-5 TOP: Nursing Process: Assessment MSC: Psychosocial Integrity 2. A Hispanic patient explains that the Hispanic culture believes that dietary management would be just as effective in managing her problems as medication, so the patients prescription has not been filled. Which action by the nurse illustrates cultural accommodation? a. Asking the patient to give more details regarding this belief b. Discussing how to add dietary preferences into the treatment plan c. Offering to have a registered nutritionist discuss the situation with the patient d. Researching the patients proposed dietary beliefs ANS: B Cultural care accommodation or negotiation refers to those assistive, supportive, facilitative, or enabling creative professional actions and decisions that help people of a designated culture adapt to or negotiate with others for a beneficial or satisfying health outcome. The nurse can ask the patient to share more about beliefs, offer a consultation with a nutritionist, or research the beliefs, but these actions do not show accommodation. DIF: Applying (Application) REF: N/A OBJ: 5-9 TOP: Caring MSC: Psychosocial Integrity 3. A geriatric nurse practitioner working with a tribe of Native Americans makes the decision to acculturate in an attempt to provide culturally appropriate care. The nurse does this best by: a. living the values of the tribe. b. researching the tribes belief systems. c. learning the language of the tribe. d. residing among the tribe members. ANS: A Acculturation is a process that occurs when a member of one cultural group adopts the values, beliefs, expectations, and behaviors of another group, usually in an attempt to become recognized as a member of the group. The other actions might be helpful in acculturating. DIF: Applying (Application) REF: N/A OBJ: 5-3 TOP: Nursing process: Implementation MSC: Psychosocial Integrity 4. The nurse in an assisted living facility is practicing a form of cultural bias called ethnocentrism when: a. requesting the bridge group only use the game room for 2 hours at a time. b. encouraging Christian residents to attend mass or church services. c. repeatedly confiscating herbs and food products used in healing. d. telling potential patients who are Jewish that the facility does not have a kosher kitchen, ANS: C Ethnocentrism is a belief that ones own cultural group is superior to that of anothers. In nursing we have a unique culture and expect our patients to adapt to us rather than attempting to adapt to the culture of the patient. Confiscating items used in healing rituals shows ethnocentrism and disrespect to the resident. Limiting activities in a group room, encouraging people to attend church services of their religion, and letting prospective Jewish residents know that the facility does not have a kosher kitchen are not examples of ethnocentrism. DIF: Applying (Application) REF: N/A OBJ: 5-6 TOP: Nursing Process: Implementation MSC: Psychosocial Integrity 5. While caring for an older Korean patient, the nurse notes that the patient answers questions regarding health history when asked but is otherwise silent and does not maintain eye contact. Being culturally sensitive, the nurse recognizes that the patients actions are most likely a(n): a. sign of respect for the wisdom and expertise of the nurse. b. indication that he has no questions regarding the care he is receiving. c. expression of discomfort discussing personal matters. d. means of communicating his dissatisfaction with his care. ANS: A Asian cultures generally view eye contact as rude and are often passive in their care. The patient may or may not have further questions. It is not a sign of discomfort or dissatisfaction. DIF: Remembering (Knowledge) REF: Page 93 OBJ: 5-7 TOP: Caring MSC: Psychosocial Integrity 6. The culturally sensitive nurse will recognize that an older adult patient with a high-context ethnic background will appreciate: a. not having a treatment scheduled during a favorite television program. b. both a written and verbal explanation describing how to monitor her blood sugar levels. c. a concise explanation as to why her physical therapy appointment has been canceled. d. having a conversation about her grandchildren while her dressing is changed. ANS: D The interactional patterns of high-context (universalism) patients refer to the characteristics of relationships and behaviors toward others. When a person from a high-context culture interacts with the nurse, a more personal relationship is expected. This is not related to television shows, teaching materials, or appointment cancellations. DIF: Understanding (Comprehension) REF: Page 92 OBJ: 5-7 TOP: Caring MSC: Psychosocial Integrity 7. In an attempt to be sensitive to varying cultural responses to touch, before shaking a patients hand, the nurse will: a. offer the patient his or her upturned palm. b. wait until the patient extends his or her hand. c. establish eye contact with the patient first. d. address the patient by his or her full name. ANS: B The best way to show respect and implement the appropriate response is to follow the lead of the patient by waiting for the patient to extend a hand. DIF: Applying (Application) REF: N/A OBJ: 5-7 TOP: Caring MSC: Psychosocial Integrity 8. A older Asian patient receiving physical therapy after hip surgery has developed a low-grade fever. The patient explains that the fever will lessen if the treatment includes the principles of yin/yang. The nurse expects to support the patient by: a. providing privacy when his shaman visits. b. arranging for his diet to include cold foods and liquids. c. planning his physical therapy so it does not conflict with meditation. d. keeping a magical amulet under his pillow. ANS: B The yin/yang theory proposes that health is a result of balance within the body. A principle of this theory is that an illness is either hot or cold and must be treated by elements of the opposite state in order to put the system back into balance. It is not related to shaman visits, meditation, or amulets. DIF: Applying (Application) REF: N/A OBJ: 5-9 TOP: Caring MSC: Psychosocial Integrity 9. The nurse in an assisted living facility is preparing to admit an older adult patient who speaks very little English. The nurse decides that it is most important that an interpreter be present when the patient: a. indicates a desire to talk with the physician. b. is being oriented to the facility. c. is required to sign official documents. d. begins crying and is inconsolable. ANS: C The more complex the decision making, the more important it is to have an interpreter present. Although all situations would benefit from an interpreter, the most important time is when the patient is signing official documents that have legal implications. DIF: Applying (Application) REF: N/A OBJ: 5-8 TOP: Communication and Documentation MSC: Psychosocial Integrity 10. When attempting to provide culturally sensitive care according to the explanatory model, the nurse asks the patient: a. Who will be able to help you when you go home? b. Do you think the treatment is helping? c. When did you first notice the problem? d. Has this illness changed your life? ANS: D The gerontologic nurse uses this model to explore the meaning of the health problem from the patients perspective. DIF: Applying (Application) REF: N/A OBJ: 5-7 TOP: Caring MSC: Psychosocial Integrity 11. The nurse is caring for an older adult patient in need of hospitalization. The nurse is aware this patient is a member of an ethnic group that holds a collectivist perspective on community. The nurse best addresses the patients medical needs by: a. calling an interpreter to assure the patient is making an informed decision. b. assuring the patient that his spiritual advisor will meet him at the hospital. c. arranging for admission to a hospital that is familiar with this patients culture. d. offering to phone the patients family and ask them to come in and discuss the hospitalization. ANS: D People with a collectivist perspective derive their identity from affiliation with and participation in a social group such as a family or clan. The needs of the group are more important than those of the individual, and decisions are made with consideration of the effect on the whole. Health care decisions may be made by a group (such as the tribal elders) or a group leader (such as the oldest son). The other options may or may not be needed depending on the specifics of the patients case. DIF: Applying (Application) REF: N/A OBJ: 5-9 TOP: Caring MSC: Psychosocial Integrity 12. The nurse is most effectively using the concept of future time orientation when: a. promising to help the patient call his daughter each weekend. b. offering to complete the health assessment history after the patient eats dinner. c. encouraging an older patient to keep a follow-up clinic appointment. d. arranging for a colorectal cancer screen for senior citizens. ANS: D In the concept of future orientation, people accept the idea that what is done now affects future health. This means that health screenings will help detect a problem today for potentially better health at a later time, days, weeks, or years ahead; it means that prevention may be worth pursuing. The other actions do not show a future orientation. DIF: Applying (Application) REF: N/A OBJ: 5-9 TOP: Caring MSC: Psychosocial Integrity 13. The student learns that which of the following is the best definition of culture? a. A group of similarly appearing individuals b. Shared beliefs, behaviors, and expectations of groups c. Group beliefs about what is right and wrong d. Groups that come from the same part of the world ANS: B A culture is a set of shared and learned beliefs, behaviors, and expectations among a group of people. The individuals in different cultures may or may not look similar. Group beliefs about what is right or wrong are known as values. Cultural members may come from many different parts of the world. DIF: Remembering (Knowledge) REF: Page 87 OBJ: 5-3 TOP: Teaching-Learning MSC: Psychosocial Integrity 14. A student nurse expresses frustration to the faculty member regarding an ethnic older adult who appears to be noncompliant. The student states, Why cant the patient just do what we teach her to do? What response by the nurse is best? a. Yes, I realize how frustrating this must be for you. b. People from her culture are never compliant. c. Maybe you can find a different way to get through. d. Culture dictates how people respond to others. ANS: D Culture is a blueprint for responding to individuals, family, and the community. Persons from strong cultural backgrounds cannot just change their behavior when instructed to do so. The nurse explains this to the student. Stating that the nurse understands the frustration is helpful but does not give the student any information that could help him or her work with this patient. Stating that people from a certain culture are never compliant is biased and prejudicial. Getting through to the patient implies ethnocentrism and bias. DIF: Applying (Application) REF: N/A OBJ: 5-7 TOP: Caring MSC: Psychosocial Integrity 15. A patient from a culture that differs from that of the nurse is hospitalized and near death. What action by the nurse best demonstrates cultural care preservation? a. Allowing the family to remain at the bedside b. Pinning a healing amulet to the patients gown c. Offering the family food and drink in the room d. Giving the family time to be alone with the patient ANS: B Cultural care preservation refers to those assistive, supportive, facilitative, or enabling professional actions and decisions that help people of a particular culture to retain and maintain their well-being, to recover from illness, or to face handicaps or death. Allowing the patient to have healing artifacts important in his or her culture nearby best demonstrates this concept. The other actions are caring but do not demonstrate this principle. DIF: Applying (Application) REF: N/A OBJ: 5-9 TOP: Caring MSC: Psychosocial Integrity