UPDATED Gerontological Nursing Exam 1 ACTUAL EXAM ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |A+ GUARANTEE

Who are the fastest growing segment of the population - ANSWER- Older adults In 2010 the 65+ population reached how big - ANSWER- 41.4 million (18% increase) Has grown steadily since the 1900s What fraction of people in the US are older adults - ANSWER- 1 in 8 people (12.6%) Reasons why people are living longer - ANSWER- Influx of immigrants before WWI Improvements in healthcare What improvements in healthcare are causing people to live longer - ANSWER- Decreased infant/child mortality rate Improved sanitation practices Widespread use of vaccinations and immunizations Widespread use of antibiotics What % increase in the number of minorities is expected to occur by 2020 - ANSWER- 50% -Older racial and ethnic minorities have lower health status and receive fewer services Role of culture on the nursing care of older adults - ANSWER- Older racial ad ethnic minorities have lower health status and receive fewer services Role of family on the nursing care of older adults - ANSWER- Families often are the ones taking care of the older adults Socioeconomic concerns on the nursing care of older adults - ANSWER- Consider: -Who cares for the elderly in this culture? -Where do they live? -How are finances handled? -Insurance= mainly medicare 3 models for providing culturally congruent care (theory of cultural care diversity and universality) - ANSWER- Cultural care preservation or maintenance Cultural care accommodation or negotiation Cultural care repatterining or restructuring Explanatory model for providing culturally competent care - ANSWER- Using explanatory questions to discuss cultural or family issues with the older adult (exploring the meaning of the health problem from the patient's perspective) -"How has this problem or change affected your life?" -Do you think there is a way to keep this from happening again? -What treatments have you tried? -What do you think we can do for you? LEARN model for providing culturally competent care - ANSWER- Uses same approach as Explanatory model *L*isten with sympathy and understanding to the patient's perceptions of the problem *E*xplain your perception of the situation and the problems *A*cknowldge and discuss the differences and the similarities between your perceptions and goals and those of the older person *R*ecommend a plan of action that takes both perspectives into account *N*egotiate a plan that is mutually acceptable ASKED model for providing culturally competent care - ANSWER- *A*wareness: "Am I aware of my personal biases and prejudices towards cultural groups different than mine?" *S*kill: "Do I have the skill to conduct a cultural assessment and perform a culturally- based physical assessment in a sensitive manner?" *K*nowledge: "Do I have knowledge of the patient's world view and the field of biocultural ecology?" *E*ncounters: "How many face-to-face encounters have I had with patients from diverse cultural backgrounds?" *D*esire: What is my genuine desire to "want to be" culturally competent?" What percent of older adults 75+ need help with 1+ ADLs - ANSWER- 30% Where is the majority of care for the elderly provided? - ANSWER- In the home environment -80% of this care is provided by family -Family is part of the care team Culture - ANSWER- *Universal phenomenon* -The shared and learned beliefs, expectations, and behaviors of a group of people (*dress, foods, language, social systems*) Enculturation - ANSWER- How cultural knowledge is transmitted from one member to another Values - ANSWER- Cultural beliefs about what is right and wrong Acculturation - ANSWER- 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 new group Race - ANSWER- Outward expression of specific genetically influenced, hereditary traits such as *skin and eye color, facial structures, hair texture, and body shape and proportions* Ethnicity - ANSWER- Social differentiation of people based on group membership, shared history, and common characteristics Ethnic identity - ANSWER- An individual's identification with a particular group of persons who share similar beliefs and values Ethnocentrism - ANSWER- Belief that one's own ethnic group, race, or nation of origin is superior to that of another's Racism - ANSWER- Assumption of negative beliefs, attitudes, or behavior toward a person or groups or persons based solely on skin color Cultural Conflict - ANSWER- Anxiety experienced when people interact with individuals who have beliefs, values, customs, languages, and ways of life different than their own Cultural Influence on Nursing Care - ANSWER- Individual vs Collective Time orientation Appropriate eye contact Touch Decision-making What tools are needed to overcome barriers to culturally compassionate care to reduce health disparities - ANSWER- Increasing awareness, knowledge, and skills Changing Family Roles with aging - ANSWER- Change in living arrangements Considering nursing care facilities Financial concerns Legal concerns (surrogate decision-makers) End of life decisions Family caregivers Caregiver burden - ANSWER- Expanded definition of families Family dynamics Stress- physical, emotional, financial Loss of independence, no driving Role reversal Cost of long term care Surrogate decision making