Chapter 01 Overview of Gerontologic NursingMeiner Gerontologic Nursing 5th Edition
1. In 2010 the revised Standards and Scope of Gerontological Nursing Practice was published. The nurse would use these standards toa.promote the practice of gerontologic nursing within the acute care setting.b.define the concepts and dimensions of gerontologic nursing practice.c.elevate the practice of gerontologic nursing.d.incorporate suggested interventions from others who practice gerontologic nursing.ANS DThe current publishing of the Standards and Scope of Gerontological Nursing Practice in 2010 incorporates the input of gerontologic nurses from across the United States. It was not intended to promote gerontologic nursing practice within acute care settings define concepts or dimensions of gerontologic nursing practice or elevate the practice of gerontologic nursing.DIF Remembering Knowledge REF Page 2 OBJ 11TOP NA MSC Safe and Effective Care Environment
2. When attempting to minimize the effect of ageism on the practice of nursing older adults a nurse needs to firsta.recognize that nurses must act as advocates for aging patients.b.accept that this population represents a substantial portion of those requiring nursing care.c.selfreflect and formulate ones personal view of aging and the older patient.d.recognize ageism as a form of bigotry shared by many Americans.ANS CAgeism is an everincreasing prejudicial view of the effects of the aging process and of the older population as a whole. With nurses being members of a society holding such views it is critical that the individual nurse selfreflect on personal feelings and determine whether such feelings will affect the nursing care that he or she provides to the aging patient. Acting as an advocate is an important nursing role in all settings. Simply accepting a fact does not help end ageism nor does recognizing ageism as a form of bigotry.
DIF Applying Application REF NA OBJ 19TOP TeachingLearning MSC Safe and Effective Care Environment3. When discussing factors that have helped to increase the number of healthy independent older Americans the nurse includes the importance ofa.increased availability of inhome care services.b.government support of retired citizens.c.effective antibiotic therapies. PASING GRADESd.the development of lifeextending therapies.ANS CThe health and ultimate autonomy of older Americans has been positively impacted by the development of antibiotics better sanitation and vaccines. These public health measures have been more instrumental in increasing the numbers of healthy independent older Americans than have inhome care services government programs or lifeextending therapies.DIF Remembering Knowledge REF Page 2 OBJ 33TOP Nursing Process Implementation MSC Health Promotion and Maintenance4. Based on current data when presenting an older adults discharge teaching plan the nurse includes the patientsa.nonrelated caretaker.b.paid caregiver.c.family member.d.intuitional representative.ANS CLess than 4 of older adults live in a formal health care environment. The majority of the geriatric population lives at home or with family members.
DIF Applying Application REF NA OBJ 33TOP Nursing Process Planning MSC Safe and Effective Care Environment5. The nurse planning care for an older adult who has recently been diagnosed with rheumatoid arthritis views the priority criterion for continued independence to be the patientsa.age.b.financial status.c.gender. PASING GRADESd.functional status.ANS DMaintaining the functional status of older adults may avert the onset of physical frailty and cognitive impairment two conditions that increase the likelihood of institutionalization.DIF Remembering Knowledge REF Page 8 OBJ 16TOP Nursing Process Planning MSC Physiologic Integrity6. A nurse working with the older adult population is most likely to assess a need for a financial social services referral for ana.white male.b.black female.c.Hispanic male.d.Asian American female.
ANS BThe poverty rate among older black women is substantially higher than that seen among males or females of other ethnic groups. White males had the least poverty.DIF Applying Application REF NA OBJ 14TOP Nursing Process Assessment MSC Safe and Effective Care Environment7. Which of the following statements made by a nurse preparing to complete a health assessment and history on an older patient reflects an understanding of the general health status of this populationa.Ill need to document well regarding the medications the patient is currently prescribed.b.I would like to understand how supportive the patients family members are.c.Most older patients are being treated for a variety of chronic health care issues.d.It will be interesting to see whether this patient sees herself as being healthy. PASING GRADESANS DIt is a misconception that old age is synonymous with disease and illness. The nurse should always determine the patients sense of wellness and independence when conducting a health and history assessment. An assessment of medication use and family support is important for any patient. Many older adults do have chronic health conditions but their perception is more important than a single number.DIF Applying Application REF NA OBJ 14TOP Nursing Process Assessment MSC Health Promotion8. The nurse is caring for an older adult who has been admitted to an acute care hospital for treatment of a fractured femur. The family expresses concern about the patients pending transfer to a subacute care facility. What response by the nurse is besta.Acute care facilities lack the longterm physical therapy support your dad requires.b.Your dad will be much happier in a more serene private environment.c.The subacute facility will focus on helping your dad maintain his independence.d.Insurance including Medicare will cover only a limited amount of time here.
ANS CThe transfer of the patient to a subacute facility is based on the need to maintain the patients level of function and independence a task the acute care facility is not prepared to address once the patient is physiologically stable. The patient may or may not be happier in the new setting the nurse should not make this judgment. It is true that insurance only pays for a limited amount of time in an acute care facility but this is not the best reason for the patient to transfer.
DIF Applying Application REF NA OBJ 16TOP Communication and Documentation PASING GRADESMSC Health Promotion and Maintenance
9. To best assure both the quality of care and the safety of the older adult patient who requires inhome unlicensed assistive personal UAP assistance the geriatric nursea.evaluates the competency of the UAP staff.b.assumes the roles of case manager and patient advocate.c.arranges for the needed UAP provided services.d.assesses the patient for functional limitations.ANS AAs more care traditionally provided by professional nurses is being transferred to UAP the nurse must assume more responsibility for educating training and evaluating the competency of UAP staff to provide safe effective care for the older adult patient.DIF Applying Application REF NA OBJ 12TOP Communication and DocumentationMSC Safe and Effective Care Environment
10. The nurse working with older adults understands what information about certification in gerontologic nursinga.It is mandatory for those in longterm care settings.b.It is voluntary and shows clinical expertise in an area.c.It allows nurses to be paid by thirdparty payers.d.It allows nurses to advance their careers in a job.ANS BCertification is voluntary and shows that a nurse has additional knowledge and expertise in a certain area of practice. It is not mandatory in specific care settings. It does not allow for thirdparty reimbursement. It may be part of a career ladder program but that is not true of all work settings.DIF Remembering Knowledge REF Page 2 OBJ 12TOP TeachingLearning MSC Safe Effective Care Environment
11. A nurse works in a gerontologic clinic. What action by the nurse takes highest prioritya.Serving as a patient advocateb.Educating patients about diseasesc.Helping patients remain independentd.Referring patients to home health careANS COne of the challenges and priorities of the gerontologic nurse is helping patients maintain their independence.DIF Remembering Knowledge REF Page 10 OBJ 12TOP Nursing Process Implementation MSC Health Promotion
12. A nurse is caring for an older patient in the emergency department. What information about the patient will be most helpful in creating a plan of carea.Baseline physical and cognitive functioning PASING GRADESb.Living conditions and family supportc.Medications and current medical problemsd.Results of the Mini Mental State examinationANS AThe nurse is encouraged to view older patients as individuals and consider their baseline physical and cognitive functional status as a standard by which to compare the patients current status. The other information is also important but the basis of individualized care begins with the patients strengths and weaknesses.DIF Applying Application REF NA OBJ 16TOP Nursing Process Assessment MSC Health Promotion
13. The faculty member explains to students that many older Americans continue to work past the retirement age. What best explains this trenda.Feeling healthier longerb.Changing financial outlookc.Becoming bored in retirementd.A desire to give backANS BAs financial situations may have declined as a result of many economic factors more older adults work past their retirement age. The other options may be reasons for some to continue working but financial necessity is the reason the majority continue to do so.DIF Remembering Knowledge REF Page 7 OBJ 13TOP TeachingLearning MSC Health Promotion
14. What information does the faculty member teach students about Medicarea.Covers anyone with end stage renal diseaseb.Part A covers some prescription costs PASING GRADESc.Part B covers inpatient hospital costsd.Part D eliminates the drug donut hole.