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TEST BANK FOR HAM'S PRIMARY CARE GERIATRICS A CASE-BASED APPROACH 6TH EDITION BY RICHARD J. HAM! RATED A+
TEST BANK FOR HAM'S PRIMARY CARE GERIATRICS A CASE-BASED APPROACH 6TH EDITION BY RICHARD J. HAM! RATED A+
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Ham's Primary Care Geriatrics A Case-Based Approach 6th Edition TestBank Updated Version 2023 100%
Chapter 1. Principles of Primary Care of Older Adults
MULTIPLE CHOICE
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published.
The nurse would use these standards to:
a. 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:
D
The 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: msc: 2 OBJ: 1-1 TOP:
N/A MSC: Safe and Effective Care Environment
2. When attempting to minimize the effect of ageism on the practice of nursing older adults,
anurse needs to first:
a. 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. self-reflect and formulate ones personal view of aging and the older patient.
d. recognize ageism as a form of bigotry shared by many Americans.
ANS: C
Ageism is an ever-increasing 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 self-reflect 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: N/A
OBJ: 1-9
TOP: Teaching-Learning MSC: Safe and Effective Care Environment
3. When discussing factors that have helped to increase the number of healthy, independent
older
Americans, the nurse includes the importance of:
a. increased availability of in-home care services.
b. government support of retired citizens.
c. effective antibiotic therapies.
d. the development of life-extending therapies.
ANS: C
The 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 in-home care services, government programs, or life-extending therapies. DIF:
Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
,4. Based on current data, when presenting an older adults discharge teaching plan, the
nurseincludes the patients:
a. nonrelated caretaker.
b. paid caregiver.
c. family member.
d. intuitional representative.
ANS: C
Less 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: N/A OBJ: 3-3
TOP: Nursing Process: Planning MSC: Safe and Effective Care Environment
5. The nurse planning care for an older adult who has recently been diagnosed with
rheumatoidarthritis views the priority criterion for continued independence to be the patients:
a. age.
b. financial status.
c. gender.
d. functional status.
ANS: D
Maintaining 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: msc: 8 OBJ: 1-6
TOP: Nursing Process: Planning MSC: Physiologic Integrity
6. A nurse working with the older adult population is most likely to assess a need for a financial
social services referral for a(n):
a. white male.
b. black female.
c. Hispanic male.
d. Asian American female.
ANS: B
The 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: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
7. 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
population?
a. 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. ANS: D
It 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: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Health Promotion
,8. 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 best?
a. Acute care facilities lack the long-term 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: C
The 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: N/A OBJ: 1-6
TOP: Communication and Documentation MSC:
Health Promotion and Maintenance
9. To best assure both the quality of care and the safety of the older adult patient who
requires in home unlicensed assistive personal (UAP) assistance, the geriatric nurse:
a. 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: A
As 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: N/A OBJ: 1-2 TOP:
Communication and Documentation
MSC: Safe and Effective Care Environment
10. The nurse working with older adults understands what information about certification
ingerontologic nursing?
a. It is mandatory for those in long-term care settings.
b. It is voluntary and shows clinical expertise in an area.
c. It allows nurses to be paid by third-party payers.
d. It allows nurses to advance their careers in a job.
ANS: B
Certification 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 third
party reimbursement. It may be part of a career ladder program, but that is not true of all work
settings.
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 1-2
TOP: Teaching-Learning MSC: Safe Effective Care Environment
11. A nurse works in a gerontologic clinic. What action by the nurse takes highest
priority?a. Serving as a patient advocate
b. Educating patients about diseases
c. Helping patients remain independent
d. Referring patients to home health care
ANS: C
, One of the challenges and priorities of the gerontologic nurse is helping patients maintain their
independence.
DIF: Remembering (Knowledge) REF: msc: 10 OBJ: 1-2
TOP: Nursing Process: Implementation MSC: Health Promotion
12. A nurse is caring for an older patient in the emergency department. What information
aboutthe patient will be most helpful in creating a plan of care?
a. Baseline physical and cognitive functioning
b. Living conditions and family support
c. Medications and current medical problems
d. Results of the Mini Mental State examination
ANS: A
The 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: N/A OBJ: 1-6
TOP: Nursing Process: Assessment MSC: Health Promotion
13. The faculty member explains to students that many older Americans continue to work
pastthe retirement age. What best explains this trend?
a. Feeling healthier longer
b. Changing financial outlook
c. Becoming bored in retirement
d. A desire to give back
ANS: B
As 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: msc: 7 OBJ: 1-3
TOP: Teaching-Learning MSC: Health Promotion
14. What information does the faculty member teach students about
Medicare?
a. Covers anyone with end stage renal disease
b. Part A covers some prescription costs
c. Part B covers inpatient hospital costs
d. Part D eliminates the drug donut hole
ANS: A
Although Medicare is primarily for those over the age of 65, it does cover people of any age
with end-stage kidney disease. Part A covers hospital costs. Part B is medical insurance. The
donut hole was fixed by the Affordable Care Act.
DIF: Understanding (Comprehension) REF: msc: 9 OBJ: 1-3
TOP: Teaching-Learning MSC: Health Promotion
15. A nursing manager notes that many older patients are admitted to the nursing unit for
acuteproblems. What action can the manager take to most benefit this population? a.
Provide mandatory education on the needs of the older patient.
b. Provide restorative therapy programs designed for this group.
c. Ensure staffing numbers are adequate for dependent patients.
d. Encourage all nurses to obtain gerontologic certification.
ANS: B
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