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TEST BANK FOR GERONTOLOGIC NURSING 6TH EDITION BY MEINER ALL CHAPTERS
TEST BANK FOR GERONTOLOGIC NURSING 6TH EDITION BY MEINER ALL CHAPTERS
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TEST BANK FORGERONTOLOGIC
NURSING 6TH
EDITION BY MEINER
ALL CHAPTERS
,chapter 01: Overview of Gerontologic Nursing
Meiner: Gerontologic Nursing, 5th Edition
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: Page 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, a nurse 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 one’s 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: Page 2 OBJ: 3-3
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
4. Based on current data, when presenting an older adult’s discharge teaching plan, the nurse includes the patient’s:
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 rheumatoid arthritis views the priority
criterion for continued independence to be the patient’s:
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: Page 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 service’s 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. “I’ll need to document well regarding the medications the patient is currently prescribed.”
b. “I would like to understand how supportive the patient’s 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 patient’s
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 patient’s 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 patient’s 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 in gerontologic 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: Page 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: Page 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 about the 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 patient’s current status. The other information is also important, but the basis of
individualized care begins with the patient’s 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 past the “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: Page 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: Page 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 acute problems. 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
Many older adults need acute care for sudden illness and injury but live in a state of functional decline, which could possibly
be prevented by establishing a restorative therapy program. The other actions will help the older patients cared for in the unit,
but only to limited degrees.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Implementation MSC: Physiologic Integrity: Reduction of Risk Potential
16. The dean of a new nursing program wishes to ensure graduates are prepared to care for older patients. What document
should guide the dean in designing the curriculum?
a. The Nurse Practice Act for that state
,b. The American Nurses Association (ANA) code of ethics for nurses
c. Healthy People 2020
d. The Recommended Baccalaureate Competencies and Curricular Guidelines
ANS: D
The Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older Adults is an
updated version of The Essentials of Baccalaureate Education for Professional Nursing Practice. This document was first
published by the American Association of Colleges of Nursing (AACN) in 2008 and was updated in 2010. The other three
documents do not have information about curricular requirements to prepare students to care for the older population.
DIF: Applying (Application) REF: N/A OBJ: 1-2
TOP: Teaching-Learning MSC: Health Promotion
17. A nurse wants to plan a community event at a retirement center. What topic would most likely be best received?
a. Heart healthy living
b. Financial planning
c. Avoiding scams
d. Ethnic cooking classes
ANS: A
Older adults are demanding more programs and services aimed at health maintenance and promotion and disease and
disability prevention. Based on this information, the heart healthy living presentation would be best received.
DIF: Applying (Application) REF: N/A OBJ: 1-3
TOP: Teaching-Learning MSC: Health Promotion
18. What does the bedside nurse understand about his or her role in nursing research?
a. Research is only done by doctorally prepared nurses.
b. All nurses have a role in delivering research-based care.
c. A bedside nurse can be part of a hospital research team.
d. The bedside nurse can collect data if the nurse has been properly trained.
ANS: B
All nurses are charged to deliver patient-centered care based on evidence-based practice, research, quality improvement, and
informatics. The bedside nurse is part of an interdisciplinary team that is responsible for redesigning the health care structure
of the future.
DIF: Understanding (Comprehension) REF: Page 13 TOP: Teaching-Learning
MSC: Safe Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. The clinic nurse caring for an older diabetic patient with a sixth grade education anticipates that the patient may experience
difficulty (Select all that apply.)
a. recognizing the importance of keeping clinic appointments.
b. following a low-carbohydrate diet.
c. paying for insulin and syringes.
d. deciding on a primary health care provider.
e. naming a health care surrogate.
ANS: A, B, C
Even though the educational level of the older population has steadily increased, as a population they are less educated than
the general population. This deficiency can account for a lack of understanding regarding the need for medical care and the
importance of following a treatment plan. These patients may also have fewer financial resources to devote to health care
issues.
DIF: Analyzing (Analysis) REF: N/A OBJ: 1-4
,TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
2. The nurse studying the history of gerontologic nursing learns which information about the specialty? (Select all that
apply.)
a. The number of older Americans is diminishing.
b. The geriatric nursing conference group was established in 1962.
c. The gerontologic clinical nurse specialist certification was offered in 1989.
d. There were no writings about the care of older persons until World War II.
e. The first Standards of Practice for Geriatric Nursing was written in 1969.
ANS: B, C, E
The geriatric nursing conference group was established in 1962, the gerontologic clinical nurse specialist certification was
first offered in 1989, and the first Standards of Practice for Geriatric Nursing was written in 1969. The population of older
Americans is the fastest-growing subset of the population. Writings about care of the aged can be found from as early as
1900.
DIF: Remembering (Knowledge) REF: Page 2-3 OBJ: 1-2
TOP: Teaching-Learning MSC: Nursing Process: Assessment
3. The student asks the gerontologic clinic nurse why so many older people are women. What information does the nurse
provide? (Select all that apply.)
a. Reduced maternal mortality
b. Decreased deaths from infectious diseases
c. More deaths from chronic disease in men
d. More deaths in war occur in men
e. Women tend to smoke and drink less than men
ANS: A, C, D
A decrease in maternal mortality, decreased deaths from infectious diseases, and more chronic illness in men account for the
disparity in genders as people age.
DIF: Understanding (Comprehension) REF: Page 6 OBJ: 1-5
TOP: Teaching-Learning MSC: Health Promotion
4. The gerontologic nurse plans community programming for older women, noting what facts about this population
subgroup? (Select all that apply.)
a. More likely to live alone
b. Increased chance of living in poverty
c. Taking care of a spouse
d. Suffering many chronic diseases
e. Living with extended families
ANS: A, B, D
Older women have a greater chance than men of living alone and in poverty. They also have a greater degree of functional
impairment and chronic disease.
DIF: Remembering (Knowledge) REF: Page 6 OBJ: 1-5
TOP: Nursing Process: Analysis MSC: Health Promotion
5. The nurse knows that the most common causes of death in the older population result from which diseases? (Select all that
apply.)
a. Cerebrovascular disease
b. End-stage kidney disease
c. Heart disease
,d. Cancer
e. Diabetes
ANS: A, C, D
The most common causes of death in the older population are cerebrovascular disease, heart conditions, and cancer. End-
stage renal disease and diabetes are not among the top three causes of death.
Chapter 02: Theories of Aging
Meiner: Gerontologic Nursing, 5th Edition
MULTIPLE CHOICE
1. The practitioner who believes in the free radical theory of aging is likely to recommend that the older adult:
a. avoid excessive intake of zinc or magnesium.
b. supplement his or her diet with vitamins C and E.
c. increase intake of complex carbohydrates.
d. avoid the use of alcohol or tobacco.
ANS: B
Vitamins C and E are two naturally occurring antioxidants that appear to inhibit the functioning of the free radicals or
possibly decrease their production in the body. The free radical theory of aging is not related to zinc, magnesium,
carbohydrates, or alcohol and tobacco.
DIF: Applying (Application) REF: N/A OBJ: 2-2
TOP: Nursing Process: Planning MSC: Health Promotion
2. To provide effective care to the older adult, the nurse must understand that:
a. older adults are not a homogeneous sociologic group.
b. little variation exists in cohort groups of older adults.
c. health problems are much the same for similar age groups of older adults.
d. withdrawal by an older adult is a normal physiologic response to aging.
ANS: A
The key societal issue addressed by the age stratification theory is the concept of interdependence between the aging person
and society at large. This theory views the aging person as an individual element of society and also as a member, with peers,
interacting in a social process. The theory attempts to explain the interdependence between older adults and society and how
they constantly influence each other in a variety of ways. Variation exists among the members of a cohort. Health problems
are not the same for every individual of the same age. Withdrawal by an older adult is not a normal response to aging but
may be a sign of depression.
DIF: Understanding (Comprehension) REF: Page 16 OBJ: 2-2
TOP: Nursing Process: Planning MSC: Health Promotion and Maintenance
3. The nurse is using the eight stages of life theory to help an older adult patient assess the developmental stage of personal
ego differentiation. The nurse does this by assisting the patient to:
a. determine feelings regarding the effects of aging on the physical being.
b. describe feelings regarding what he or she expects the future to hold.
c. identify aspects of work, recreation, and family life that provide a sense of self-worth and pleasure.
d. elaborate on feelings about the prospect of his or her personal death.
ANS: C
During the stage of ego differentiation versus work role preoccupation, the task for older adults is to achieve identity and
feelings of worth from sources other than the work role. The onset of retirement and termination of the work role may reduce
feelings of self-worth. In contrast, a person with a well-differentiated ego, who is defined by many dimensions, can replace
the work role as the major defining source for self-esteem. Determining feelings related to the effects of aging, future death,
or what the future may hold is not part of this theory.
DIF: Applying (Application) REF: N/A OBJ: 2-4
TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
,4. A patient is recovering from a mild cerebral vascular accident (stroke). The home care nurse notes that the patient is
talking about updating a will and planning funeral arrangements. Which of the following responses is most appropriate for
the nurse to make?
a. “You seem to be preoccupied with dying.”
b. “Is there anything I can do to help you?”
c. “Are you worried about dying before you get your affairs in order?”
d. “Let’s focus on how you are recovering rather than on your dying.”
ANS: B
According to Peck’s expansion of Erikson’s theory, the older adult who has successfully achieved ego integrity and ego
transcendence accepts death with a sense of satisfaction regarding the life led and without dwelling on its inevitability. The
patient’s action reflects a healthy transition and should be supported.
DIF: Applying (Application) REF: N/A OBJ: 2-4
TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
5. Your patient’s spouse died recently from a sudden illness after 45 years of marriage. The patient was the primary caregiver
for the spouse during this time. The patient is now depressed and withdrawn and has verbalized feelings of uselessness.
Which action by the nurse is best?
a. Encourage the patient take up a hobby that will occupy some time.
b. Explain that volunteering would be an excellent way to stay useful.
c. Assure the patient that these feelings of sadness will pass with time.
d. Ask the patient to share some cherished memories of the spouse.
ANS: B
Volunteering will help the patient to interact with people and feel productive and valued for the ability to help others as stated
in the activity theory. A hobby does not offer the chance to help others. Assuring the patient that feelings will pass is false
reassurance and does nothing to help the patient to be proactive. Reminiscing is a valued activity, but it is not the best choice
for regaining a sense of usefulness.
DIF: Applying (Application) REF: N/A OBJ: 2-4
TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
6. A patient has recently been diagnosed with end-stage renal disease. The patient has cried often throughout the day and
finally confides in the nurse that “I am going home to be with my Lord.” The nurse’s best response is:
a. “There is no reason to believe the end is near.”
b. “Do you want me to call your family?”
c. “We have a wonderful chaplain if you’d like me to call him.”
d. “I think this is the time for us to pray together.”
ANS: C
It is important for the nurse to acknowledge the spiritual dimension of a person and support spiritual expression and growth
while addressing spirituality as a component in holistic care without imposing upon the patient. Because the patient has made
reference to the Lord, the nurse can safely offer religion-oriented spiritual care. Telling the patient there is no reason to
believe that death is near does not help the patient work through emotions. Asking about calling the family is a yes/no
question and is not therapeutic. The nurse is assuming too much by saying it is time to pray.
DIF: Applying (Application) REF: N/A OBJ: 2-4
TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
7. A nurse is responsible for the care of 20 older adults in a unit of an assisted living facility. In order to best address the
needs and wants of the entire unit’s population, the nurse:
a. strictly adheres to facility policies so that all patients will be treated equally.
b. encourages specific age cohorts to gather in the dayroom because they share similar interests.
c. has the unit vote on which television programs will be watched each evening.
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d. schedules the patients’ bathing times according to their individual preferences.
ANS: D
Older adults continue to feel valued and viewed as active members of society when allowed to maintain a sense of control
over their living environment by attention to personal choices and rituals. Adhering strictly to policies does not allow for
individualized care. Not all in the same age cohort will have similar interests. Voting on television programs does not ensure
each individual feels a sense of worth.
DIF: Applying (Application) REF: N/A OBJ: 2-5
TOP: Nursing Process: Planning MSC: Psychosocial Integrity
8. An older patient who reports being “healthy enough to cut my own fire wood” is being assessed prior to outpatient surgery.
The nurse recognizes which assessment observation as a possible result of the wear-and-tear theory?
a. Swollen finger joints
b. Red, watery eyes
c. Grimacing when raising left arm
d. Bilaterally bruising on the forearms
ANS: C
This theory proposes that cells wear out over time because of continued use. The pain caused by movement of the shoulder is
the observation most likely a result of the patient’s practice of cutting his own firewood. The other choices do not
demonstrate continued use that is part of the wear-and-tear theory of aging.
DIF: Applying (Application) REF: N/A OBJ: 2-2
TOP: Nursing Process: Assessment MSC: Physiologic Integrity
9. A nurse cares for many older patients. Which finding should the nurse identify as pathologic in a 72-year-old?
a. Two hospitalizations in 6 months for respiratory infections
b. Patient reports of sleeping only of 5 to 6 hours each night
c. Thinning hair and brittle nails
d. Dry, tissue paper–like skin
ANS: A
Although there is an age-related decrease in immune function, reoccurring infections serious enough to require
hospitalization are not considered a normal age-related finding. Decreased sleeping, thinning hair, brittle nails, and dry skin
are all normal signs of aging.
DIF: Application (Apply) REF: N/A OBJ: 2-1
TOP: Nursing Process: Assessment MSC: Physiologic Integrity
10. In planning the care for an older adult patient, the nurse will best promote health and wellness by:
a. encouraging independent living and self-care.
b. scheduling regular cardiac and respiratory health screenings.
c. effectively delivering health-related educational information.
d. promoting a nutritious diet and an age-appropriate exercise routine.
ANS: C
Providing well-prepared and effectively delivered health-related educational information will provide the best means of
promoting a patient’s ability to impact his or her wellness and general health. Each of the other options is too narrow to be
the most effective way to promote health and wellness.
DIF: Applying (Application) REF: N/A OBJ: 2-5
TOP: Nursing Process: Planning MSC: Health Promotion
11. The student learning about aging theories understands that the main difference between stochastic theories and
nonstochastic theories is which of the following?
a. Stochastic theories view aging as a random, cumulative process.
b. Stochastic theories view aging as similar among all people.
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