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Test Bank Ham's Primary Care Geriatrics A Case-Based Approach 6th Edition

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Chamberlain College Of Nursing

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primary care geriatrics
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Chamberlain College Of Nursing
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Test Bank Ham's Primary Care Geriatrics A Case-Based
Approach 6th Edition
Table of Contents
Chapter 1. Principles of Primary Care of Older Adults ............................................................................... 2
Chapter 4. Wellness and Prevention ......................................................................................................... 7
Chapter 5. Advanced Cultural Competency in Caring for Geriatric Patients ............................................ 13
Chapter 7. Ethics .................................................................................................................................... 20
Chapter 8. Financing and Organization of Health Care ........................................................................... 26
Chapter 11. Long-Term Care .................................................................................................................. 29
Chapter 14. Palliative Care ..................................................................................................................... 37
Chapter 16. Delirium ............................................................................................................................... 43
Chapter 17. Alzheimer’s Disease and Other Dementias .......................................................................... 46
Chapter 18. Depression .......................................................................................................................... 52
Chapter 21. Dizziness ............................................................................................................................. 56
Chapter 23. Urinary Incontinence ............................................................................................................ 57
Chapter 29. Frailty .................................................................................................................................. 63
Chapter 31. Sleep Disorders ................................................................................................................... 70
Chapter 32. Sexual Health ...................................................................................................................... 76
Chapter 33. Mistreatment and Neglect .................................................................................................... 82
Chapter 40. Transient Ischemic Attacks and Stroke ................................................................................ 84
Chapter 46. Cancer ................................................................................................................................ 92
Chapter 49. Infectious Diseases ............................................................................................................. 99
Chapter 51. Benign Prostate Disease ................................................................................................... 105
Chapter 52. Parkinson’s Disease .......................................................................................................... 113

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, 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, 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 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 nurse includes the patients:
a. nonrelated caretaker.
b. paid caregiver.
c. family member.
d. intuitional
representative. ANS: C
2|Page

,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
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
3|Page

, 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 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: 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 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
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Test Bank Ham's Primary Care Geriatrics A Case-Based Approach 6th Edition

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