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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023), Chapter 1-20 + NCLEX Case Studies with answers | All Chapters
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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023), Chapter 1-20 + NCLEX Case Studies with answers | All Chapters

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TEST BANK
Basic Geriatric Nursing


Patricia A. Williams
8th Edition

,Table of Contents

Chapter 01 Trends and Issues 1
Chapter 02 Theories of Aging 11
Chapter 03 Physiologic Changes 17
Chapter 04 Health Promotion, Health Maintenance, and Home Health Considerations 27
Chapter 05 Communicating With Older Adults 36
Chapter 06 Maintaining Fluid Balance and Meeting Nutritional Needs 46
Chapter 07 Medications and Older Adults 55
Chapter 08 Health Assessment for Older Adults 65
Chapter 09 Meeting Safety Needs of Older Adults 74
Chapter 10 Cognition and Perception 83
Chapter 11 Self-Perception and Self-Concept 92
Chapter 12 Roles and Relationships 100
Chapter 13 Coping and Stress 108
Chapter 14 Values and Beliefs 117
Chapter 15 End-of-Life Care 121
Chapter 16 Sexuality and Aging 130
Chapter 17 Care of Aging Skin and Mucous Membranes 138
Chapter 18 Elimination 147
Chapter 19 Activity and Exercise 155
Chapter 20 Sleep and Rest 162
NCLEX Case Studies 170
Case Study 1. Abuse and Neglect 170
Case Study 2. Chronic Pain 171
Case Study 3. Delirium 172
Case Study 4. Parkinson’s Disease 173
Case Study 5. Unintentional Weight Loss 174
Case Study 6. Transitions in Care 176
NCLEX Case Studies Answer Key 181
Case Study 1. Abuse and Neglect Answer Key 181
Case Study 2. Chronic Pain Answer Key 182
Case Study 3. Delirium Answer Key 183
Case Study 4. Parkinson’s Disease Answer Key 184
Case Study 5. Unintentional Weight Loss Answer Key 185
Case Study 6. Transitions in Care Answer Key 187

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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

Chapter 01: Trends and Issues
Williams: Basic Geriatric Nursing, 8th Edition


MULTIPLE CHOICE

1. Which fact explains the shift of health care focus toward the older adult in the late 1960s?
a. Disability was viewed as unavoidable.
b. Complications from disease increased mortality.
c. Older adults’ needs are similar to those of all adults.
d. Preventive health care practices increased longevity.
ANS: D
Increased preventive health care practices, disease control, and focus on wellness helped
people live longer.

PTS: 1 DIF: 4 REF: p. 2 OBJ: 2
TOP: Aging Trends KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
NOT: Understanding

2. To which age group does the term “aged” apply?
a. 55–64 years of age
b. 65–74 years of age
c. 75–84 years of age
d. 85 and older
ANS: C
The term aged refers to persons who are 75–84 years of age.

PTS: 1 DIF: 1 REF: p. 2 | Table 1.1
OBJ: 1 TOP: Age Categories
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
NOT: Remembering

3. Which is true of ageism?
a. It is discrimination against persons solely on the basis of age.
b. It causes a person to fear aging.
c. It involves the use of cultural sensitivity to address concerns of aging.
d. It focuses on resources for the older adult.
ANS: A
Ageism is a negative belief pattern that influences persons to discriminate against persons
solely on the basis of age and can lead to destructive behaviors toward the older adult.

PTS: 1 DIF: 4 REF: p. 4 OBJ: 3
TOP: Ageism KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation NOT: Understanding

4. Which legislation has been the most beneficial legislation that has influenced health care for
the older adult?


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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

a. Medicare and Medicaid
b. Elimination of the mandatory retirement age
c. The Americans with Disabilities Act
d. The Drug Benefit Program
ANS: A
The broadest sweeping legislation beneficial to the older adult is Medicare and Medicaid. The
elimination of the mandatory retirement age does not apply to health care. The Americans
with Disabilities Act deals with all Americans with disabilities, not just the older adult. The
Drug Benefit Program was added to Medicare, but deals only with medications.

PTS: 1 DIF: 4 REF: p. 11 OBJ: 6
TOP: Legislation KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A NOT: Understanding

5. Which housing option for the older adult offers the privacy of an apartment with
restaurant-style meals and some medical and personal care services?
a. Government-subsidized housing
b. Long-term care facility
c. Assisted-living center
d. Group housing plan
ANS: C
Assisted-living arrangements offer the privacy of an apartment or condominium with meals
prepared and served, limited medical care, and a variety of personal services.

PTS: 1 DIF: 3 REF: p. 14 OBJ: 9
TOP: Housing Options KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation NOT: Remembering

6. The 75-year-old man who has been hospitalized following a severe case of pneumonia is
concerned about his mounting hospital bill and asks if his Medicare coverage will pay for his
care. Which would be the most helpful response by the nurse?
a. Medicare Part C pays 50% of all medical costs for persons older than 65.
b. Medicare Part B pays hospital costs and physician fees.
c. Medicare Part A pays for inpatient hospital costs.
d. Medicare Part D pays 80% of the charges made by physicians.
ANS: C
Medicare Part A pays inpatient hospital costs, Part B pays 80% of physician’s charges, and
Part D helps defray prescription drug costs. Medicare Part C allows individuals to receive
health insurance through private insurance companies and typically pays entire costs.

PTS: 1 DIF: 7 REF: p. 16 OBJ: 6
TOP: Medicare Provisions KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation NOT: Applying

7. The daughter of a patient who has been diagnosed with terminal cancer asks which documents
are required to allow her to make health care decisions for her parent. Which response would
provide the most accurate information to the daughter?
a. Advance directives indicate the degree of intervention desired by the patient.




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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

b. A ‘Do Not Resuscitate’ document signed by the patient transfers authority to the
next of kin.
c. A durable power of attorney for health care transfers decision-making authority for
health care to a designated person.
d. A living will transfers authority to the physician.
ANS: C
A durable power of attorney for health care transfers the authority for decision making to a
designated person. An advance directive specifies the type of care an individual desires when
he cannot speak for himself. The durable power of attorney is only one type of advance
directive. A “Do Not Resuscitate” document states that the patient wishes to die naturally with
no intervention. A living will prohibits the use of life-prolonging measures.

PTS: 1 DIF: 7 REF: p. 19 OBJ: 11
TOP: Advance Directives KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation NOT: Applying

8. The daughter of a resident in a long-term care facility is frustrated with her 80-year-old
mother’s refusal to eat. Which response would be the most appropriate?
a. The refusal to eat is an effort to maintain a portion of independence and
self-direction.
b. The refusal to eat is an indication of approaching Alzheimer disease.
c. The refusal to eat is an effort to gain attention.
d. The refusal to eat is an indication of the dislike of the institutional food.
ANS: A
Loss of independence and control is a significant issue for the older adult. Some residents will
exercise whatever control they may retain.

PTS: 1 DIF: 7 REF: p. 21 OBJ: 11
TOP: Loss of Independence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation NOT: Applying

9. When do the conditions of a living will go into effect?
a. When the patient declares that desire in writing
b. When a family member indicates the desire for curative therapy to cease
c. When two physicians agree in writing that the criteria in the living will have been
met
d. When the physician and a family member agree that the criteria in the living will
have been met
ANS: C
Two physicians must agree in writing that the criteria of the living will have been met before
the document can go into effect.

PTS: 1 DIF: 4 REF: p. 19 OBJ: 11
TOP: Living Wills KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
NOT: Understanding




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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

10. In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce
hospital costs. How did the DRGs reduce hospital costs?
a. By classifying various diagnoses as ineligible for hospitalization
b. By allotting a set amount of hospital days and prospective payment on the basis of
the admitting diagnosis
c. By specifying particular physicians to treat specified diagnoses
d. By using frequency of a particular diagnosis to set a payment schedule
ANS: B
DRGs set up a system of preset hospitalization time and payment on the basis of the admitting
diagnosis.

PTS: 1 DIF: 4 REF: p. 16 OBJ: 6
TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
NOT: Understanding

11. Which facility would be recommended for a patient with diabetes who has had a hip
replacement and needs physical therapy?
a. Basic care facility
b. Skilled care facility
c. Subacute care facility
d. Assisted-living residence
ANS: B
Skilled care facilities offer not only basic care but also services from experienced licensed
professionals such as nurses, physical therapists, speech therapists, and occupational
therapists.

PTS: 1 DIF: 7 REF: p. 15 OBJ: 9
TOP: Extended-Care Facilities KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
NOT: Applying

12. The 80-year-old woman who is recovering from a stroke is being sent to a skilled care facility.
She is concerned about the expense. The nurse can decrease anxiety by explaining that
Medicare will cover extended-care facility costs for which period of time?
a. A period of 30 days
b. A period of 45 days for physical therapy
c. A period of 100 days for needed skilled care
d. Until she is able to be discharged home
ANS: C
Medicare will cover skilled care costs for 100 days. After 100 days, the resident must revert to
private pay or ancillary long-term care insurance.

PTS: 1 DIF: 4 REF: p. 16 OBJ: 8
TOP: Extended Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
NOT: Understanding




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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

13. Which senior citizen political action group uses volunteers and lobbyists to advance the
interests of older adults?
a. American Association of Retired Persons (AARP)
b. National Council of Senior Citizens (NCSC)
c. National Alliance of Senior Citizens (NASC)
d. Gray Panthers
ANS: A
The AARP uses volunteers and lobbyists to advance the interests and welfare of older adults.

PTS: 1 DIF: 2 REF: p. 12 OBJ: 7
TOP: Political Action Groups KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A NOT: Remembering

14. Which caregiver could be found guilty of elder abuse?
a. A daughter who uses her mother’s Social Security money to purchase her mother’s
medication
b. A son who puts an alarm on the front door to prevent his mother from wandering
out of the house
c. A wife who allows her mentally competent husband to refuse to take a bath for a
week
d. A son who uses his mother’s checking account funds to purchase alcohol for
himself
ANS: D
It is financial abuse if the older person’s money is taken and spent by others for their own
purposes.

PTS: 1 DIF: 8 REF: p. 23 OBJ: 13
TOP: Elder Abuse KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort NOT: Analyzing

15. Which is the most frequent response to elder abuse by the abused older adult?
a. Anger
b. Physical retaliation
c. Notification of authorities
d. Nothing at all
ANS: D
Fear of retaliation or abandonment keeps most abused older adults silent.

PTS: 1 DIF: 5 REF: p. 24 OBJ: 14
TOP: Response to Abuse KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation NOT: Understanding

16. Which reason is often stated by nurses today for not seeking careers in gerontology?
a. The physical work is too difficult.
b. Their technical skills are not used.
c. There is too much challenge.
d. There are limited options for employment.
ANS: B



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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

Many nurses feel that their technical skills will not be used in the care of the older adult.
There are many employment options that offer challenge and fulfillment.

PTS: 1 DIF: 4 REF: p. 5 OBJ: 2
TOP: Employment Options KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A NOT: Understanding

17. “Baby boomers” is a term used to classify which of the following persons?
a. Those who entered school in 1945
b. Those who served in the military in World War II
c. Those who were born between 1946 and 1964
d. Those who were eligible for Social Security benefits in 2000
ANS: C
Baby boomers are those born between 1946 and 1964. The impact of the retirement of this
cohort is unprecedented in terms of the impact on society.

PTS: 1 DIF: 3 REF: p. 8 OBJ: 5
TOP: Baby Boomers KEY: Nursing Process Step: N/A
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation NOT: Remembering

18. The home health nurse recognizes which type of abuse is occurring when finding an older
adult restrained in a recliner?
a. Physical abuse
b. Neglect
c. Emotional abuse
d. Self-neglect
ANS: A
Physical abuse is any action that causes physical pain or injury. Inappropriate use of drugs,
force-feeding, physical restraints, and punishment of any kind are examples of physical abuse.

PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data Collection
MSC: NCLEX: N/A NOT: Applying

19. The nurse discovers a family member has not provided prescribed medications and dressing
changes for an older adult. Which type of elder abuse is demonstrated by the nonprovision of
medical care?
a. Physical abuse
b. Neglect
c. Emotional abuse
d. Self-neglect
ANS: B
Neglect is a passive form of abuse in which caregivers fail to provide for the needs of the
older person under their care. Failure to provide necessary medical care may constitute neglect
because with no means of going to the doctor or pharmacy, the older person may suffer or
even die.

PTS: 1 DIF: 7 REF: p. 23 OBJ: 13




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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

TOP: Types of Abuse KEY: Nursing Process Step: Data Collection
MSC: NCLEX: N/A NOT: Applying

20. A patient reports to the nurse that a health care worker told the patient the call light would be
taken away if it continues to be used excessively. The nurse recognizes this as which type of
elder abuse?
a. Physical abuse
b. Neglect
c. Emotional abuse
d. Self-neglect
ANS: C
Emotional abuse is more subtle and difficult to recognize than physical abuse or neglect. It
often includes behaviors such as isolating, ignoring, or depersonalizing older adults.
Emotional abusers can use verbal abuse to inflict damage such as threatening punishment.

PTS: 1 DIF: 7 REF: p. 23 OBJ: 13
TOP: Types of Abuse KEY: Nursing Process Step: Data Collection
MSC: NCLEX: N/A NOT: Applying


MULTIPLE RESPONSE

1. The nurse is aware that a person’s attitude about aging is influenced mainly by which factor?
___________________ . (Select all that apply.)
a. Life experiences
b. Income level
c. Level of education
d. Current age
e. Occupation
ANS: A, D
A person’s current age and life experiences are the main influences on his or her attitude
relative to aging.

PTS: 1 DIF: 7 REF: p. 3 OBJ: 2
TOP: Attitudes Toward Aging KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation NOT: Understanding

2. Gerontology encompasses applying to which aspect? (Select all that apply.)
a. Appropriate housing
b. Health care
c. Education
d. Business ventures
e. Government-sponsored pensions
ANS: A, B, C, D
Gerontological concerns extend and influence provision of appropriate housing, health care,
education, business ventures, and political stands relative to the welfare of the older adult.

PTS: 1 DIF: 4 REF: p. 2 OBJ: 1
TOP: Gerontology KEY: Nursing Process Step: N/A MSC: NCLEX: N/A



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Test Bank - Basic Geriatric Nursing, 8th Edition (Williams, 2023)

NOT: Understanding

3. Medicare Part C allows eligible persons to receive Medicare benefits via the services of
private insurance companies through which program? (Select all that apply.)
a. Health maintenance organization (HMO)
b. Preferred provider organization (PPO)
c. Medications provided free of charge (FOC)
d. Medicaid is supplemented with Medicare (MCD/MA)
e. Medical service organization (MSO)
ANS: A, B
Medicare Part C allows benefits via the services of managed care organizations, such as an
HMO or PPO. Medications are not provided free of charge. Medicaid is not supplemented
with Medicare in Medicare Part C. Medical service organization is not one of them.

PTS: 1 DIF: 7 REF: p. 16 OBJ: 6
TOP: Medicare Part C KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A NOT: Understanding

4. Which emotional response would be expected from a family who is coping with an aging
loved one’s diminishing abilities and increased care needs? (Select all that apply.)
a. Grief
b. Anger
c. Frustration
d. Loss
e. Resentment
ANS: A, B, C, D
As the family witnesses the decline of a loved one and attempts to respond to the increasing
care needs, the emotional responses are varied and changing. The responses include grief,
anger, frustration, loss, and confusion.

PTS: 1 DIF: 7 REF: p. 21 OBJ: 11
TOP: Impact of Aging on the Family KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation NOT: Applying

5. Which characteristic is typical for a caregiver of an aging family member? (Select all that
apply.)
a. Average age of 32
b. Female
c. Spending about 24 hours a week giving care
d. Caring for a parent or parent-in-law
e. Giving care for an average of 4 years
ANS: B, C, D
The average age of the caregiver is 49 and is caring for a parent or parent-in-law. About 75%
of caregivers to older adults are females, who spend about 24 hours weekly providing care. As
the population ages, women will spend more time caring for their parents than they did caring
for their children.

PTS: 1 DIF: 7 REF: p. 20 | Box 1.5




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