,Chapter 01: Trends and Issues
Test Bank
MULTIPLE CHOICE
1. What 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.
DIF: Cognitive Level: Comprehension REF: p. 1 OBJ: 2
TOP: Aging Trends KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
2. To what 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.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: Age Categories KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
3. Which of the following 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.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3
TOP: Ageism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
4. What is the most beneficial legislation that has influenced health care for the older adult?
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.
DIF: Cognitive Level: Comprehension REF: pp. 15-16 OBJ: 6
TOP: Legislation KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
5. What 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.
DIF: Cognitive Level: Knowledge REF: p. 13 OBJ: 9
TOP: Housing Options KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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. What 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.
DIF: Cognitive Level: Application REF: p. 15 OBJ: 6
TOP: Medicare Provisions KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
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 information to the daughter?
a. Advance directives indicate the degree of intervention desired by the patient.
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.
DIF: Cognitive Level: Application REF: p. 18 OBJ: 11
TOP: Advance Directives KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
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.
DIF: Cognitive Level: Application REF: p. 20 OBJ: 11
TOP: Loss of Independence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
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.
DIF: Cognitive Level: Comprehension REF: p. 18 OBJ: 11
TOP: Living Wills KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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
Test Bank
MULTIPLE CHOICE
1. What 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.
DIF: Cognitive Level: Comprehension REF: p. 1 OBJ: 2
TOP: Aging Trends KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
2. To what 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.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: Age Categories KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
3. Which of the following 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.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3
TOP: Ageism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
4. What is the most beneficial legislation that has influenced health care for the older adult?
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.
DIF: Cognitive Level: Comprehension REF: pp. 15-16 OBJ: 6
TOP: Legislation KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
5. What 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.
DIF: Cognitive Level: Knowledge REF: p. 13 OBJ: 9
TOP: Housing Options KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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. What 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.
DIF: Cognitive Level: Application REF: p. 15 OBJ: 6
TOP: Medicare Provisions KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
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 information to the daughter?
a. Advance directives indicate the degree of intervention desired by the patient.
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.
DIF: Cognitive Level: Application REF: p. 18 OBJ: 11
TOP: Advance Directives KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
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.
DIF: Cognitive Level: Application REF: p. 20 OBJ: 11
TOP: Loss of Independence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
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.
DIF: Cognitive Level: Comprehension REF: p. 18 OBJ: 11
TOP: Living Wills KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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
