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EBERSOLE AND HESS GERONTOLOGICAL
NURSING AND HEALTHY AGING 6TH EDITION
BY TOUHY
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,Table of Contents
Chapter 01 Introduction to Healthy Aging 1
Chapter 02 Gerontological Nursing History, Education, and Roles 11
Chapter 03 Communicating with Older Adults 17
Chapter 04 Culture, Ethnicity, Diversity, and Aging 25
Chapter 05 Nursing Documentation 32
Chapter 06 Biological Theories and Physical Changes of Aging 38
Chapter 07 Social, Psychological, Spiritual, and Cognitive Aspects of Aging 45
Chapter 08 Nutritional Needs 51
Chapter 09 Hydration and Continence 58
Chapter 10 Rest, Sleep, and Activity 65
Chapter 11 Promoting Healthy Skin and Feet 72
Chapter 12 Maintaining Mobility and Environmental Safety 80
Chapter 13 Assessment Tools in Gerontological Nursing 87
Chapter 14 Safe Medication Use for Older Adults 94
Chapter 15 Living with Chronic Illness 100
Chapter 16 Pain and Comfort 106
Chapter 17 Diabetes Mellitus 113
Chapter 18 Bone and Joint Health 119
Chapter 19 Visual and Auditory Changes 127
Chapter 20 Cardiovascular and Respiratory Disorders 133
Chapter 21 Cognitive Impairment 141
Chapter 22 Neurological Disorders 147
Chapter 23 Mental Health and Wellness in Later Life 152
Chapter 24 Economic and Legal Issues 160
Chapter 25 Relationships and Roles 167
Chapter 26 Sexual Health and Well-being 174
Chapter 27 Comfort, Palliative Care, Death, and Loss 180
Chapter 28 Care Across the Continuum 189
,Chapter 01: Introduction to Healthy Aging
Boscart: Ebersole and Hess' Gerontological Nursing & Healthy Aging in Canada, 6th
Edition
MULTIPLE CHOICE
1. A man is terminally ill with end-stage prostate cancer. What is the best statement about this
man’s wellness?
a. Wellness is not possible, because the patient uses medication to assist in
management of his medical care.
b. Wellness is unfortunately not a real option for the patient.
c. Wellness is the same thing as faith healing, and if the patient were more receptive,
he could be back at work in a few weeks.
d. Nursing interventions can help empower a patient to achieve a higher level of
wellness.
ANS: D
Feedback
A Incorrect. An individual can achieve wellness even if using medications.
B Incorrect. All persons, regardless of age or life–health situation, can be helped to
achieve a higher level of wellness.
C Incorrect. Biomedical approaches and other treatments and techniques are used
to achieve realistic improvements in wellness.
D Correct. A NURSE can foster wellness at all levels of the needs hierarchy.
PTS: 1 DIF: Application OBJ: 2
TOP: NCLEX: Health Promotion and Maintenance
2. In differentiating between health and wellness in health care, WHICH of the
followingstatements is true?
a. Health is a broad term encompassing attitudes and behaviours.
b. The concept of wellness was rarely or never considered by previous generations.
c. Wellness and self-actualization develop simultaneously through learning and
compromise.
d. It is impossible to have wellness when one’s health is compromised.
ANS: A
Feedback
A Correct. Holistically, health includes wellness, WHICH involves one’s whole
being.
B Incorrect. Throughout history, basic self-care requirements have been
recognized.
C Incorrect. As basic needs are met, higher level needs can be satisfied in turn,
with ever-deepening richness to life.
D Incorrect. Even with chronic illness, with multiple disabilities, or in dying,
movement toward higher wellness is possible.
1|Page
, PTS: 1 DIF: Comprehension OBJ: 2
TOP: NCLEX: Health Promotion and Maintenance
3. WHICH province or territory is predicted to have the fastest growing older-person
populationin Canada between the years 2006 and 2031?
a. Ontario
b. British Columbia
c. Yukon
d. Newfoundland
ANS: C
Feedback
A Incorrect. As shown in Figure 1-1 in your text, the older-person population of
Ontario does not rise as rapidly as the older-person population of Yukon
between 2006 and 2031.
B Incorrect. As shown in Figure 1-1 in your text, the older-person population of
British Columbia does not rise as rapidly as the older-person population of
Yukon between 2006 and 2031.
C Correct. As shown in Figure 1-1 in your text, the older-person population of
Yukon rises faster than any of the other provinces and territories between 2006
and 2031.
D Incorrect. As shown in Figure 1-1 in your text, the older-person population of
Newfoundland does not rise as rapidly as the older-person population of Yukon
between 2006 and 2031.
PTS: 1 DIF: Knowledge OBJ: 3
TOP: NCLEX: Health Promotion and Maintenance
4. Historical influences that have shaped the lives of the majority of the middle-old in Canada
today include WHICH of the following?
a. Influenza epidemic of 1918
b. Immigration from Communist Europe
c. Child-rearing during the Depression
d. Post-World War II effects
ANS: D
Feedback
A Incorrect. A person who survived the influenza epidemic would be at least 93
years old in 2011 and therefore be considered old-old, or centenarian.
B Incorrect. Those who are middle-old in 2011 were born between 1920 and 1930,
before Communism swept Europe.
C Incorrect. Most of those who are middle-old in 2011 had not reached
childbearing age by the end of the Depression.
D Correct. Those who are middle-old in 2011 were in their teens and twenties
during the war; in particular, the men were very likely to have fought in it.
PTS: 1 DIF: Comprehension OBJ: 3
2|Page
, TOP: NCLEX: Health Promotion and Maintenance
5. A NURSE prepares for the arrival of older persons evacuated from a forest fire in
northern Manitoba to a shelter for short-term care. WHICH of the following is the
priority nursingintervention?
a. Demonstrate that the staff is prepared to meet their needs.
b. Use individual medical records to develop a medication plan.
c. Help older persons to display family photos and memorabilia.
d. Help older persons to teach one another a new skill in the shelter.
ANS: B
Feedback
A Incorrect. Providing safety and security from the fire is evident and implied, as
the older persons have been evacuated from danger. The priority nursing
intervention is caring for any health concerns; e.g., medication or treatments that
were left behind.
B Correct. The NURSE prepares for short-term care by prioritizing the needs of
theolder persons, and this intervention helps to maintain the therapeutic plan,
thereby addressing the need for physiological integrity. Furthermore, the
NURSEmaintains continuity of care by preparing a medication schedule to
prevent missed doses of medication.
C Incorrect. In emergency conditions, the NURSE provides basic care relating
to safety, security, and physical well-being. Maintaining a sense of belonging
isimportant, but not in emergency conditions.
D Incorrect. A state of emergency is not the time to develop self-esteem because
meeting safety, security, and physical needs is more important.
PTS: 1 DIF: Analysis OBJ: 4
TOP: NCLEX: Safe and Effective Care Environment
6. According to researchers, WHICH characteristic will most centenarians share in the future?
a. Being female
b. Having dementia
c. Being malnourished
d. Being wheelchair-bound
ANS: A
Feedback
A Correct. Researchers expect women to comprise the majority of centenarians in
the future.
B Incorrect. Gerontologists expect dementia to be common among older persons,
but they are not predicting most centenarians will have dementia.
C Incorrect. Malnutrition is common among older persons, but researchers have
not predicted that most centenarians will be malnourished.
D Incorrect. Decreased mobility is common among older persons, but researchers
have not predicted that most centenarians will be confined to a wheelchair.
PTS: 1 DIF: Knowledge OBJ: 3
3|Page
, TOP: NCLEX: Health Promotion and Maintenance
7. WHICH statement describes aging in developing countries?
a. Many developing countries have historically had many members live to be
centenarians.
b. The biggest problem for older persons will be lack of food.
c. Most of the world’s older persons are likely to reside in developing countries.
d. Like fertility, life expectancy is increasing, although at a different rate.
ANS: C
Feedback
A Incorrect. Historically only 2% of the world’s population was defined as old.
B Incorrect. The biggest problem of the world’s oldest persons is most likely to be
lack of regular income.
C Correct. Developing countries contain 62% of the world’s older persons already.
D Incorrect. Life expectancy is increasing, but fertility is decreasing worldwide.
PTS: 1 DIF: Knowledge OBJ: 3
TOP: NCLEX: Health Promotion and Wellness
8. The NURSE develops a community program to promote exercise for older persons.
WHICH ofthe following should the NURSE include in the exercise program?
a. Reinforce the ease of exercising every day.
b. Use exercise to relax any dietary restrictions.
c. Describe ways to resume exercise after lapses.
d. Teach participants that exercise achieves wellness.
ANS: C
Feedback
A Incorrect. The NURSE tells the participants that achieving wellness takes work
andregular effort. Instead of offering false hope, the NURSE shares practical
advice about how to incorporate exercise into everyday life.
B Incorrect. The NURSE avoids suggesting that older persons can look forward to
relaxing dietary or medical restrictions by using a single method because it is
unethical to offer false hope, the plan can be ineffective, and the plan can have
adverse effects.
C Correct. Because the path to wellness includes progression as well as regression,
the NURSE shares information to help participants anticipate these events. The
NURSE encourages participants by telling them to expect periods of regression,
that progress made up to that point is not lost, and how to approach resumption in
progress toward wellness with exercise.
D Incorrect. The NURSE avoids instructing older persons to rely on one method
ofachieving wellness because wellness is achieved by balancing emotional,
spiritual, social, cultural, and physical processes.
PTS: 1 DIF: Application OBJ: 4
TOP: NCLEX: Health Promotion and Maintenance
4|Page
, 9. Determinants of health are the underlying causes of illness and wellness. WHICH of the
following describes the older person who is likely to experience the best overall health and
well-being?
a. Resides in assisted-living facility, watches television alone, uses herbal remedies,
is underweight
b. Resides alone, was moved to a new city recently by the family for their
convenience, has osteoarthritis
c. Has prostate cancer with metastasis to the lungs, is receiving radiation therapy, is
wealthy, has a large family
d. Uses a wheelchair, has peripheral arterial disease, attends weekly baseball games
with three friends
ANS: D
Feedback
A Incorrect. This older person is not thriving in an assisted-living facility, despite
having other people in the facility, as evidenced by television viewing habits and
weight, both potential indicators of depression. Various aspects of this person’s
life are unbalanced, thus inhibiting progress on the path to optimal health and
wellness. In addition, the use of herbal remedies can be aggravating or
precipitating the problems.
B Incorrect. After a move to a new region, an older person, especially one who
lives alone and is moved to a new area for the family’s convenience, is likely to
experience loneliness and isolation until a new social network is established.
Thus, although this person has a less-acute health problem, the social isolation is
likely to create significant disruption on the path to health and wellness.
C Incorrect. Although this older person’s financial resources are plentiful, the
existence of a large family does not ensure any type of psychosocial support.
Most likely, this person faces a grim prognosis because the prostate cancer has
crossed the diaphragm, thus reducing the likelihood of a prolonged life.
D Correct. Despite a serious chronic illness and mobility restrictions, this person
has a social network and planned activities with friends. Further, this older
person overcomes mobility issues to pursue personal interests; thus, this person is
most likely to experience the best health and well-being because of an optimal
functional status.
PTS: 1 DIF: Analysis OBJ: 4
TOP: NCLEX: Health Promotion and Maintenance
10. WHICH of the following nursing interventions represent a holistic approach to caring for
anolder person?
a. Performs glucose testing during the weekly worship service
b. Wheels ambulatory adults to exercise when running late
c. Assigns female NURSEs to older female persons who are Muslim, if requested
d. Allows older persons in a nursing home to eat meals alone
ANS: C
Feedback
A Incorrect. Interrupting an older person’s worship with glucose testing can be
5|Page
, interpreted as a lack of respect for spiritual needs. The NURSE can provide for
and respect the physical and spiritual aspects of the older person’s life by testing
for glucose before the service begins.
B Incorrect. In transporting the older persons to the exercise program in a
wheelchair to save time, the NURSE disregards the need for self-esteem and
exercise, important aspects of physical well-being. Ambulatory older persons
can walk, with assistance if needed, to exercise programs and benefit from the
additional activity and independence.
C Correct. The NURSE uses a holistic approach to the care of an older female
personwho is Muslim because the woman and her family are more likely to be
willing participants in a therapeutic regimen that respects a tenet of their culture.
D Incorrect. The NURSE can be tempted to allow an older person to eat meals
alone in his or her room if this will motivate the person to eat or if the older
person hasdysphagia and is embarrassed. However, while focusing on physical
needs, the NURSE ignores psychosocial and other aspects of health and well-
being.
PTS: 1 DIF: Comprehension OBJ: 4
TOP: NCLEX: Health Promotion and Maintenance
11. An older-person male (pronouns he/him) who resides in a nursing home has very high
cholesterol levels. WHICH nursing intervention is most likely to assist this man in
achievinghis highest level of wellness?
a. Instruct him about increasing dietary fibre.
b. Ask the health care provider for a low-fat diet.
c. Schedule a consultation for him with the dietitian.
d. Review a menu with him to choose suitable foods.
ANS: D
Feedback
A Incorrect. Informing the older person about dietary fibre offers no control to the
older person because he is not part of the decision. Nursing interventions
developed with the older person’s collaboration are most likely to help him
achieve health and wellness.
B Incorrect. Collaborating with the health care provider for a low-fat diet is a
reasonable approach to help this man with dyslipidemia achieve health and
wellness. However, the older person is more likely to have motivation and
enthusiasm for a therapeutic regimen over WHICH he has some control.
C Incorrect. This is a reasonable approach for an older person with dyslipidemia
and is a part of a multifaceted approach to optimizing his health. However, he is
more likely to engage in a regimen over WHICH he has input.
D Correct. The NURSE collaborates with the older person to choose suitable foods.
This is likely to be an effective nursing intervention to help an older person with
dyslipidemia achieve optimal health and well-being because it gives him some
control over the regimen and thus engages him in the process of lowering serum
cholesterol.
PTS: 1 DIF: Analysis OBJ: 2
TOP: NCLEX: Health Promotion and Maintenance
6|Page
