Chapter 01: Health and Wellness in an Aging Society
Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition
MULTIPLE CHOICE
1. When asked by new
... [Show More] parents what the life expectancy is for their African American newborn,
the nurse replies that, “2010 statistics indicate that your son:
a. will have a life expectancy of approximately 65 years.”
b. can realistically expect to live into his late 80s.”
c. has a good chance of celebrating his 75th birthday.”
d. is likely to live into his late 90s.”
ANS: C
In 2010, men in the United States at age 60 can expect to live another 22 years. The life
expectancy of African American men is about 4.7 years less than white men. Of the options
above, C is the only response that fits into those parameters. The other options are not
supported by reliable research.
DIF: Cognitive Level: Understanding REF: p. 3
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
2. A nurse is planning care for a group of super-centenarians in an assisted living facility. The
nurse considers which of the following?
a. Most super-centenarians are functionally independent or require minimal
assistance with activities of daily living
b. The majority of super-centenarians have cognitive impairment
c. The number of super-centenarians is expected to decrease in coming years as a
result of heart disease and stroke
d. It is theorized that super-centenarians survived as long as they have due to genetic
mutations that made them less susceptible to common diseases
ANS: A
Research supports that most super-centenarians are functionally and cognitively intact,
requiring minimal assistance with ADLs. The number of super-centenarians is expected to
increase in coming years as the number of older adults increases. The reason why individuals
survived as long as they have is not known.
DIF: Cognitive Level: Remembering REF: p. 4
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. One reason why many “baby boomers” have multiple chronic conditions such as heart disease,
diabetes, and arthritis is that:
a. they have less access to medication and other treatment regimens.
b. there was a lack of importance placed on healthy living as they were growing up.
c. they did not have access to immunizations against communicable disease when
they were children.
d. they grew up in an era of rampant poverty and malnutrition.
ANS: B
The baby boomers, individuals born between 1946 and 1964, post-WWII, have better access
to medication and treatment regimens than other cohorts. They have had the benefit of the
development of immunizations against communicable diseases. They grew up in an era of
prosperity post-WWII. However, there was a lack of importance placed on what we now
consider healthy living when they were younger. Smoking, for example, was not condoned,
but was considered a symbol of status. Candy in the shape of cigarettes was popular, and there
was much secondhand smoke.
DIF: Cognitive Level: Remembering REF: p. 6
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
4. A nurse is planning an education program on wellness in a local senior citizen center. The
nurse plans to provide education on the importance of immunizations, annual physical
examinations, screening for diabetes, and vision and hearing screening. It is important for the
nurse to understand which of the following?
a. Approximately 40% of older adults (ages 65 and older) utilize available preventive
services
b. Preventive strategies are more widely used in the 40-64 age group than in the 65
and over age group
c. The research on health promotion strategies in older adults demonstrates that they
have low efficacy
d. There is an abundance of research specific to health promotion and aging
ANS: A
Approximately 40% of individuals, ages 65 and older, utilize the preventive services that are
available to them. However, only 24% of those between the ages of 40 and 64 do so. There is
a paucity of research specific to health promotion and aging; however, the research that exists
demonstrates that health promotion strategies are highly effective.
DIF: Cognitive Level: Understanding REF: p. 7
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
5. A nurse is caring for an 85-year-old male client with diabetes in a community setting. The
nurse promotes functional wellness by which of the following activities?
a. Encouraging the client maintains current levels of physical activity
b. Assisting the client to receive all the recommended preventive screenings that are
appropriate for his age group
c. Teaching the patient how to use a rolling walker so that he can ambulate for longer
distances
d. Encouraging the client to attend his weekly chess games
ANS: A
Maintaining existing levels of physical activity is consistent with functional wellness.
Teaching the client how to use a rolling walker enables the client to remain active at the
highest level possible, which is an example of promoting functional wellness. Receiving
recommended screening is an example of promoting biological wellness. The use of a rolling
walker should be based on assessment of physical ability. Encouraging the client to attend
weekly chess games is an example of promoting social wellness.
DIF: Cognitive Level: Applying REF: p. 10
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
6. Based on the census reports of 2010, the typical profile of a centenarian in the United States
includes which of the following characteristics?
a. A Caucasian woman who lives in an urban area of a Southern state
b. An African American woman who lives in a rural area of a Southern state
c. A Hispanic man who lives in an urban area of a Midwestern state
d. A Caucasian man who lives in a rural area of a Midwestern state
ANS: A
Based on the 2010 U.S. Census data, centenarians were overwhelmingly white (82.5%),
women (82.8%), and living in urban areas of the Southern states.
DIF: Cognitive Level: Applying REF: p. 5
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
MULTIPLE RESPONSE
1. Primary prevention strategies for older adults include which of the following? (Select all that
apply.)
a. An annual influenza immunization clinic
b. A smoking cessation program
c. A prostate screening program
d. A cardiac rehabilitation program
e. A meal planning education program for type 2 diabetics
ANS: A, B
Primary prevention refers to strategies that are used to prevent an illness before it occurs and
maintaining wellness across the continuum of care. Immunizations and smoking cessation are
examples of primary prevention. Secondary prevention is the early detection of a disease or a
health problem that has already developed. Prostate screening is an example of secondary
prevention. Tertiary prevention addresses the needs of individuals who already have their
wellness challenged. Cardiac rehabilitation and meal planning for diabetics are examples of
tertiary prevention.
DIF: Cognitive Level: Applying REF: pp. 8–9
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Management of Care
2. A nurse organizes a health fair for older adults. The nurse’s goal is to focus on the six priority
areas identified by the National Prevention Council. Which of the following activities should
the nurse include? (Select all that apply.)
a. Smoking cessation
b. Depression screening
c. Recognizing elder abuse
d. Cholesterol screening
e. Fitness training
ANS: A, B, C
The six priority areas of the National Prevention Council include tobacco-free living,
preventing drug abuse and excessive alcohol use, healthy eating, injury- and violence-free
living, reproductive and sexual health, and mental and emotional well-being. Smoking
cessation, depression screening, and recognizing elder abuse all directly address these areas.
While cholesterol screening and fitness training are important for older adults, they do not
address these six priority areas.
DIF: Cognitive Level: Analyzing REF: p. 8
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. The “in-between” generation (individuals born between 1915 and 1945) were subject to which
of the following health challenges during their childhood? (Select all that apply.)
a. Polio
b. Lack of fluoride in the water causing teeth to be soft and cavity prone
c. “Pigeon Chest,” a malformation of the rib cage due to a lack of vitamin D
d. Smallpox
e. HIV/AIDS
ANS: A, B, C
Polio was a major fear of this group; the polio vaccine was not available in the United States
until 1955. In many areas water was not fluoridated. “Pigeon Chest” was common. Smallpox
was a concern for the centenarians, not this generation. HIV/AIDS had not been identified in
the early years of 1915-1945.
DIF: Cognitive Level: Remembering REF: p. 5
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
4. A nursing student is preparing a presentation on the Wellness-Based Model for Healthy Aging.
Which of the following concepts should the student include in the presentation? (Select all
that apply.)
a. Healthy aging is defined by the absence of physical illness alone
b. Healthy aging is individually defined and can change over time
c. There are many strategies to promote healthy aging that are believed to be helpful
but do not have empirical evidence to support them
d. Healthy aging cannot be achieved by only focusing on later life. It is a lifelong
process
e. According to this model, an individual with a chronic disease would not be
considered healthy
ANS: B, C, D
Healthy aging is a lifelong process that begins with birth and ends with death. The concept of
healthy aging from a wellness perspective is uniquely defined by each individual and can
change over time. There are challenges to implementing evidence-based practices on healthy
aging because there is a paucity of research on this area. Therefore, there are many strategies
that have been used and determined to be effective but do not have research evidence
supporting them. The subcomponents with the wellness model are functional independence,
self-care management of illness, personal growth, positive outlook, and social contribution
and activities that promote one’s health.
DIF: Cognitive Level: Applying REF: p. 7
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
Chapter 02: Gerontological Nursing: Past, Present, and Future
Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition
MULTIPLE CHOICE
1. Serious and well-controlled research studies on aging have been available:
a. only in the past 60 years.
b. since the turn of the 20th century.
c. following the Great Depression.
d. since the year 2000.
ANS: A
Only in the past 60 years have serious and carefully controlled research studies flourished.
Before that, anecdotal evidence was used to illustrate issues assumed to be universal, making
all the remaining options incorrect.
DIF: Cognitive Level: Remembering REF: p. 19
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
2. The son of a nursing home resident asks a nurse: “What is the significance of being certified
in gerontology? I see that you are, but not all of the nurses are.” The best response by the
nurse is which of the following?
a. “National certification as a gerontological nurse is a way to demonstrate special
knowledge in caring for older adults”
b. “National certification in gerontology is required for all nurses who have worked
in this setting for 2 or more years”
c. “National certification is only available to nurses who have a Baccalaureate degree
in nursing”
d. “Only advanced practice nurses, like nurse practitioners, are certified in
gerontology”
ANS: A
National certification is a way to demonstrate special expertise in caring for older adults. It is
not required for practice in any setting across the continuum of care, and it is not exclusive to
nurses with Baccalaureate degrees. There is both a generalist and a specialist gerontological
nursing certification. The generalist functions in a variety of settings providing care to older
adults and their families. The specialist has advanced gerontological education at a Masters
level.
DIF: Cognitive Level: Analyzing REF: pp. 20–21
TOP: Integrated Process: Communication and Documentation
MSC: Client Needs: Management of Care
3. The major goal of the NICHE (Nurses Improving Care for Health System Elders) program
includes which of the following?
a. Improve outcomes for hospitalized older adults
b. Increase the number of older adults cared for in hospitals
c. Increase the number of iatrogenic complications that occur in hospitalized older
adults
d. Decrease 30-day readmission rates for hospitalized older adults
ANS: A
The goal of NICHE is to improve outcomes for hospitalized older adults. Although D is a
good outcome for hospitalized older adults, it is not one of the major goals of NICHE, which
are broader. Options b and c are not goals that would improve care for older adults, but would
be negative outcomes themselves.
DIF: Cognitive Level: Remembering REF: p. 22
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
MULTIPLE RESPONSE
1. The impact of the Patient Protection and Affordable Care Act of 2010 on gerontological
nursing includes which of the following? (Select all that apply.)
a. Funding to support advanced education in gerontological nursing
b. Funding to support education of faculty in gerontology
c. Funding to increase the number of direct care workers in hospitals
d. Funding to increase nurse-patient ratios in long-term care
e. Funding for advanced training of direct care workers in long-term care
ANS: A, B, E
The Patient Protection and Affordable Care Act of 2010 provides funding for advanced
education in gerontology, education for faculty in gerontology, and advanced training for
direct care workers in long-term care. The act does not address nurse-patient ratios or staffing
issues in any setting.
DIF: Cognitive Level: Understanding REF: p. 14
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
2. Which of the following are true statements about the current health care workforce? (Select all
that apply.)
a. Approximately 10% of registered nurses (RNs) are certified in gerontological
nursing
b. The number of geriatricians is expected to increase about 50% over the next 25
years
c. The professions of social work, physical therapy, and psychiatry are demonstrating
the same trends as nursing
d. Europe and the developing countries are experiencing similar shortages in health
care workers with geriatric expertise as in the United States
e. It is anticipated that there will be a need for approximately 3 million additional
direct care and professional health care workers by the year 2030
ANS: C, D, E
Less than 1% of RNs are certified in gerontological nursing. The number of geriatricians is
decreasing, not increasing. Responses C, D, and E are all true.
DIF: Cognitive Level: Understanding REF: p. 14
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. Best practice recommendations for undergraduate nursing education in relation to gerontology
include which of the following? (Select all that apply.)
a. Provision of a “stand-alone” course in gerontological nursing
b. Integration of gerontological content throughout the curriculum
c. Replacement of acute care pediatric clinical experiences with gerontological
clinical experiences
d. Recruitment of nurses with Masters and Doctoral degrees and a specialty in
gerontology to faculty roles
e. Requiring all undergraduate nursing students to obtain gerontological certification
as a requirement for graduation
ANS: A, B, D
Best practices include providing a stand-alone gerontological nursing course as well as
integrating gerontology throughout the curriculum. Recruitment of nurses with a specialty in
gerontology and a Masters or Doctoral degree to faculty roles is a critical step in making sure
that the next generation of nurses is prepared to care for older adults. Best practices do not
recommend removing pediatric clinical experiences and replacing them with gerontological
experiences. Nursing certification is only available to practicing nurses who meet specific
education and practice requirements. It is not applicable to nursing students.
DIF: Cognitive Level: Understanding REF: pp. 17–18
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
4. Goals of the Eldercare Workforce Alliance include which of the following? (Select all that
apply.)
a. Mandating a minimum of a Baccalaureate degree in nursing in order to care for
older adults
b. Increasing wages of certified nursing assistants (CNAs) in nursing homes
c. Providing loan forgiveness for individuals who assume faculty roles
d. Developing a nursing certification specific to long-term care
e. Adopting cost-effective care coordination models for older adults across the
continuum of care
ANS: B, C, E
A, B, and C are all included in the Elder Workforce Alliance goals. Options A and D are not.
DIF: Cognitive Level: Understanding REF: p. 14
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
5. A nurse interviews for a job in a hospital that advertises that it is “elderly friendly.” The nurse
would expect to see which of the following in place? (Select all that apply.)
a. An elder-assistance program to help patients remember their appointments and
navigate the hospital services.
b. A long-term care facility that is affiliated with the hospital
c. Rooms furnished with foldout beds for family members/caregivers
d. An initiative to provide gerontological education for all nurses
e. An initiative to increase the number of patients referred to long-term care facilities
upon discharge from the hospital
ANS: A, C, D
The guiding principles of an elder friendly facility include treating each patient as a unique
individual and accommodating the patient and family’s special needs. Other principles include
ensuring that the nurses are clinically competent in gerontological nursing. Tailoring the
environment to support the implementation of these principles is part of this initiative. Option
B is not correct as it does not relate to the concept of an elder friendly hospital. Option E is
not correct since this might not be a supportive intervention for all patients.
DIF: Cognitive Level: Analyzing REF: p. 22, Box 2-7
TOP: Integrated Process: Caring MSC: Client Needs: Psychosocial Integrity
6. Significant factors contributing to the growth of community-based care include: (Select all
that apply.)
a. a decrease in the number of available nursing home beds.
b. rapidly escalating health care costs.
c. older adults’ preferences to “age in place.”
d. inadequate numbers of nurses with gerontological specialty education.
e. decreasing numbers of family caregivers.
ANS: B, C
Care will continue to move out of hospitals and long-term care facilities because of rapidly
escalating health care costs and individual preferences to “age in place.” There has not been a
decrease in nursing home beds. Although there are inadequate numbers of nurses with
gerontological specialty training, this is not a factor that has impacted the growth of
community-based care. There is projected to be a decrease in the number of family caregivers
as the caregivers themselves are aging; however, this does not contribute to the growth of
community-based care.
DIF: Cognitive Level: Remembering REF: p. 23
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
7. Changes in certified nursing facilities in recent years include which of the following? (Select
all that apply.)
a. Increase in the number of subacute beds
b. Decrease in nursing facility length of stay
c. Increase in level of acuity of the residents
d. Decrease in cost of care in the nursing facility
e. Decrease in the number of registered nurses employed in long-term care facilities
ANS: A, B, C
Certified nursing facilities have evolved over recent years. Most facilities have subacute care
units that resemble hospital units caring for more patients with higher acuity than in the past.
Therefore, the average length of stay in a facility has decreased. The cost of care in the facility
has increased due to the increased complexity of illnesses treated, and the number of
registered nurses has increased in order to care for these complex patients.
DIF: Cognitive Level: Analyzing REF: p. 23
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
8. Which of the following factors contribute to poor outcomes for older adults during transitions
of care? (Select all that apply.)
a. Inability to read and understand discharge instructions
b. Inadequate financial resources to purchase medications
c. Lack of desire to comply with discharge instructions
d. Improved medication reconciliation during hospitalization
e. High levels of nurse-patient engagement
ANS: A, B
Language and literacy levels and socioeconomic factors are major contributors to poor
transitions of care for older adults. A high level of nurse-patient engagement contributes to
safe and effective transitions. Medication reconciliation during hospitalization, at discharge
and after discharge, decreases medication discrepancies, which are the most prevalent adverse
event following hospital discharge. There is no evidence that patients lack the desire to
comply with discharge instructions.
DIF: Cognitive Level: Analyzing REF: p. 24
TOP: Integrated Process: Communication and Documentation
MSC: Client Needs: Safety and Infection Control
Chapter 04: Cross-Cultural Caring and Aging
Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition
MULTIPLE CHOICE
1. A paper on culture and illness would be likely to include the statement that:
a. culture is the same as ethnicity.
b. ethnic groups always share common geographic origin and religion.
c. ethnicity involves recognized traditions, symbols, and literature.
d. most members of an ethnic group exhibit identical cultural traits.
ANS: C
Ethnicity is a complex phenomenon including traditions, symbols, literature, folklore, food
preferences, and dress. It is a shared identity. Ethnicity is more than just culture. It is social
differentiation based on culture. Even within ethnic groups, there is considerable diversity.
DIF: Cognitive Level: Remembering REF: p. 44
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Psychosocial Integrity
2. Ethnocentrism is defined as:
a. an understanding of another’s cultural beliefs and practices.
b. a conflict that occurs when an individual interacts with another whose beliefs
differ from his own.
c. application of limited knowledge about one person with characteristics specific to
another person.
d. a belief that one’s ethnic group is superior to that of another.
ANS: D
A belief that one’s ethnic group is superior to that of another is the definition of ethnocentrism.
Ethnocentrism does not involve an understanding of the beliefs of others. A conflict that
occurs when an individual interacts with another whose beliefs differ from his own is the
definition of cultural conflict. Application of limited knowledge about one person with
characteristics specific to another person is the definition of stereotyping.
DIF: Cognitive Level: Remembering REF: p. 42
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Psychosocial Integrity [Show Less]