Ebersole and Hess’ Toward Healthy Aging 10th Edition Touhy Test Bank
CONTENTS
Chapter 01: Aging, Health, and Wellness in a Global Community
... [Show More] ................................ .............. 2 Chapter 02: Gerontological Nursing: Past, Present, and Future ................................ ................ 7 Chapter 03: Theories and Processes of Aging ................................ ............................. 11 Chapter 04: Cross-Cultural Caring and Aging ................................ .............................. 16 Chapter 05: Cognition and Learning ................................ ................................ ..... 20 Chapter 06: Communicating With Older Adults ................................ ............................ 25 Chapter 07: Health Assessment ................................ ................................ ......... 28 Chapter 08: Laboratory Diagnostics and Geriatrics ................................ ......................... 32 Chapter 09: Geropharmacology ................................ ................................ ......... 38 Chapter 10: The Use of Dietary Supplements: Focus on Herbal Products ................................ ...... 44 Chapter 11: Vision ................................ ................................ .................... 48 Chapter 12: Hearing ................................ ................................ .................. 52 Chapter 13: Skin Care ................................ ................................ ................. 55 Chapter 14: Nutrition ................................ ................................ ................. 59 Chapter 15: Hydration and Oral Care ................................ ................................ .... 64 Chapter 16: Elimination ................................ ................................ ............... 68 Chapter 17: Sleep ................................ ................................ ..................... 72 Chapter 18: Physical Activity and Exercise ................................ ................................ 76 Chapter 19: Falls and Fall Risk Reduction ................................ ................................ 80 Chapter 20: Safety and Security ................................ ................................ ......... 85 Chapter 21: Living Well With Chronic Illness ................................ .............................. 88 Chapter 22: Cardiovascular and Cerebrovascular Health and Wellness ................................ ........ 91 Chapter 23: Neurodegenerative Disorders ................................ ................................ 95 Chapter 24: Endocrine and Immune Disorders ................................ ............................ 99 Chapter 25: Respiratory Health and Illness ................................ .............................. 105 Chapter 26: Common Musculoskeletal Concerns ................................ .......................... 108 Chapter 27: Pain and Comfort ................................ ................................ ......... 112 Chapter 28: Mental Health ................................ ................................ ............ 119 Chapter 29: Care of Individuals With Neurocognitive Disorders ................................ ............. 124 Chapter 30: Economics and Health Care in Later Life ................................ ...................... 129 Chapter 31: Common Legal and Ethical Issues ................................ ........................... 132 Chapter 32: Long-Term Care ................................ ................................ ........... 137 Chapter 33: Intimacy and Sexuality ................................ ................................ ..... 143 1 | P a g eChapter 34: Relationships, Roles, and Transitions ................................ ......................... 148
Chapter 35: Loss, Death, and Palliative Care ................................ ............................. 153
Chapter 36: Self-Actualization, Spirituality, and Transcendence ................................ ............. 158
Chapter 01: Aging, Health, and Wellness in a Global Community
MULTIPLE CHOICE
1. When asked by new parents what the life expectancy is for their African American
newborn, the nurse replies that, “2015 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
The overall life expectancy at birth in the United States in 2015 was 78.8. The
disparity between life expectancies for black and white Americans has narrowed
significantly between 1999 and 2015, with the death rate for blacks (African
Americans) dropping by 25% (Office of Minority Health, 2017). 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 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 ofdailyliving.
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.
Although centenarians still carry genetic markers within their chromosomes for any
number of health problems, for as yet unknown reasons, these are not “activated”
until much later, if at all, when compared with other persons.
DIF: Cognitive Level: Remembering
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance3. 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
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. Less than 50% of older adults (ages 65 and older) utilize available preventive
services.
b. Preventive strategies are more widely used in the 50-64 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
Less than 50% of individuals, ages 65 and older, utilize the preventive services that
are available to them. However, only 25% of those between the ages of 50 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 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 to maintain 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 distancesd. 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 TOP: Integrated Process: Teaching/Learning MSC:
Client Needs: Health Promotion and Maintenance
6. Based on the census reports of 2015, the typical profile of a centenarian includes
which of the following characteristics?
a. An American woman with no signs of dementia
b. A Japanese woman with chronic inflammation
c. A Chinese man with an immune disorder
d. An American man who is a lifelong vegetarian
ANS: A
Based on the 2015 U.S. Census data, while the United States has highest number of
centenarians, Japan has over double the number relative to the population as a
whole. The relatively low number of centenarians (and super-centenarians) with
dementia of some kind may be explained by the presence of some type of genetic
neuroprotective factors. While most people have normal age-related declines in
immune functioning and increases in a state of chronic inflammation, this does not
appear to be the case for this group of long lived people.
DIF:
Cognitive Level: ApplyingTOP: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 theneeds of individuals who already have their wellness challenged. Cardiac
rehabilitation and meal planning for diabetics are examples of tertiary prevention.
DIF: Cognitive Level: Applying
MSC: Client Needs: Management of Care
2. A nurse organizes a symposium for health care professionals in the field of geriatrics.
Which of the following topics align with Healthy People 2020s emerging issues
relevant to healthy aging? (Select all that apply.)
a. Fair pay and compensation standards for informal caregivers
b. Longevity and genetics
c. Emerging chronic conditions among baby boomers
d. Minimum competency levels for health care professionals
e. Health disparities in LGBT older adults
ANS: A, C, D, E
Issues outlined in Healthy People 2020: Emerging issues in the health of older adults
include person-centered care planning that includes caregivers; quality measures of
care and monitoring of health conditions; fair pay and compensation standards for
formal and informal caregivers; minimum levels of geriatric training for health
professionals; and enhanced data on certain subpopulations of older adults, including
aging LGBT populations. Longevity and genetics is an important subject to study but
is not listed as an emerging issue to focus on for Healthy People 2020.
DIF: Cognitive Level: Analyzing TOP: Integrated Process: Teaching/Learning MSC:
Client Needs: Health Promotion and Maintenance
3. Baby boomers born before 1960 were subject to which of the following health
challenges during their childhood? (Select all that apply.) a. Measles
b. Scarlet fever
c. Rubella
d. Smallpox
e. HIV/AIDS
ANS: A, B, C
Most boomers born in 1950s contracted at least several of the “childhood diseases”
of measles, mumps, rubella, and chicken pox. Scarlet fever was also 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
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.
TOP: Integrated Process: Teaching/Learningc. 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 TOP: Integrated Process: Teaching/Learning MSC:
Client Needs: Health Promotion and MaintenanceChapter 02: Gerontological Nursing: Past, Present, and Future
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 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 moreyears.”
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
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
option 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
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
MULTIPLE RESPONSE
1. The impact of the Hospital Readmission Reduction Program (HRRP) on avoidable
readmissions includes which of the following? (Select all that apply.)
a. Readmission rates for the selected conditions have dropped nationwide.
b. Many hospitals have instituted system-wide interventions to prevent
readmissions.
c. Hospitals are keeping patients longer to avoid readmissions.
d. Potentially avoidable hospitalizations among nursing home residents is increasing.
e. Hospitals have a financial incentive to develop programs to reduce readmissions.
ANS: A, B, E
The Hospital Readmission Reduction Program (HRRP) was established as a provision
in the Affordable Care Act (ACA) requiring Medicare to reduce payments to hospitals
with relatively high readmission rates for selected conditions for patients in
traditional Medicare. Since the HRRP, readmission rates for the selected conditions
have dropped nationwide but estimates are that in 2018, about80%of
hospitalsevaluated by CMS will face penalties totaling $564 million (Advisory Board,
2017). Additionally, the HRRP has been the impetus for many hospitals to institute
system-wide interventions to prevent readmissions that have also contributed to the
decline in readmission rates. The rate of potentially avoidable hospitalizations among
SNF residents has fallen by nearly a third in recent years as a result of many quality
improvement initiatives.
DIF: Cognitive Level: Understanding 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 3.5 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 TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. Best practice recommendations for 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: UnderstandingTOP:Integrated Process: Teaching/Learning MSC:
Client Needs: Health Promotion and Maintenance
4. Current initiatives to enhance the specialty of gerontological nursing include which of
the following? (Select all that apply.)
a. Mandation of a minimum of a Baccalaureate degree in nursing in order to care for
older adults
b. Development of the Nurse Competence in Aging project
c. Promotion of geriatric nursing to excellence to the nursing community
d. Developing a nursing certification specific to long-term care
e. Offering scholarships for study and research in geriatric nursing
ANS: B, C, E
Initiatives in nursing education, nursing practice, nursing research, and nursing
policy include enhancement of geriatrics in nursing education programs through
curricular reform and faculty development and development of the National Hartford
Centers of
Gerontological Nursing Excellence, predoctoral and postdoctoral scholarships for
study and research in geriatric nursing. Another significant influence on improving
care for older adults was the Nurse Competence in Aging (NCA) project. Thisinitiative addressed the need to ensure competence in geriatrics among nursing
specialty organizations. Options A and D are not current initiatives.
DIF: Cognitive Level: Understanding 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 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“ageinplace.
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
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance7. 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 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
TOP: Integrated Process: Communication and Documentation
MSC: Client Needs: Safety and Infection Control
Chapter 03: Theories and Processes of Aging
MULTIPLE CHOICE
1. The nurse is aware inflamm-aging most likely explains why the older population is
at risk for autoimmune disorder. What common strategy has been found to have
deleterious effects on immunity?
a. Judicious use of herbal supplements
b. Regular exercise
c. Annual influenza vaccinationd. Use of supplemental antioxidants ANS: D Slowing or reducing cellular damage may have the potential to promote healthy
aging. Levels of naturally occurring antioxidants can be increased through regular exercise and diet. Because we have realized the deleterious effects of supplemental antioxidents, the gerontological nurse can use this knowledge to encourage persons to abandon long-held habits and beliefs and replace these with the healthiest diets. The conscientious nurse can take an active role in promoting specific preventive strategies such as the use of immunizations (especially influenza and pneumococcal) and the avoidance of exposure to others with infections.
DIF: Cognitive Level: Understanding TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance [Show Less]