Test Bank Ham's Primary Care Geriatrics A Case-Based Approach 6th Edition
Table of Contents
Chapter 1. Principles of Primary Care of Older Adults
... [Show More] ................................ ............. 2 Chapter 4. Wellness and Prevention ................................ ............................ 7 Chapter 5. Advanced Cultural Competency in Caring for Geriatric Patients .......................... 13 Chapter 7. Ethics ................................ ................................ ........... 20 Chapter 8. Financing and Organization of Health Care ................................ ............ 26 Chapter 11. Long-Term Care ................................ ................................ . 28 Chapter 14. Palliative Care................................ ................................ ... 37 Chapter 16. Delirium ................................ ................................ ....... 43 Chapter 17. Alzheimer’s Disease and Other Dementias ................................ ........... 46 Chapter 18. Depression ................................ ................................ ..... 52 Chapter 21. Dizziness ................................ ................................ ....... 55 Chapter 23. Urinary Incontinence ................................ ............................. 57 Chapter 29. Frailty ................................ ................................ ......... 63 Chapter 31. Sleep Disorders ................................ ................................ .. 69 Chapter 32. Sexual Health ................................ ................................ ... 75 Chapter 33. Mistreatment and Neglect ................................ ......................... 82 Chapter 40. Transient Ischemic Attacks and Stroke ................................ .............. 83 Chapter 46. Cancer ................................ ................................ ......... 92 Chapter 49. Infectious Diseases ................................ ............................... 98 Chapter 51. Benign Prostate Disease ................................ ......................... 104 Chapter 52. Parkinson’s Disease ................................ ............................. 112
1 | P a g eChapter 1. Principles of Primary Care of Older Adults
MULTIPLE CHOICE
1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was
published. The nurse would use these standards to:
a. promote the practice of gerontologic nursing within the acute care setting.
b. define the concepts and dimensions of gerontologic nursing practice.
c. elevate the practice of gerontologic nursing.
d. incorporate suggested interventions from others who practice gerontologic nursing. ANS:
D
The current publishing of the Standards and Scope of Gerontological Nursing Practice in
2010 incorporates the input of gerontologic nurses from across the United States. It was
not intended to promote gerontologic nursing practice within acute care settings, define
concepts or dimensions of gerontologic nursing practice, or elevate the practice of
gerontologic nursing.
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 1-1
TOP: N/A MSC: Safe and Effective Care Environment
2. When attempting to minimize the effect of ageism on the practice of nursing older
adults, a nurse needs to first:
a. recognize that nurses must act as advocates for aging patients.
b. accept that this population represents a substantial portion of those requiring nursing care.
c. self-reflect and formulate ones personal view of aging and the older patient.
d. recognize ageism as a form of bigotry shared by many
Americans. ANS: C
Ageism is an ever-increasing prejudicial view of the effects of the aging process and of the
older population as a whole. With nurses being members of a society holding such views,
it is critical that the individual nurse self-reflect on personal feelings and determine
whether such feelings will affect the nursing care that he or she provides to the aging
patient. Acting as an advocate is an important nursing role in all settings. Simply
accepting a fact does not help end ageism, nor does recognizing ageism as a form of
bigotry.
DIF: Applying (Application) REF: N/A OBJ: 1-9
TOP: Teaching-Learning MSC: Safe and Effective Care Environment
3. When discussing factors that have helped to increase the number of healthy,
independent older Americans, the nurse includes the importance of:
a. increased availability of in-home care services.
b. government support of retired citizens.
c. effective antibiotic therapies.
d. the development of life-extending
therapies. ANS: C
The health and ultimate autonomy of older Americans has been positively impacted by
the development of antibiotics, better sanitation, and vaccines. These public health
measures have been more instrumental in increasing the numbers of healthy,
independent older Americans than have in-home care services, government programs, or
life-extending therapies. DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 3-3
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
4. Based on current data, when presenting an older adults discharge teaching plan,
the nurse includes the patients:
a. nonrelated caretaker.
b. paid caregiver.
c. family member.
2 | P a g ed. intuitional
representative. ANS: C
Less than 4% of older adults live in a formal health care environment. The majority of
the geriatric population lives at home or with family members.
DIF: Applying (Application) REF: N/A OBJ: 3-3
TOP: Nursing Process: Planning MSC: Safe and Effective Care Environment
5. The nurse planning care for an older adult who has recently been diagnosed with
rheumatoid arthritis views the priority criterion for continued independence to be the
patients:
a. age.
b. financial status.
c. gender.
d. functional
status. ANS: D
Maintaining the functional status of older adults may avert the onset of physical frailty
and cognitive impairment, two conditions that increase the likelihood of
institutionalization.
DIF: Remembering (Knowledge) REF: msc: 8 OBJ: 1-6
TOP: Nursing Process: Planning MSC: Physiologic
Integrity
6. A nurse working with the older adult population is most likely to assess a need for a
financial social services referral for a(n):
a. white male.
b. black female.
c. Hispanic male.
d. Asian American
female. ANS: B
The poverty rate among older black women is substantially higher than that seen among
males or females of other ethnic groups. White males had the least poverty.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
7. Which of the following statements made by a nurse preparing to complete a health
assessment and history on an older patient reflects an understanding of the general
health status of this population?
a. Ill need to document well regarding the medications the patient is currently prescribed.
b. I would like to understand how supportive the patients family members are.
c. Most older patients are being treated for a variety of chronic health care issues.
d. It will be interesting to see whether this patient sees herself as being
healthy. ANS: D
It is a misconception that old age is synonymous with disease and illness. The nurse
should always determine the patients sense of wellness and independence when
conducting a health and history assessment. An assessment of medication use and family
support is important for any patient. Many older adults do have chronic health
conditions, but their perception is more important than a single number.
DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Health Promotion
8. The nurse is caring for an older adult who has been admitted to an acute care
hospital for treatment of a fractured femur. The family expresses concern about the
patients pending transfer to a subacute care facility. What response by the nurse is best?
a. Acute care facilities lack the long-term physical therapy support your dad requires.
b. Your dad will be much happier in a more serene, private environment.
c. The subacute facility will focus on helping your dad maintain his independence.
d. Insurance, including Medicare, will cover only a limited amount of time
3 | P a g ehere. ANS: C
The transfer of the patient to a subacute facility is based on the need to maintain the
patients level of function and independence, a task the acute care facility is not
prepared to address once the patient is physiologically stable. The patient may or may
not be happier in the new setting; the nurse should not make this judgment. It is true
that insurance only pays for a limited amount of time in an acute care facility, but this is
not the best reason for the patient to transfer. DIF: Applying (Application) REF: N/A
OBJ: 1-6
TOP: Communication and Documentation
MSC: Health Promotion and Maintenance
9. To best assure both the quality of care and the safety of the older adult patient who
requires in home unlicensed assistive personal (UAP) assistance, the geriatric nurse:
a. evaluates the competency of the UAP staff.
b. assumes the roles of case manager and patient advocate.
c. arranges for the needed UAP provided services.
d. assesses the patient for functional
limitations. ANS: A
As more care traditionally provided by professional nurses is being transferred to UAP,
the nurse must assume more responsibility for educating, training, and evaluating the
competency of UAP staff to provide safe, effective care for the older adult patient.
DIF: Applying (Application) REF: N/A OBJ: 1-
2 TOP: Communication and Documentation
MSC: Safe and Effective Care Environment
10. The nurse working with older adults understands what information about
certification in gerontologic nursing?
a. It is mandatory for those in long-term care settings.
b. It is voluntary and shows clinical expertise in an area.
c. It allows nurses to be paid by third-party payers.
d. It allows nurses to advance their careers in a
job. ANS: B
Certification is voluntary and shows that a nurse has additional knowledge and
expertise in a certain area of practice. It is not mandatory in specific care settings. It
does not allow for third party reimbursement. It may be part of a career ladder
program, but that is not true of all work settings.
DIF: Remembering (Knowledge) REF: msc: 2 OBJ: 1-2
TOP: Teaching-Learning MSC: Safe Effective Care Environment
11. A nurse works in a gerontologic clinic. What action by the nurse takes highest priority?
a. Serving as a patient advocate
b. Educating patients about diseases
c. Helping patients remain independent
d. Referring patients to home health
care ANS: C
One of the challenges and priorities of the gerontologic nurse is helping patients
maintain their independence.
DIF: Remembering (Knowledge) REF: msc: 10 OBJ: 1-2
TOP: Nursing Process: Implementation MSC: Health Promotion
12. A nurse is caring for an older patient in the emergency department. What
information about the patient will be most helpful in creating a plan of care?
a. Baseline physical and cognitive functioning
b. Living conditions and family support
c. Medications and current medical problems
d. Results of the Mini Mental State
examination ANS: A
4 | P a g eThe nurse is encouraged to view older patients as individuals and consider their baseline
physical and cognitive functional status as a standard by which to compare the patients
current status. The other information is also important, but the basis of individualized
care begins with the patients strengths and weaknesses.
DIF: Applying (Application) REF: N/A OBJ: 1-6
TOP: Nursing Process: Assessment MSC: Health Promotion
13. The faculty member explains to students that many older Americans continue to
work past the retirement age. What best explains this trend?
a. Feeling healthier longer
b. Changing financial outlook
c. Becoming bored in retirement
d. A desire to give
back ANS: B
As financial situations may have declined as a result of many economic factors, more
older adults work past their retirement age. The other options may be reasons for some
to continue working, but financial necessity is the reason the majority continue to do so.
DIF:
Remembering (Knowledge) REF: msc: 7 OBJ: 1-3
TOP: Teaching-Learning MSC: Health Promotion
14. What information does the faculty member teach students
about Medicare?
a. Covers anyone with end stage renal disease
b. Part A covers some prescription costs
c. Part B covers inpatient hospital costs
d. Part D eliminates the drug donut
hole ANS: A
Although Medicare is primarily for those over the age of 65, it does cover people of any
age with end-stage kidney disease. Part A covers hospital costs. Part B is medical
insurance. The donut hole was fixed by the Affordable Care Act.
DIF: Understanding (Comprehension) REF: msc: 9 OBJ: 1-3
TOP: Teaching-Learning MSC: Health Promotion
15. A nursing manager notes that many older patients are admitted to the nursing unit
for acute problems. What action can the manager take to most benefit this population?
a. Provide mandatory education on the needs of the older patient.
b. Provide restorative therapy programs designed for this group.
c. Ensure staffing numbers are adequate for dependent patients.
d. Encourage all nurses to obtain gerontologic
certification. ANS: B
Many older adults need acute care for sudden illness and injury but live in a state of
functional decline, which could possibly be prevented by establishing a restorative
therapy program. The other actions will help the older patients cared for in the unit,
but only to limited degrees. DIF: Applying (Application) REF: N/A OBJ: 1-4
TOP: Nursing Process: Implementation MSC: Physiologic Integrity: Reduction of Risk Potential
16. The dean of a new nursing program wishes to ensure graduates are prepared to care
for older patients. What document should guide the dean in designing the curriculum?
a. The Nurse Practice Act for that state
b. The American Nurses Association (ANA) code of ethics for nurses
c. Healthy People 2020
d. The Recommended Baccalaureate Competencies and Curricular Guidelines ANS:
D
The Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing
Care of Older Adults is an updated version of The Essentials of Baccalaureate Education
for Professional Nursing Practice. This document was first published by the American
5 | P a g eAssociation of Colleges of Nursing (AACN) in 2008 and was updated in 2010. The other
three documents do not have information about curricular requirements to prepare
students to care for the older population.
DIF: Applying (Application) REF: N/A OBJ: 1-2
TOP: Teaching-Learning MSC: Health Promotion
17. A nurse wants to plan a community event at a retirement center. What topic
would most likely be best received?
a. Heart healthy living
b. Financial planning
c. Avoiding scams
d. Ethnic cooking
classes ANS: A
Older adults are demanding more programs and services aimed at health maintenance
and promotion and disease and disability prevention. Based on this information, the
heart healthy living presentation would be best received.
DIF: Applying (Application) REF: N/A OBJ: 1-3
TOP: Teaching-Learning MSC: Health Promotion
18. What does the bedside nurse understand about his or her role in
nursing research? a. Research is only done by doctorally prepared
nurses.
b. All nurses have a role in delivering research-based care.
c. A bedside nurse can be part of a hospital research team.
d. The bedside nurse can collect data if the nurse has been properly trained. ANS:
B
All nurses are charged to deliver patient-centered care based on evidence-based practice,
research, quality improvement, and informatics. The bedside nurse is part of an
interdisciplinary team that is responsible for redesigning the health care structure of the
future. DIF: Understanding (Comprehension) REF: msc: 13 TOP: Teaching-Learning MSC:
Safe Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. The clinic nurse caring for an older diabetic patient with a sixth grade education
anticipates that the patient may experience difficulty (Select all that apply.)
a. recognizing the importance of keeping clinic appointments.
b. following a low-carbohydrate diet.
c. paying for insulin and syringes.
d. deciding on a primary health care provider.
e. naming a health care
surrogate. ANS: A, B, C
Even though the educational level of the older population has steadily increased, as a
population they are less educated than the general population. This deficiency can
account for a lack of understanding regarding the need for medical care and the
importance of following a treatment plan. These patients may also have fewer financial
resources to devote to health care issues.
DIF: Analyzing (Analysis) REF: N/A OBJ: 1-4
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment
2. The nurse studying the history of gerontologic nursing learns which information
about the specialty? (Select all that apply.)
a. The number of older Americans is diminishing.
b. The geriatric nursing conference group was established in 1962.
c. The gerontologic clinical nurse specialist certification was offered in 1989.
d. There were no writings about the care of older persons until World War II.
e. The first Standards of Practice for Geriatric Nursing was written in 1969. ANS:
6 | P a g eB, C, E
The geriatric nursing conference group was established in 1962, the gerontologic clinical
nurse specialist certification was first offered in 1989, and the first Standards of Practice
for Geriatric Nursing was written in 1969. The population of older Americans is the
fastest-growing subset of the population. Writings about care of the aged can be found
from as early as 1900. DIF: Remembering (Knowledge) REF: msc: 2-3 OBJ: 1-2
TOP: Teaching-Learning MSC: Nursing Process: Assessment
3. The student asks the gerontologic clinic nurse why so many older people are
women. What information does the nurse provide? (Select all that apply.)
a. Reduced maternal mortality
b. Decreased deaths from infectious diseases
c. More deaths from chronic disease in men
d. More deaths in war occur in men
e. Women tend to smoke and drink less than
men ANS: A, C, D
A decrease in maternal mortality, decreased deaths from infectious diseases, and more
chronic illness in men account for the disparity in genders as people age.
DIF: Understanding (Comprehension) REF: msc: 6 OBJ: 1-5
TOP: Teaching-Learning MSC: Health Promotion
4. The gerontologic nurse plans community programming for older women, noting
what facts about this population subgroup? (Select all that apply.)
a. More likely to live alone
b. Increased chance of living in poverty
c. Taking care of a spouse
d. Suffering many chronic diseases
e. Living with extended families
ANS: A, B, D
Older women have a greater chance than men of living alone and in poverty. They also
have a greater degree of functional impairment and chronic disease.
DIF: Remembering (Knowledge) REF: msc: 6 OBJ: 1-5
TOP: Nursing Process: Analysis MSC: Health Promotion
5. The nurse knows that the most common causes of death in the older population
result from which diseases? (Select all that apply.)
a. Cerebrovascular disease
b. End-stage kidney disease
c. Heart disease
d. Cancer
e. Diabete
s ANS: A, C, D
The most common causes of death in the older population are cerebrovascular disease,
heart conditions, and cancer. End-stage renal disease and diabetes are not among the
top three causes of death
Chapter 4. Wellness and Prevention
MULTIPLE CHOICE
1. When the home health nurse assists the older adult patient with rearranging
furniture within the home to prevent the patient from falling, the nurse is
demonstrating:
a. health promotion.
b. health protection.
7 | P a g ec. health prevention.
d. disease
prevention. ANS: B
The overarching goals are to attain high-quality, long lives free of preventable disease,
disability, and injury; to eliminate disparities; create social and physical environments
that promote health; and optimize quality of life across the life span. Health protection
targets five areas including unintentional injury. Rearranging furniture to prevent falls is
a health protection activity. DIF: Applying (Application) REF: N/A OBJ: 8-1
TOP: Nursing Process: Implementation MSC: Safe Effective Care Environment 2. The
primary focus of the health belief model of health promotion is addressed when the
nurse: a. accompanies the assisted living residents on a walk before dinner. b. asks a
senior citizens group what health screening they want to have. c. plans a program on
cooking diabetic-friendly meals in cooperation with a dietician. d. asks the patient if he
believes smoking puts him at risk for lung cancer. ANS: D
The health belief model, which was developed to determine the likelihood of an
individuals participation in health promotion, health protection, and disease
prevention services, includes assessing an individuals perception of his or her
susceptibility to developing an illness. Asking the patient about beliefs related to
tobacco use and health is an activity that falls within this model. The other activities do
not.
DIF: Understanding (Comprehension) REF: msc: 141 OBJ:
8-2 TOP: Nursing Process: Assessment MSC: Health
Promotion
3. Financial considerations are a major barrier to the older adults
participation in health promotion because:
a. most older adults have accepted poor health as a part of growing older.
b. Medicare often does not cover the cost of preventive services.
c. many already have been diagnosed with chronic illnesses.
d. they generally place more value on saving their disposable
income. ANS: B
Older adults must incur the cost of many preventive services because Medicare does not
cover them all. This can be hard on the fixed, limited income of many older adults. It is
not true that older adults accept poor health as inevitable. Health promotion activities
can occur in the presence of chronic illnesses. Some older adults do place high value on
saving money, but not all older adults are influenced by this desire.
DIF: Understanding (Comprehension) REF: msc: 148 OBJ:
8-4 TOP: Nursing Process: Assessment MSC: Health
Promotion
4. To engage the older adults who frequently attend a senior citizens center in primary
disease prevention, the nurse:
a. immunizes those attending a weekly luncheon against the H1N1
virus. b. arranges for a colorectal cancer screening at the center.
c. schedules a speaker to discuss cooking for diabetic patients.
d. surveys the members to identify health issues of interest to them. ANS:
A
Primary prevention refers to specific action taken to optimize the health of the older
individual by helping him or her to become more resistant to disease or to ensure that
the environment will be less harmful. Providing immunizations would be included in this
level of prevention.
Colorectal cancer screening is secondary prevention. Cooking for diabetic patients is
tertiary prevention. Surveying patients does not fall into any level of prevention.
DIF: Applying (Application) REF: N/A OBJ: 8-5
TOP: Nursing Process: Implementation MSC: Health Promotion
5. The nurse has the greatest impact on a patients health promotion
8 | P a g ewhen: a. evaluating a diabetic patients ability to administer his insulin
injections. b. encouraging an obese patient to limit both fat and
carbohydrate intake. c. volunteering to take blood pressures at a
community health fair. d. educating the patient about vitamin D and
calcium to prevent bone loss. ANS: D
Health promotion includes interventions that help prevent disease and disability in a
patient. Education regarding health promotion issues has the greatest impact on the
health of a patient. The other patients already have established diseases.
DIF: Applying (Application) REF: N/A OBJ: 8-1
TOP: Teaching-Learning MSC: Health Promotion
6. A nurse is assessing a patients ability to manage existing health problems. What
question by the nurse is most helpful?
a. Can you tell me why its important to test your blood glucose level at least daily?
b. What were the results of your most recent A1C blood test?
c. Which pharmacy do you use when your prescription needs to be refilled?
d. Have you been experiencing pain in your
feet? ANS: B
The results of a laboratory test used to monitor glucose control will show how well the
patient has been managing the various aspects of his or her treatment plan. This
information is collected in the health perception/health management functional health
pattern. The other questions do not demonstrate the patients knowledge level.
DIF: Applying (Application) REF: N/A OBJ: 8-5
TOP: Nursing Process: Assessment MSC: Health Promotion
7. During a home visit, a nurse is assessing the nutritional awareness of an older adult
patient who lives alone. The nurse is most effective in obtaining objective information
when:
a. asking to see what types of foods the patient keeps readily available.
b. reviewing the components of a healthy diet with the patient.
c. asking the patient to describe what he or she ate for all three meals yesterday.
d. observing the patient eat a meal that he or she has
prepared. ANS: D
Objective information is best obtained when observing general appearance and various
body system indicators of nutritional status. Note height, weight, and fit of clothes. If
possible, observe the older adult eating a meal. Food available in the home does not
indicate the patients knowledge, as someone else may have bought the food. Asking the
patient for information is requesting subjective data. Reviewing a healthy diet does not
allow the patient to demonstrate knowledge.
DIF: Applying (Application) REF: N/A OBJ: 8-5
TOP: Nursing Process: Assessment MSC: Physiologic Integrity
8. The nurse is discussing an older adults past marital history during the admission
assessment. The nurse can best determine that the patient has a healthy ability to cope
with emotional stressors when the patient states:
a. After my husband died, I managed to raise and educate our two children by myself.
b. Since my husbands death, Ive grown even closer to my sisters.
c. Its been hard since my husband died, but you manage to go on somehow.
d. After my husband died, I married a good man who was there for me and my children.
ANS: A This pattern encompasses the patients reserve and capacity to resist challenges to
self-integrity
and his or her ability to manage difficult situations. The ability to view herself as a
success in fulfilling her responsibilities as a mother is evidence of healthy stress coping
skills. DIF: Evaluating (Evaluation) REF: N/A OBJ: 8-5
TOP: Nursing Process: Evaluation MSC: Psychosocial Integrity
9. An older adult patient has recently experienced some difficulty sustaining an erection
9 | P a g eas a result of medication he has been prescribed. The nurse best assesses the patients
perception of his own sexuality by asking:
a. How are you and your wife coping with your sexual dysfunction?
b. What problems has your sexual dysfunction caused between you and your wife?
c. What impact has this dysfunction had on your ability to be intimate with your wife?
d. Are you and your wife prepared to deal with this dysfunction over the long
term? ANS: C
Asking about the impact of the dysfunction directly assesses the patients satisfaction or
dissatisfaction with current circumstances related to sexual function and intimacy, thus
providing the best evaluation of his self-perception of the issue.
DIF: Applying (Application) REF: N/A OBJ: 8-5
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
10. The nurse admitting an 89-year-old patient to an assisted living facility notes that the
patient is currently taking numerous prescribed and over-the-counter medications. The
nurses initial intervention is to:
a. confirm with the physician that all the medications are required.
b. evaluate the patients understanding of why he is taking each medication.
c. explain to the patient the dangers of taking so many different medications.
d. review the listed medications for possible
interactions. ANS: D
The first nursing action is to determine if the patients health is at risk from possible
drug interactions. The other actions might be warranted, but patient safety comes first.
DIF: Understanding (Comprehension) REF: msc: 143 OBJ: 8-6
TOP: Nursing Process: Assessment MSC: Physiologic Integrity
11. When assessing the older adult for bowel health, the nurse is most effective in
obtaining subjective data when asking:
a. Would you describe your bowel movements as usually normal?
b. Do you have a problem with constipation?
c. How often do you usually have a bowel movement?
d. Have your bowel movements changed
recently? ANS: C
Subjective data can be obtained through the health history. Asking the patient to
identify how often the bowels move would establish the fundamental baseline of the
patients elimination patterns. Normal is a vague term that should not be used. Asking if
there are problems with constipation or if bowel habits have changed are yes/no
questions, which are generally avoided. DIF: Applying (Application) REF: N/A OBJ: 8-5
TOP: Nursing Process: Assessment MSC: Physiologic Integrity
12. Using social cognitive theory, which action by the nurse will have the most impact
on older adults participation in health promotion behaviors?
a. Creating a walking club in the community
b. Offering private nutritional counseling
c. Providing meals at the senior center
d. Handing out educational
materials ANS: A
According to this theory, self-efficacy and outcome expectations are influenced by
successful performance of the behavior, verbal encouragement, seeing similar people do
the behavior,
decreasing unpleasant aspects of the behavior, caring approaches to facilitate the
behavior, and education about benefits. A local walking club with other seniors fulfills
many of these criteria. Private nutritional counseling does not allow the participant to see
others engaged in this activity. Meals may or may not be healthy or palatable. Educational
materials on their own may not have great benefit.
DIF: Applying (Application) REF: N/A OBJ: 8-2
10 | P a g eTOP: Nursing Process: Implementation MSC: Health Promotion
13. The nurse wishes to participate in a community secondary prevention activity. Which activity does the nurse choose? a. Administering blood pressure screening at a mall b. Dispensing free flu vaccinations at a clinic c. Fitting impoverished older adults with glasses d. Teaching about the risks of sun
exposure ANS: A Secondary prevention is screening and early diagnosis. It aims to find people with clinical conditions that have not yet become apparent to them. Blood pressure screening would fit this description. Flu vaccinations and teaching about sun exposure are examples of primary prevention. Fitting older adults with glasses is a tertiary prevention. DIF: Applying (Application) REF: N/A OBJ: 8-5 TOP: Nursing Process: Implementation MSC: Health Promotion
14. A patient who is homeless has not followed through with getting an influenza vaccination. What response by the nurse to a student is most appropriate? a. Its hard to be proactive when you are hungry. b. If the patient would just come in, we have the shot. c. These patients never follow through on directions. d. Too bad we cant take the shot to him where
he is. ANS: A
Competing priorities often cause patients to seem uninterested or noncompliant with health recommendations. According to Maslow, basic needs such as food, water, shelter, and safety take priority over other matters. Perhaps it is a good idea to take shots into the community, but that is not the best response by the nurse, as it does not help the student understand the situation. The other two statements are biased and show disregard for the patients circumstances. DIF: Applying (Application) REF: N/A OBJ: 8-4 TOP: Communication and Documentation MSC: Health Promotion
15. The nurse is seeing a 68-year old woman for a physical exam in the family practice clinic. The woman complains about having another pelvic exam. What response by the nurse is best? a. I know its uncomfortable, but its important to do it. b. You are past the age where this exam is recommended. c. Why dont you want to have your pelvic exam? d. This will be the last time you need this
exam. ANS: B According to the U.S. Preventative Task Force, pelvic exams and pap smears can be discontinued after age 65 if prior testing was normal and the patient is not at high risk for cervical cancer. The other statements are incorrect. DIF: Understanding (Comprehension) REF: msc: 143 OBJ: 8-5 TOP: Teaching-Learning MSC: Health Promotion
16. A male patient complains about the digital rectal prostate exam and blood work for prostate specific antigen (PSA) and asks, How long am I expected to do this? What response by the nurse is best? a. Every year for the rest of your life. b. Until you turn 75 years of [Show Less]