Test Bank for Nursing for Wellness in Older Adults, 9th Edition (Chapters 1-29)
Test Bank for Nursing for Wellness in Older Adults, 9th Edition (Chapters 1-29) helps you prepare with confidence by providing real exam-style practice.
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Nursing for Wellness in Older Adults Miller 9th Edition Test Bank
Chapter 1 Seeing Older Adults Through the Eyes of Wellness
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: MCS: 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
Chapter 1 Seeing Older Adults Through the Eyes of Wellness
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: MCS: 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
Nursing for Wellness in Older Adults Miller 9th Edition Test Bank
Chapter 1 Seeing Older Adults Through the Eyes of Wellness
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: MCS: 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
Chapter 1 Seeing Older Adults Through the Eyes of Wellness
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: MCS: 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: MCS: 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.
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: MCS: 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.
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: MCS: 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.
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: MCS: 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.
d. 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: MCS: 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. 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: MCS: 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?
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 here.
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
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 here.
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
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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: MCS: 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.
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: MCS: 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.
Loading page 7...
DIF: Remembering (Knowledge) REF: MCS: 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
The 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
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
The 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
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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: MCS: 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: MCS: 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
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: MCS: 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: MCS: 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
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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 Association
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
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 Association
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
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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: MCS: 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.
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: MCS: 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.
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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: B, 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: MCS: 2-3 OBJ: 1-2
TOP: Teaching-Learning MSC: Nursing Process: Assessment
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: B, 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: MCS: 2-3 OBJ: 1-2
TOP: Teaching-Learning MSC: Nursing Process: Assessment
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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: MCS: 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: MCS: 6 OBJ: 1-5
TOP: Nursing Process: Analysis MSC: Health Promotion
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: MCS: 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: MCS: 6 OBJ: 1-5
TOP: Nursing Process: Analysis MSC: Health Promotion
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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. Diabetes
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 2 Addressing Diversity of Older Adults
MULTIPLE CHOICE
1. A postmenopausal black woman who has been experiencing uterine bleeding tells the nurse, I
expect Ill need a total hysterectomy because when my sister had this problem thats what she had
done. The nurse recognizes that this woman belongs to a cultural subgroup whose health care
beliefs are most influenced by the:
a. biomedical model.
b. magico-religious model.
c. balance/harmony model.
d. personal experience.
ANS: A
The patient shows a tendency to identify with the biomedical model, which views the body as a
functioning machine. When a part gives out or is functioning abnormally, traditional Western
which diseases? (Select all that apply.)
a. Cerebrovascular disease
b. End-stage kidney disease
c. Heart disease
d. Cancer
e. Diabetes
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 2 Addressing Diversity of Older Adults
MULTIPLE CHOICE
1. A postmenopausal black woman who has been experiencing uterine bleeding tells the nurse, I
expect Ill need a total hysterectomy because when my sister had this problem thats what she had
done. The nurse recognizes that this woman belongs to a cultural subgroup whose health care
beliefs are most influenced by the:
a. biomedical model.
b. magico-religious model.
c. balance/harmony model.
d. personal experience.
ANS: A
The patient shows a tendency to identify with the biomedical model, which views the body as a
functioning machine. When a part gives out or is functioning abnormally, traditional Western
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medical treatment is sought and expected. The magico-religious models believe that health is a
reward from a higher power. The balance/harmony models state that illness is the result of a state
of imbalance in body energies. Personal experience influences all of these models.
DIF: Understanding (Comprehension) REF: MCS: 91 OBJ: 5-5
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
2. A Hispanic patient explains that the Hispanic culture believes that dietary management would
be just as effective in managing her problems as medication, so the patients prescription has not
been filled. Which action by the nurse illustrates cultural accommodation?
a. Asking the patient to give more details regarding this belief
b. Discussing how to add dietary preferences into the treatment plan
c. Offering to have a registered nutritionist discuss the situation with the patient
d. Researching the patients proposed dietary beliefs
ANS: B
Cultural care accommodation or negotiation refers to those assistive, supportive, facilitative, or
enabling creative professional actions and decisions that help people of a designated culture
adapt to or negotiate with others for a beneficial or satisfying health outcome. The nurse can ask
the patient to share more about beliefs, offer a consultation with a nutritionist, or research the
beliefs, but these actions do not show accommodation.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
3. A geriatric nurse practitioner working with a tribe of Native Americans makes the decision to
acculturate in an attempt to provide culturally appropriate care. The nurse does this best by:
a. living the values of the tribe.
b. researching the tribes belief systems.
c. learning the language of the tribe.
reward from a higher power. The balance/harmony models state that illness is the result of a state
of imbalance in body energies. Personal experience influences all of these models.
DIF: Understanding (Comprehension) REF: MCS: 91 OBJ: 5-5
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
2. A Hispanic patient explains that the Hispanic culture believes that dietary management would
be just as effective in managing her problems as medication, so the patients prescription has not
been filled. Which action by the nurse illustrates cultural accommodation?
a. Asking the patient to give more details regarding this belief
b. Discussing how to add dietary preferences into the treatment plan
c. Offering to have a registered nutritionist discuss the situation with the patient
d. Researching the patients proposed dietary beliefs
ANS: B
Cultural care accommodation or negotiation refers to those assistive, supportive, facilitative, or
enabling creative professional actions and decisions that help people of a designated culture
adapt to or negotiate with others for a beneficial or satisfying health outcome. The nurse can ask
the patient to share more about beliefs, offer a consultation with a nutritionist, or research the
beliefs, but these actions do not show accommodation.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
3. A geriatric nurse practitioner working with a tribe of Native Americans makes the decision to
acculturate in an attempt to provide culturally appropriate care. The nurse does this best by:
a. living the values of the tribe.
b. researching the tribes belief systems.
c. learning the language of the tribe.
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d. residing among the tribe members.
ANS: A
Acculturation is a process that occurs when a member of one cultural group adopts the values,
beliefs, expectations, and behaviors of another group, usually in an attempt to become
recognized as a member of the group. The other actions might be helpful in acculturating.
DIF: Applying (Application) REF: N/A OBJ: 5-3
TOP: Nursing process: Implementation MSC: Psychosocial Integrity
4. The nurse in an assisted living facility is practicing a form of cultural bias called
ethnocentrism when:
a. requesting the bridge group only use the game room for 2 hours at a time.
b. encouraging Christian residents to attend mass or church services.
c. repeatedly confiscating herbs and food products used in healing.
d. telling potential patients who are Jewish that the facility does not have a kosher
kitchen,
ANS: C
Ethnocentrism is a belief that ones own cultural group is superior to that of anothers. In nursing
we have a unique culture and expect our patients to adapt to us rather than attempting to adapt to
the culture of the patient. Confiscating items used in healing rituals shows ethnocentrism and
disrespect to the resident. Limiting activities in a group room, encouraging people to attend
church services of their religion, and letting prospective Jewish residents know that the facility
does not have a kosher kitchen are not examples of ethnocentrism.
DIF: Applying (Application) REF: N/A OBJ: 5-6
TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
ANS: A
Acculturation is a process that occurs when a member of one cultural group adopts the values,
beliefs, expectations, and behaviors of another group, usually in an attempt to become
recognized as a member of the group. The other actions might be helpful in acculturating.
DIF: Applying (Application) REF: N/A OBJ: 5-3
TOP: Nursing process: Implementation MSC: Psychosocial Integrity
4. The nurse in an assisted living facility is practicing a form of cultural bias called
ethnocentrism when:
a. requesting the bridge group only use the game room for 2 hours at a time.
b. encouraging Christian residents to attend mass or church services.
c. repeatedly confiscating herbs and food products used in healing.
d. telling potential patients who are Jewish that the facility does not have a kosher
kitchen,
ANS: C
Ethnocentrism is a belief that ones own cultural group is superior to that of anothers. In nursing
we have a unique culture and expect our patients to adapt to us rather than attempting to adapt to
the culture of the patient. Confiscating items used in healing rituals shows ethnocentrism and
disrespect to the resident. Limiting activities in a group room, encouraging people to attend
church services of their religion, and letting prospective Jewish residents know that the facility
does not have a kosher kitchen are not examples of ethnocentrism.
DIF: Applying (Application) REF: N/A OBJ: 5-6
TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
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5. While caring for an older Korean patient, the nurse notes that the patient answers questions
regarding health history when asked but is otherwise silent and does not maintain eye contact.
Being culturally sensitive, the nurse recognizes that the patients actions are most likely a(n):
a. sign of respect for the wisdom and expertise of the nurse.
b. indication that he has no questions regarding the care he is receiving.
c. expression of discomfort discussing personal matters.
d. means of communicating his dissatisfaction with his care.
ANS: A
Asian cultures generally view eye contact as rude and are often passive in their care. The patient
may or may not have further questions. It is not a sign of discomfort or dissatisfaction.
DIF: Remembering (Knowledge) REF: MCS: 93 OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
6. The culturally sensitive nurse will recognize that an older adult patient with a high-context
ethnic background will appreciate:
a. not having a treatment scheduled during a favorite television program.
b. both a written and verbal explanation describing how to monitor her blood sugar
levels.
c. a concise explanation as to why her physical therapy appointment has been
canceled.
d. having a conversation about her grandchildren while her dressing is changed.
ANS: D
The interactional patterns of high-context (universalism) patients refer to the characteristics of
relationships and behaviors toward others. When a person from a high-context culture interacts
with the nurse, a more personal relationship is expected. This is not related to television shows,
teaching materials, or appointment cancellations.
regarding health history when asked but is otherwise silent and does not maintain eye contact.
Being culturally sensitive, the nurse recognizes that the patients actions are most likely a(n):
a. sign of respect for the wisdom and expertise of the nurse.
b. indication that he has no questions regarding the care he is receiving.
c. expression of discomfort discussing personal matters.
d. means of communicating his dissatisfaction with his care.
ANS: A
Asian cultures generally view eye contact as rude and are often passive in their care. The patient
may or may not have further questions. It is not a sign of discomfort or dissatisfaction.
DIF: Remembering (Knowledge) REF: MCS: 93 OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
6. The culturally sensitive nurse will recognize that an older adult patient with a high-context
ethnic background will appreciate:
a. not having a treatment scheduled during a favorite television program.
b. both a written and verbal explanation describing how to monitor her blood sugar
levels.
c. a concise explanation as to why her physical therapy appointment has been
canceled.
d. having a conversation about her grandchildren while her dressing is changed.
ANS: D
The interactional patterns of high-context (universalism) patients refer to the characteristics of
relationships and behaviors toward others. When a person from a high-context culture interacts
with the nurse, a more personal relationship is expected. This is not related to television shows,
teaching materials, or appointment cancellations.
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DIF: Understanding (Comprehension) REF: MCS: 92 OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
7. In an attempt to be sensitive to varying cultural responses to touch, before shaking a patients
hand, the nurse will:
a. offer the patient his or her upturned palm.
b. wait until the patient extends his or her hand.
c. establish eye contact with the patient first.
d. address the patient by his or her full name.
ANS: B
The best way to show respect and implement the appropriate response is to follow the lead of the
patient by waiting for the patient to extend a hand.
DIF: Applying (Application) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
8. A older Asian patient receiving physical therapy after hip surgery has developed a low-grade
fever. The patient explains that the fever will lessen if the treatment includes the principles of
yin/yang. The nurse expects to support the patient by:
a. providing privacy when his shaman visits.
b. arranging for his diet to include cold foods and liquids.
c. planning his physical therapy so it does not conflict with meditation.
d. keeping a magical amulet under his pillow.
ANS: B
The yin/yang theory proposes that health is a result of balance within the body. A principle of
this theory is that an illness is either hot or cold and must be treated by elements of the opposite
TOP: Caring MSC: Psychosocial Integrity
7. In an attempt to be sensitive to varying cultural responses to touch, before shaking a patients
hand, the nurse will:
a. offer the patient his or her upturned palm.
b. wait until the patient extends his or her hand.
c. establish eye contact with the patient first.
d. address the patient by his or her full name.
ANS: B
The best way to show respect and implement the appropriate response is to follow the lead of the
patient by waiting for the patient to extend a hand.
DIF: Applying (Application) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
8. A older Asian patient receiving physical therapy after hip surgery has developed a low-grade
fever. The patient explains that the fever will lessen if the treatment includes the principles of
yin/yang. The nurse expects to support the patient by:
a. providing privacy when his shaman visits.
b. arranging for his diet to include cold foods and liquids.
c. planning his physical therapy so it does not conflict with meditation.
d. keeping a magical amulet under his pillow.
ANS: B
The yin/yang theory proposes that health is a result of balance within the body. A principle of
this theory is that an illness is either hot or cold and must be treated by elements of the opposite
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state in order to put the system back into balance. It is not related to shaman visits, meditation, or
amulets.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
9. The nurse in an assisted living facility is preparing to admit an older adult patient who speaks
very little English. The nurse decides that it is most important that an interpreter be present when
the patient:
a. indicates a desire to talk with the physician.
b. is being oriented to the facility.
c. is required to sign official documents.
d. begins crying and is inconsolable.
ANS: C
The more complex the decision making, the more important it is to have an interpreter present.
Although all situations would benefit from an interpreter, the most important time is when the
patient is signing official documents that have legal implications.
DIF: Applying (Application) REF: N/A OBJ: 5-8
TOP: Communication and Documentation MSC: Psychosocial Integrity
10. When attempting to provide culturally sensitive care according to the explanatory model, the
nurse asks the patient:
a. Who will be able to help you when you go home?
b. Do you think the treatment is helping?
c. When did you first notice the problem?
d. Has this illness changed your life?
ANS: D
amulets.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
9. The nurse in an assisted living facility is preparing to admit an older adult patient who speaks
very little English. The nurse decides that it is most important that an interpreter be present when
the patient:
a. indicates a desire to talk with the physician.
b. is being oriented to the facility.
c. is required to sign official documents.
d. begins crying and is inconsolable.
ANS: C
The more complex the decision making, the more important it is to have an interpreter present.
Although all situations would benefit from an interpreter, the most important time is when the
patient is signing official documents that have legal implications.
DIF: Applying (Application) REF: N/A OBJ: 5-8
TOP: Communication and Documentation MSC: Psychosocial Integrity
10. When attempting to provide culturally sensitive care according to the explanatory model, the
nurse asks the patient:
a. Who will be able to help you when you go home?
b. Do you think the treatment is helping?
c. When did you first notice the problem?
d. Has this illness changed your life?
ANS: D
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The gerontologic nurse uses this model to explore the meaning of the health problem from the
patients perspective.
DIF: Applying (Application) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
11. The nurse is caring for an older adult patient in need of hospitalization. The nurse is aware
this patient is a member of an ethnic group that holds a collectivist perspective on community.
The nurse best addresses the patients medical needs by:
a. calling an interpreter to assure the patient is making an informed decision.
b. assuring the patient that his spiritual advisor will meet him at the hospital.
c. arranging for admission to a hospital that is familiar with this patients culture.
d. offering to phone the patients family and ask them to come in and discuss the
hospitalization.
ANS: D
People with a collectivist perspective derive their identity from affiliation with and participation
in a social group such as a family or clan. The needs of the group are more important than those
of the individual, and decisions are made with consideration of the effect on the whole. Health
care decisions may be made by a group (such as the tribal elders) or a group leader (such as the
oldest son). The other options may or may not be needed depending on the specifics of the
patients case.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
12. The nurse is most effectively using the concept of future time orientation when:
a. promising to help the patient call his daughter each weekend.
b. offering to complete the health assessment history after the patient eats dinner.
c. encouraging an older patient to keep a follow-up clinic appointment.
patients perspective.
DIF: Applying (Application) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
11. The nurse is caring for an older adult patient in need of hospitalization. The nurse is aware
this patient is a member of an ethnic group that holds a collectivist perspective on community.
The nurse best addresses the patients medical needs by:
a. calling an interpreter to assure the patient is making an informed decision.
b. assuring the patient that his spiritual advisor will meet him at the hospital.
c. arranging for admission to a hospital that is familiar with this patients culture.
d. offering to phone the patients family and ask them to come in and discuss the
hospitalization.
ANS: D
People with a collectivist perspective derive their identity from affiliation with and participation
in a social group such as a family or clan. The needs of the group are more important than those
of the individual, and decisions are made with consideration of the effect on the whole. Health
care decisions may be made by a group (such as the tribal elders) or a group leader (such as the
oldest son). The other options may or may not be needed depending on the specifics of the
patients case.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
12. The nurse is most effectively using the concept of future time orientation when:
a. promising to help the patient call his daughter each weekend.
b. offering to complete the health assessment history after the patient eats dinner.
c. encouraging an older patient to keep a follow-up clinic appointment.
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d. arranging for a colorectal cancer screen for senior citizens.
ANS: D
In the concept of future orientation, people accept the idea that what is done now affects future
health. This means that health screenings will help detect a problem today for potentially better
health at a later time, days, weeks, or years ahead; it means that prevention may be worth
pursuing. The other actions do not show a future orientation.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
13. The student learns that which of the following is the best definition of culture?
a. A group of similarly appearing individuals
b. Shared beliefs, behaviors, and expectations of groups
c. Group beliefs about what is right and wrong
d. Groups that come from the same part of the world
ANS: B
A culture is a set of shared and learned beliefs, behaviors, and expectations among a group of
people. The individuals in different cultures may or may not look similar. Group beliefs about
what is right or wrong are known as values. Cultural members may come from many different
parts of the world.
DIF: Remembering (Knowledge) REF: MCS: 87 OBJ: 5-3
TOP: Teaching-Learning MSC: Psychosocial Integrity
14. A student nurse expresses frustration to the faculty member regarding an ethnic older adult
who appears to be noncompliant. The student states, Why cant the patient just do what we teach
her to do? What response by the nurse is best?
a. Yes, I realize how frustrating this must be for you.
ANS: D
In the concept of future orientation, people accept the idea that what is done now affects future
health. This means that health screenings will help detect a problem today for potentially better
health at a later time, days, weeks, or years ahead; it means that prevention may be worth
pursuing. The other actions do not show a future orientation.
DIF: Applying (Application) REF: N/A OBJ: 5-9
TOP: Caring MSC: Psychosocial Integrity
13. The student learns that which of the following is the best definition of culture?
a. A group of similarly appearing individuals
b. Shared beliefs, behaviors, and expectations of groups
c. Group beliefs about what is right and wrong
d. Groups that come from the same part of the world
ANS: B
A culture is a set of shared and learned beliefs, behaviors, and expectations among a group of
people. The individuals in different cultures may or may not look similar. Group beliefs about
what is right or wrong are known as values. Cultural members may come from many different
parts of the world.
DIF: Remembering (Knowledge) REF: MCS: 87 OBJ: 5-3
TOP: Teaching-Learning MSC: Psychosocial Integrity
14. A student nurse expresses frustration to the faculty member regarding an ethnic older adult
who appears to be noncompliant. The student states, Why cant the patient just do what we teach
her to do? What response by the nurse is best?
a. Yes, I realize how frustrating this must be for you.
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b. People from her culture are never compliant.
c. Maybe you can find a different way to get through.
d. Culture dictates how people respond to others.
ANS: D
Culture is a blueprint for responding to individuals, family, and the community. Persons from
strong cultural backgrounds cannot just change their behavior when instructed to do so. The
nurse explains this to the student. Stating that the nurse understands the frustration is helpful but
does not give the student any information that could help him or her work with this patient.
Stating that people from a certain culture are never compliant is biased and prejudicial. Getting
through to the patient implies ethnocentrism and bias.
DIF: Applying (Application) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
15. A patient from a culture that differs from that of the nurse is hospitalized and near death.
What action by the nurse best demonstrates cultural care preservation?
a. Allowing the family to remain at the bedside
b. Pinning a healing amulet to the patients gown
c. Offering the family food and drink in the room
d. Giving the family time to be alone with the patient
ANS: B
Cultural care preservation refers to those assistive, supportive, facilitative, or enabling
professional actions and decisions that help people of a particular culture to retain and maintain
their well-being, to recover from illness, or to face handicaps or death. Allowing the patient to
have healing artifacts important in his or her culture nearby best demonstrates this concept. The
other actions are caring but do not demonstrate this principle.
DIF: Applying (Application) REF: N/A OBJ: 5-9
c. Maybe you can find a different way to get through.
d. Culture dictates how people respond to others.
ANS: D
Culture is a blueprint for responding to individuals, family, and the community. Persons from
strong cultural backgrounds cannot just change their behavior when instructed to do so. The
nurse explains this to the student. Stating that the nurse understands the frustration is helpful but
does not give the student any information that could help him or her work with this patient.
Stating that people from a certain culture are never compliant is biased and prejudicial. Getting
through to the patient implies ethnocentrism and bias.
DIF: Applying (Application) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
15. A patient from a culture that differs from that of the nurse is hospitalized and near death.
What action by the nurse best demonstrates cultural care preservation?
a. Allowing the family to remain at the bedside
b. Pinning a healing amulet to the patients gown
c. Offering the family food and drink in the room
d. Giving the family time to be alone with the patient
ANS: B
Cultural care preservation refers to those assistive, supportive, facilitative, or enabling
professional actions and decisions that help people of a particular culture to retain and maintain
their well-being, to recover from illness, or to face handicaps or death. Allowing the patient to
have healing artifacts important in his or her culture nearby best demonstrates this concept. The
other actions are caring but do not demonstrate this principle.
DIF: Applying (Application) REF: N/A OBJ: 5-9
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TOP: Caring MSC: Psychosocial Integrity
16. The nurse uses the LEARN model when providing care. What event best demonstrates that
this model has been successful?
a. The nurse learns about the patients culture and how it impacts care.
b. The patient and nurse agree on a mutually acceptable plan of action.
c. The nurse listens carefully to the patients concerns and beliefs.
d. The patient understands how medical care will be beneficial.
ANS: B
The LEARN model includes listening to the patient, explaining your own perspectives,
acknowledging the similarities and differences in both viewpoints, recommending a plan of
action, and negotiating a final plan. If the patient and nurse have come to an agreement on a plan
of action, this model has been successful.
DIF: Evaluating (Evaluation) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
17. A new nurse is caring for a patient from Appalachia. The patient seems guarded and
secretive, which frustrates the new nurse. What advice from the mentor is most appropriate?
a. Maybe you should ask to change your assignment.
b. This is a normal behavior for this patients cultural group.
c. You could try to apologize for anything you may have done.
d. Ask the patient why she is acting so strangely around you.
ANS: B
Patients from the Appalachian culture are typically wary and guarded around strangers and view
the hospital as a place to go and die. The nurse explains this to the new nurse. Changing
assignments will not help the new nurse become culturally competent. The new nurse could ask
16. The nurse uses the LEARN model when providing care. What event best demonstrates that
this model has been successful?
a. The nurse learns about the patients culture and how it impacts care.
b. The patient and nurse agree on a mutually acceptable plan of action.
c. The nurse listens carefully to the patients concerns and beliefs.
d. The patient understands how medical care will be beneficial.
ANS: B
The LEARN model includes listening to the patient, explaining your own perspectives,
acknowledging the similarities and differences in both viewpoints, recommending a plan of
action, and negotiating a final plan. If the patient and nurse have come to an agreement on a plan
of action, this model has been successful.
DIF: Evaluating (Evaluation) REF: N/A OBJ: 5-7
TOP: Caring MSC: Psychosocial Integrity
17. A new nurse is caring for a patient from Appalachia. The patient seems guarded and
secretive, which frustrates the new nurse. What advice from the mentor is most appropriate?
a. Maybe you should ask to change your assignment.
b. This is a normal behavior for this patients cultural group.
c. You could try to apologize for anything you may have done.
d. Ask the patient why she is acting so strangely around you.
ANS: B
Patients from the Appalachian culture are typically wary and guarded around strangers and view
the hospital as a place to go and die. The nurse explains this to the new nurse. Changing
assignments will not help the new nurse become culturally competent. The new nurse could ask
Loading page 23...
the patient if there has been some offense, but this is probably not the case. Why questions put
people on the defensive and are not considered examples of therapeutic communication.
DIF: Understanding (Comprehension) REF: MCS: 87 OBJ: 5-6
TOP: Caring MSC: Psychosocial Integrity
18. A nurse is caring for an Arab American patient in the hospital. The patient has many visitors
who seem to be tiring the patient. What action by the nurse is best?
a. Limit the number of visitors the patient can have.
b. Only allow family members to visit the patient.
c. Suggest shorter visits to the patients visitors.
d. Require visitors to check in at the front desk.
ANS: C
In Arab American Muslim culture, visiting the sick is a cultural value and expectation. Although
the visits may be tiring, they may also be important to the patient. The nurse can suggest shorter
visits so the patient can have both the visitors and more rest. Limiting the number of visitors
would violate this cultural norm as would limiting visits to family only. Checking in at the front
desk serves no useful purpose.
DIF: Applying (Application) REF: N/A OBJ: 5-6
TOP: Caring MSC: Psychosocial Integrity
19. A director of nursing works in a hospital that serves many Jehovahs Witness patients. What
action by the nurse would best facilitate culturally appropriate health care?
a. Establish a bloodless surgery program.
b. Create an immunization clinic for children.
c. Employ spiritual leaders from this faith.
d. Allow faith healing ceremonies.
people on the defensive and are not considered examples of therapeutic communication.
DIF: Understanding (Comprehension) REF: MCS: 87 OBJ: 5-6
TOP: Caring MSC: Psychosocial Integrity
18. A nurse is caring for an Arab American patient in the hospital. The patient has many visitors
who seem to be tiring the patient. What action by the nurse is best?
a. Limit the number of visitors the patient can have.
b. Only allow family members to visit the patient.
c. Suggest shorter visits to the patients visitors.
d. Require visitors to check in at the front desk.
ANS: C
In Arab American Muslim culture, visiting the sick is a cultural value and expectation. Although
the visits may be tiring, they may also be important to the patient. The nurse can suggest shorter
visits so the patient can have both the visitors and more rest. Limiting the number of visitors
would violate this cultural norm as would limiting visits to family only. Checking in at the front
desk serves no useful purpose.
DIF: Applying (Application) REF: N/A OBJ: 5-6
TOP: Caring MSC: Psychosocial Integrity
19. A director of nursing works in a hospital that serves many Jehovahs Witness patients. What
action by the nurse would best facilitate culturally appropriate health care?
a. Establish a bloodless surgery program.
b. Create an immunization clinic for children.
c. Employ spiritual leaders from this faith.
d. Allow faith healing ceremonies.
Loading page 24...
ANS: A
Jehovahs Witnesses generally are opposed to receiving all blood products. A bloodless surgery
program would be a culturally competent way to improve the health care of this population.
DIF: Applying (Application) REF: N/A OBJ: 5-5
TOP: Caring MSC: Psychosocial Integrity
20. An incapacitated older adult with dementia is brought to the emergency department by a
rescue squad after falling and breaking an arm. When the patients children arrive, they are
adamantly against the patient having any medical care and insist that prayer will heal the broken
arm. What action by the nurse is most appropriate?
a. Allow the family to pray with the patient then escort them to the waiting room.
b. Call security to keep the family from interfering with medical care.
c. Check facility policies and contact the hospital social worker.
d. Call the police who can force the family to accept medical care.
ANS: C
This family may be Christian Scientists, who do not believe in medical care. Health crises are
thought to be errors of the mind that can be altered by prayer. The nurse should check the facility
policies for treating vulnerable adults and possibly notify social work, who can assist with
ensuring adequate treatment occurs as allowed by policy. Allowing the family to pray with the
patient is a caring action, but this complex situation requires more intervention. Calling security
or the police will antagonize the family even more and demonstrates an adversarial relationship.
DIF: Applying (Application) REF: N/A OBJ: 5-6
TOP: Communication and Documentation
MSC: Safe Effective Care Environment
MULTIPLE RESPONSE
Jehovahs Witnesses generally are opposed to receiving all blood products. A bloodless surgery
program would be a culturally competent way to improve the health care of this population.
DIF: Applying (Application) REF: N/A OBJ: 5-5
TOP: Caring MSC: Psychosocial Integrity
20. An incapacitated older adult with dementia is brought to the emergency department by a
rescue squad after falling and breaking an arm. When the patients children arrive, they are
adamantly against the patient having any medical care and insist that prayer will heal the broken
arm. What action by the nurse is most appropriate?
a. Allow the family to pray with the patient then escort them to the waiting room.
b. Call security to keep the family from interfering with medical care.
c. Check facility policies and contact the hospital social worker.
d. Call the police who can force the family to accept medical care.
ANS: C
This family may be Christian Scientists, who do not believe in medical care. Health crises are
thought to be errors of the mind that can be altered by prayer. The nurse should check the facility
policies for treating vulnerable adults and possibly notify social work, who can assist with
ensuring adequate treatment occurs as allowed by policy. Allowing the family to pray with the
patient is a caring action, but this complex situation requires more intervention. Calling security
or the police will antagonize the family even more and demonstrates an adversarial relationship.
DIF: Applying (Application) REF: N/A OBJ: 5-6
TOP: Communication and Documentation
MSC: Safe Effective Care Environment
MULTIPLE RESPONSE
Loading page 25...
1. When attempting to reflect about personal cultural awareness, the nurse asks himself or herself
which of the following quetions? (Select all that apply.)
a. What image do I want to project to members of other cultures?
b. What makes a culture worthy of biased treatment?
c. Have my life experiences contributed to any biases regarding other cultures?
d. Am I uncomfortable when interacting with members of other cultures?
e. Does the patients culture rely on solid science to direct health care?
ANS: A, C, D
Self-reflection implies thinking that regards how I, the individual, perceives/believes/behaves.
Awareness of ones thoughts and feelings about others who are culturally different from oneself is
necessary to become culturally aware. No culture is worthy of biased treatment. Solid science is
an ethnocentric principle.
DIF: Applying (Application) REF: N/A OBJ: 5-4
TOP: Caring MSC: Psychosocial Integrity
2. What does the nurse working with older adults from many different cultures know about the
demographics of culture in the United States? (Select all that apply.)
a. Hispanics will become the largest minority group by 2030.
b. Many persons of color are not counted in the census.
c. The percentage of Native Americans/Native Alaskans will decrease.
d. The number of refugees and immigrants is expected to decrease.
e. Some Native Americans want to identify as specific tribal members.
ANS: A, B, C
Hispanics are expected to be the largest minority group in the United States by 2030. Many
persons of color are not represented in the census, and this underestimates their presence. The
percentage of Native Alaskans and Native Americans will rise, as will the number of
which of the following quetions? (Select all that apply.)
a. What image do I want to project to members of other cultures?
b. What makes a culture worthy of biased treatment?
c. Have my life experiences contributed to any biases regarding other cultures?
d. Am I uncomfortable when interacting with members of other cultures?
e. Does the patients culture rely on solid science to direct health care?
ANS: A, C, D
Self-reflection implies thinking that regards how I, the individual, perceives/believes/behaves.
Awareness of ones thoughts and feelings about others who are culturally different from oneself is
necessary to become culturally aware. No culture is worthy of biased treatment. Solid science is
an ethnocentric principle.
DIF: Applying (Application) REF: N/A OBJ: 5-4
TOP: Caring MSC: Psychosocial Integrity
2. What does the nurse working with older adults from many different cultures know about the
demographics of culture in the United States? (Select all that apply.)
a. Hispanics will become the largest minority group by 2030.
b. Many persons of color are not counted in the census.
c. The percentage of Native Americans/Native Alaskans will decrease.
d. The number of refugees and immigrants is expected to decrease.
e. Some Native Americans want to identify as specific tribal members.
ANS: A, B, C
Hispanics are expected to be the largest minority group in the United States by 2030. Many
persons of color are not represented in the census, and this underestimates their presence. The
percentage of Native Alaskans and Native Americans will rise, as will the number of
Loading page 26...
immigrants/refugees. Some Native Americans may not view themselves as part of this larger
group, preferring to identify as a member of a specific tribe.
DIF: Remembering (Knowledge) REF: MCS: 83 OBJ: 5-1
TOP: Communication and Documentation MSC: Psychosocial Integrity
3. A nurse working in the emergency department is seeing an older patient who does not speak
English well. The nurse calls for an interpreter. The student wants to know why the patients
minor child, who speaks English, cannot interpret. What response by the nurse is best? (Select all
that apply.)
a. The child may not accurately translate.
b. The child and older adult may be embarrassed.
c. The patient has the right to interpretation.
d. Having a child interpret takes too much time.
e. Privacy laws prohibit this practice.
ANS: A, B, C
Although in a true emergency the nurse may have to use a child interpreter, this practice is not
recommended. The child may not have the vocabulary to translate, the child may edit the
comments, the child or older adult may be embarrassed by the medical condition, and patients
have a legal right to professional interpretation. Using an interpreter always takes more time and
privacy laws do not prohibit this practice.
Chapter 3 Applying a Nursing Model for Promoting Wellness in Older Adults
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.
group, preferring to identify as a member of a specific tribe.
DIF: Remembering (Knowledge) REF: MCS: 83 OBJ: 5-1
TOP: Communication and Documentation MSC: Psychosocial Integrity
3. A nurse working in the emergency department is seeing an older patient who does not speak
English well. The nurse calls for an interpreter. The student wants to know why the patients
minor child, who speaks English, cannot interpret. What response by the nurse is best? (Select all
that apply.)
a. The child may not accurately translate.
b. The child and older adult may be embarrassed.
c. The patient has the right to interpretation.
d. Having a child interpret takes too much time.
e. Privacy laws prohibit this practice.
ANS: A, B, C
Although in a true emergency the nurse may have to use a child interpreter, this practice is not
recommended. The child may not have the vocabulary to translate, the child may edit the
comments, the child or older adult may be embarrassed by the medical condition, and patients
have a legal right to professional interpretation. Using an interpreter always takes more time and
privacy laws do not prohibit this practice.
Chapter 3 Applying a Nursing Model for Promoting Wellness in Older Adults
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.
Loading page 27...
b. health protection.
c. 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: MCS: 141 OBJ: 8-2
TOP: Nursing Process: Assessment MSC: Health Promotion
c. 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: MCS: 141 OBJ: 8-2
TOP: Nursing Process: Assessment MSC: Health Promotion
Loading page 28...
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: MCS: 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.
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: MCS: 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.
Loading page 29...
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 when:
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
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 when:
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
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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:
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:
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Subject
Nursing