Chapter 02(FREE) My Nursing Test Banks

Tabloski Gerontological Nursing, 3/e
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Question 1

Type: MCSA

The nurse supports an older patients desire to discuss advance directives with the patients family. What action is the nurse performing with this patient?

1. Facilitation of palliative care

2. Engagement in professional d  aevelopment

3. Collaboration with the interdisciplinary team

4. Accountability to protect patients rights and autonomy

Correct Answer: 4

Rationale 1: Palliative care alleviates pain and suffering. There is no information to suggest the patient is in need of palliative care.
Reference: Page 29

Rationale 2: Professional development activities include continuing education and participating with professional organizations. The nurses support of the patients desires is not a professional development activity.
Reference: Page 29

Rationale 3: Collaboration with the interdisciplinary team would include the nurse working with other professionals to provide patient care. The nurse is not collaborating with other professionals regarding the patients desire to complete advance directives.
Reference: Page 29

Rationale 4: The nurse is demonstrating accountability by supporting the patient who desires control over end-of-life decisions and communicating the patients wishes to family members. This is included in the knowledge and skills of gerontological nurses.
Reference: Page 29

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Describe the ANA standards and scope of practice for gerontological nursing.

Question 2

Type: MCSA

The nurse supports an older patients decision to stop further chemotherapy treatments after diagnostic testing shows a recurrence of a malignancy. Which ethical principle is this nurse demonstrating?

1. Justice

2. Autonomy

3. Beneficence

4. Nondisclosure

Correct Answer: 2

Rationale 1: Justice involves fairness and equal distribution of resources to all in need.
Reference: Pages 42-43

Rationale 2: Autonomy is the respect for a patients self-determination, freedom, and rights including the right to refuse treatment.
Reference: Pages 42-43

Rationale 3: Beneficence is the principle of doing good and not doing harm to patients.
Reference: Pages 42-43

Rationale 4: Nondisclosure is an ethical issue when persons who care about a patient, such as family, do not want a patient to be told the entire facts of a negative prognosis in order to protect the patient from anxiety and fear.
Reference: Pages 42-43

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1. Discuss the nurses role in caring for older adults.

Question 3

Type: MCSA

The nurse is preparing to assess an older patient using functional health patterns. How does this approach ensure holistic care will be provided to the patient?

1. Focuses on the effects of diseases

2. Predicts the outcome for patients with disabilities

3. Demonstrates the patients interaction with the environment

4. Identifies the potential for rehabilitation early in the process

Correct Answer: 3

Rationale 1: Functional health patterns are an interrelated group of behavioral areas that provides a view of the whole person and the relationship with the environment. Functional health patterns do not focus on the effects of diseases.
Reference: Page 33

Rationale 2: Functional health patterns are an interrelated group of behavioral areas that provides a view of the whole person and the relationship with the environment. Functional health patterns do not predict the outcome for patients with disabilities.
Reference: Page 33

Rationale 3: Functional health patterns are an interrelated group of behavioral areas that provides a view of the whole person and the relationship with the environment.
Reference: Page 33

Rationale 4: Functional health patterns are an interrelated group of behavioral areas that provides a view of the whole person and the relationship with the environment. Functional health patterns do not identify the potential for rehabilitation early in the process.
Reference: Page 33

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Apply the use of functional health patterns in the formulation of a nursing diagnosis.

Question 4

Type: MCSA

Which action by the gerontological nurse demonstrates the role of manager?

1. Performing blood pressure screenings at a senior citizen health fair

2. Participating in a skin assessment survey of patients in a nursing home

3. Writing a letter of support for a patient who is seeking custody of a grandchild

4. Arranging respite care for a patient while the adult child caregiver recovers from surgery

Correct Answer: 4

Rationale 1: Participating in the blood pressure screening is within the traditional nursing role of clinical practitioner.
Reference: Page 32

Rationale 2: Participating in skin assessment surveys is within the traditional nursing role of clinical practitioner.
Reference: Page 32

Rationale 3: The nurse is functioning within the role of advocate when writing a letter of support for a patient who is seeking custody of a grandchild.
Reference: Page 32

Rationale 4: The nurse is functioning in the role of manager by connecting a patient to community resources and coordinating the transfer of care of the patient needing respite care.
Reference: Page 32

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1. Discuss the nurses role in caring for older adults.

Question 5

Type: MCSA

The nurse is completing a functional health pattern assessment with an older patient who volunteers for political functions. In which functional health pattern would this information be categorized?

1. Values-beliefs

2. Cognitive-perceptual

3. Coping-stress tolerance

4. Self-perception-self-concept

Correct Answer: 2

Rationale 1: The functional health pattern assessment consists of 11 health patterns. The values-beliefs category includes the patients beliefs, values, and perceptions about the meaning of life.
Reference: Page 34

Rationale 2: The functional health pattern assessment consists of 11 health patterns. The cognitive-perceptual pattern includes how the patient thinks and perceives the world and current events. The patients activities with political functions would be part of this assessment.
Reference: Page 34

Rationale 3: The functional health pattern assessment consists of 11 health patterns. Coping-stress tolerance includes patterns of coping with stressful events and the level of effectiveness of coping strategies.
Reference: Page 34

Rationale 4: The functional health pattern assessment consists of 11 health patterns. Self-perception-self-concept identifies patterns of how a person views and values the self.
Reference: Page 34

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Apply the use of functional health patterns in the formulation of a nursing diagnosis.

Question 6

Type: MCSA

The nurse would document a patients religious affiliation and participation in the local parish within which functional health pattern category?

1. Values-beliefs

2. Cognitive-perceptual

3. Coping-stress tolerance

4. Self-perception-self-concept

Correct Answer: 1

Rationale 1: The values-beliefs category of the functional health pattern assessment includes beliefs, values, and perceptions about the meaning of life. A patients participation in a religion would be part of this assessment.
Reference: Page 34

Rationale 2: The cognitive-perceptual category of the functional health pattern assessment includes ways of perceiving the world.
Reference: Page 34

Rationale 3: The coping-stress tolerance category of the functional health pattern assessment includes patterns of coping with stressful events and the effectiveness of coping strategies.
Reference: Page 34

Rationale 4: The self-perception-self-concept category of the functional health pattern assessment includes patterns of viewing and valuing the self.
Reference: Page 34

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Apply the use of functional health patterns in the formulation of a nursing diagnosis.

Question 7

Type: MCSA

A nurse caring for geriatric patients is considering becoming certified in gerontological nursing. What does this credential indicate?

1. The nurse has a masters degree in nursing.

2. The nurse works in administration at a nursing home.

3. The nurse has worked full time at least 2 years in gerontological nursing.

4. The nurses clinical competence in gerontological nursing has been validated.

Correct Answer: 4

Rationale 1: The nurse does not need to have a masters degree to be credentialed as a gerontological nurse.
Reference: Page 28

Rationale 2: Certified nurses can work in administration but also provide direct patient care. Working in administration at a nursing home is not a prerequisite for certification.
Reference: Page 28

Rationale 3: In order to qualify to take the certification examination, the nurse must have practiced the clinically equivalent of 2 years full time or a minimum of 2,000 hours over the past 3 years.
Reference: Page 28

Rationale 4: Certification is a formal process by which clinical competence is validated in a specialty area of practice.
Reference: Page 28

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2. List appropriate educational preparation and certification requirements of the gerontological nurse generalist and specialist.

Question 8

Type: MCMA

An older patient with chronic health problems does not want to be admitted to a nursing home for continued care. What can the nurse explain to the patient about nursing homes today?

Standard Text: Select all that apply.

1. Nursing homes are for short-term stays.

2. Nursing homes help the patient with activities of daily living.

3. Nursing homes are being replaced with community-based services.

4. Nurses in nursing homes provide at least 5 hours of care to each patient each day.

5. Nursing homes help with bathing, toileting, meals, and medication administration,

Correct Answer: 1,2,3,5

Rationale 1: The number of discharges from nursing homes has increased over the years, which indicate that many long-term care facility residents are short-stay rehabilitation patients.
Reference: Pages 31-32

Rationale 2: Nursing home residents are assisted with activities of daily living.
Reference: Pages 31-32

Rationale 3: The decline in nursing home occupancy is attributed to more community-based services, which can delay or prevent nursing home placement in older persons.
Reference: Pages 31-32

Rationale 4: Surveys indicate that nurse staffing time in nursing homes average 3.5 hours per resident per day.
Reference: Pages 31-32

Rationale 5: Nursing homes help patients with bathing, dressing, eating, toileting, walking, and medications.
Reference: Pages 31-32

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify components of the long-term care system.

Question 9

Type: MCMA

The director of nursing at a skilled facility is implementing knowledge, skills, and attitudes to improve the quality of care of the older residents. Which criteria will be implemented?

Standard Text: Select all that apply.

1. Safety

2. Teamwork

3. Staff incentives

4. Patient-centered care

5. Quality improvement

Correct Answer: 1,2,4,5

Rationale 1: Safety is a knowledge, skill, or attitude that will improve the quality of care of the facilitys residents by minimizing risk of harm to patients and providers.
Reference: Pages 32-33

Rationale 2: Teamwork is a knowledge, skill, or attitude that will improve the quality of care of the facilitys residents by fostering open communication, mutual respect, and shared decision making to achieve better quality.
Reference: Pages 32-33

Rationale 3: Staff incentives are not a knowledge, skill, or attitude that will improve the quality of care of the facilitys residents.
Reference: Pages 32-33

Rationale 4: Patient-centered care is a knowledge, skill, or attitude that will improve the quality of care of the facilitys residents by providing care that is based upon respect for patients references, values, and needs.
Reference: Pages 32-33

Rationale 5: Quality improvement is a knowledge, skill, or attitude that will improve the quality of care of the facilitys residents by using data to monitor the outcomes of care and implement changes to continuously improve the quality.
Reference: Pages 32-33

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Recognize the basis and use of QSEN standards to support and improve quality nursing care.

Question 10

Type: MCMA

The nurse has identified a nursing intervention for an older patient that is classified as being Class IIa level B. How effective is this intervention for the patient?

Standard Text: Select all that apply.

1. Useful and effective

2. Based on expert opinion or case studies

3. Usefulness is less established by opinion.

4. Weight of evidence is in favor of efficacy.

5. Limited evidence from nonrandomized studies

Correct Answer: 4,5

Rationale 1: Class I interventions are useful and effective.
Reference: Page 37

Rationale 2: Level C interventions are based on expect opinion or case studies.
Reference: Page 37

Rationale 3: Class IIb interventions are less established by opinion.
Reference: Page 37

Rationale 4: Class IIa interventions are weighted in favor of usefulness and efficacy.
Reference: Page 37

Rationale 5: Level B interventions have limited evidence from nonrandomized studies.
Reference: Page 37

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7. Relate the uses and need for gerontological nursing research as support for evidence-based practice.

Question 11

Type: MCSA

An older patient begins to cry when talking about the death of a daughter 20 years ago. Which response should the nurse make first?

1. Assess the patient for depression.

2. Touch the patients arm and listen in silence.

3. Ask the patient to describe the details of the death.

4. Explain that crying is an effective means to express emotions.

Correct Answer: 2

Rationale 1: Assessing the patient for depression could give the patient the impression that the expression of feelings of grief is not normal or healthy.
Reference: Page 44

Rationale 2: Attentive listening is the key to effective communication, and the most appropriate response is to demonstrate empathy and support for the patient in the expression of strong feelings. Crying can be therapeutic to the older patient and offers release from persistent feelings of sadness.
Reference: Page 44

Rationale 3: Asking the patient to describe the details of the death would not support the patients needs at this time.
Reference: Page 44

Rationale 4: Explaining that crying is an effective means to express emotions is an attempt to explain the patients emotions for crying. This would not be appropriate for the nurse to do.
Reference: Page 44

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8. Summarize effective communication techniques appropriate for use with the older adult.

Question 12

Type: MCSA

After an assessment, the nurse determines that the diagnosis of Constipation is appropriate for an older patient recovering from surgery. What would be a goal for this nursing diagnosis?

1. Decrease the frequency of pain medication.

2. Know the importance of hydration and activity in regard to constipation.

3. Drink at least 1,500 ml of noncaffeinated and nonalcoholic beverages each day.

4. Evacuate a formed bowel movement at least every 2 days with minimal distress.

Correct Answer: 4

Rationale 1: Pain control would be addressed under a separate nursing diagnosis, even though constipation may be improved by decreasing the pain medication.
Reference: Pages 34-35

Rationale 2: The nurse cannot measure if the patient will know the importance of hydration and activity in regards to constipation.
Reference: Pages 34-35

Rationale 3: Increasing the patients oral intake of fluid may or may not help with the problem of constipation.
Reference: Pages 34-35

Rationale 4: The goal should be linked to the nursing diagnosisbe measurable, realistic, and achievableand include a time frame for attainment. The type and frequency of bowel movement is directly connected to the nursing diagnosis. This is an appropriate goal for the nursing diagnosis of Constipation.
Reference: Pages 34-35

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5. Apply the use of functional health patterns in the formulation of a nursing diagnosis.

Question 13

Type: MCSA

During a home visit, an older patient recovering from cardiac surgery is concerned about weakness and not being able to enjoy dancing with the spouse anymore. What would be an appropriate response for the nurse to make to the patient?

1. Its okay, honey. In time your strength will return.

2. Tell me more about not feeling able to do what you want to do.

3. What type of dancing do you want to do? Some are more strenuous than others.

4. Do you think you are pushing yourself enough to return to that type of activity in the near future?

Correct Answer: 2

Rationale 1: The nurse should not address the patient with demeaning terms like honey.
Reference: Pages 43-44

Rationale 2: Open-ended statements will encourage the patient to talk. Sentences that ask the patient to tell me more are helpful.
Reference: Pages 43-44

Rationale 3: This statement is giving the patient advice and should be avoided.
Reference: Pages 43-44

Rationale 4: This statement is giving the patient advice and should be avoided.
Reference: Pages 43-44

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8. Summarize effective communication techniques appropriate for use with the older adult.

Question 14

Type: MCSA

The gerontological nurse is identifying interventions based upon evidence-based practice. Why are these interventions preferred?

1. They reflect methods that were previously effective for a particular patient.

2. They have been highly effective in the nurses own practice and experience.

3. They are stated specifically in the policy and procedures manual of the healthcare facility.

4. They show evidence of cause-and-effect between intervention and outcomes.

Correct Answer: 4

Rationale 1: Interventions that support evidence-based practice are those that have been tested and have the best chance of establishing a cause-and-effect relationship between the intervention and the desired outcome of care. Methods that were previously effective for a patient may or may not be evidence-based practice interventions.
Reference: Page 37

Rationale 2: Interventions that support evidence-based practice are those that have been tested and have the best chance of establishing a cause-and-effect relationship between the intervention and the desired outcome of care. Interventions that are effective in the nurses own practice and experience may or may not be based upon evidence-based practice.
Reference: Page 37

Rationale 3: Interventions that support evidence-based practice are those that have been tested and have the best chance of establishing a cause-and-effect relationship between the intervention and the desired outcome of care. Policies and procedures may or may not be based upon evidence-based practice.
Reference: Page 37

Rationale 4: Interventions that support evidence-based practice are those that have been tested and have the best chance of establishing a cause-and-effect relationship between the intervention and the desired outcome of care.
Reference: Page 37

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Recognize the basis and use of QSEN standards to support and improve quality nursing care.

Question 15

Type: MCSA

Which nursing action will promote effective communication when caring for an older patient?

1. Avoiding periods of silence while communicating

2. Asking for clarification if the content is not understandable

3. Speaking loudly because most older patients are hard of hearing

4. Changing the subject if the nurse begins to feel emotional about a subject

Correct Answer: 2

Rationale 1: Silent pauses are beneficial in that they give the patient time to think and provide more information.
Reference: Pages 43-44

Rationale 2: The nurse should avoid misunderstandings by saying, Im not sure what you mean, which helps to clarify content.
Reference: Pages 43-44

Rationale 3: Yelling or speaking loudly to older patients should be avoided because yelling could be disturbing if a hearing aid is being used.
Reference: Pages 43-44

Rationale 4: Changing the subject is a barrier that could disrupt the communication process.
Reference: Pages 43-44

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8. Summarize effective communication techniques appropriate for use with the older adult.

Question 16

Type: MCSA

An older patient is being discharged to live with adult children who need to work during the day. What referral information would be beneficial for the patient and family members?

1. Transitional care unit

2. Retirement community

3. Skilled nursing facility

4. Community nursing care

Correct Answer: 4

Rationale 1: Transitional care is within an acute care hospital and provides subacute, rehabilitation, and palliative care services. This would not be appropriate for the patient who is being discharged to a home environment.
Reference: Page 40

Rationale 2: A retirement community ranges in size and scope of services. The patient would need to live there permanently and not live with family. This would not be appropriate for the patient who is being discharged to live with adult children.
Reference: Page 40

Rationale 3: A skilled nursing facility is a place where patients are admitted for subacute or chronic care. This would not be appropriate for the patient who is being discharged to a home environment.
Reference: Page 40

Rationale 4: Community nursing care such as visiting nurses is an option for many older patients requiring skilled care in the home. Visits can be made by nurses, home health aides, or homemakers.
Reference: Page 40

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify components of the long-term care system.

Question 17

Type: MCMA

The administrator at a skilled nursing facility is concerned about registered nursing vacancies in the organization. If these positions remain vacant, what could be the consequences?

Standard Text: Select all that apply.

1. Higher risk of pneumonia

2. Increased risk of aspiration

3. Reduction in pressure ulcers

4. Higher risk of patient deaths

5. Inadequate nutritional intake

Correct Answer: 1,2,4,5

Rationale 1: Inadequate nurse staffing could lead to pneumonia because of aspiration during mealtimes.
Reference: Page 31

Rationale 2: Inadequate nurse staffing could lead to poor nutrition, leading to aspiration during mealtimes.
Reference: Page 31

Rationale 3: There is no information to support that inadequate staffing would reduce the number of pressure ulcers.
Reference: Page 31

Rationale 4: Inadequate nurse staffing is associated with the risk of death among patients.
Reference: Page 31

Rationale 5: Inadequate nurse staffing is a barrier to adequate nutritional intake in nursing homes.
Reference: Page 31

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3. Identify components of the long-term care system.

Question 18

Type: MCSA

The family of an older patient asks the nurse if the patient qualifies for Medicaid to help with hospital bills. What information should the nurse provide to the family?

1. Eligibility for Medicaid is based upon income, not age.

2. Medicaid is available to individuals once they reach the age of 65.

3. Medicaid is intended to assist low-income individuals over the age of 65.

4. Older adults are eligible for Medicaid if they are planning to enter a long-term care facility.

Correct Answer: 1

Rationale 1: Medicaid is for low-income individuals. To qualify for Medicaid, the older person must spend down their assets to cover the costs of long-term care.
Reference: Page 41

Rationale 2: Medicare is a federal program available to older people and those with disabilities and certain chronic diseases.
Reference: Page 41

Rationale 3: Medicaid eligibility is based upon income level and not age.
Reference: Page 41

Rationale 4: Eligibility for Medicaid is based upon income and not age.
Reference: Page 41

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify components of the long-term care system.

Question 19

Type: MCMA

The nurse caring for older patients wants to return to school to become a gerontological nursing specialist. Which criteria would the nurse need to achieve in order to fulfill this career goal?

Standard Text: Select all that apply.

1. Have a masters degree with advanced nursing practice specialization.

2. Complete at least 500 supervised hours of providing care to older patients.

3. Have a gerontological nurse manager recommend the nurse for the credential.

4. Complete a course in advanced pathophysiology and other health-related courses.

5. Have a doctor of nursing practice degree with advanced nursing practice specialization.

Correct Answer: 1,2,4,5

Rationale 1: To be considered as a gerontological nursing specialist, the nurse would need a masters degree with advanced nursing practice specialization.
Reference: Page 29

Rationale 2: To be considered as a gerontological nursing specialist, the nurse would need to complete at least 500 supervised hours of providing care to older patients.
Reference: Page 29

Rationale 3: To be considered as a gerontological nursing specialist, the nurse would not need to have a gerontological nurse manager recommendation.
Reference: Page 29

Rationale 4: To be considered as a gerontological nursing specialist, the nurse would need to complete a course in advanced pathophysiology and other health-related courses.
Reference: Page 29

Rationale 5: To be considered as a gerontological nursing specialist, the nurse would need to have a doctor of nursing practice degree with advanced nursing practice specialization.
Reference: Page 29

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2. List appropriate educational preparation and certification requirements of the gerontological nurse generalist and specialist.

Question 20

Type: MCMA

At times, the gerontological nurse functions in the role of consultant when working with older patients. Which activities does the nurse perform while functioning in this role?

Standard Text: Select all that apply.

1. Develops clinical pathways

2. Implements evidence-based practices

3. Develops quality assurance standards

4. Provides information about regulations

5. Provides instruction about healthy aging

Correct Answer: 1,2,3

Rationale 1: As a consultant, the gerontological nurse will participate in the development of clinical pathways.
Reference: Page 32

Rationale 2: As a consultant, the gerontological nurse will participate in the implementation of evidence-based practices.
Reference: Page 32

Rationale 3: As a consultant, the gerontological nurse will participate in the development of quality assurance standards.
Reference: Page 32

Rationale 4: As a manager, the gerontological nurse will provide information about regulations.
Reference: Page 32

Rationale 5: As an educator, the gerontological nurse will provide instruction about healthy aging.
Reference: Page 32

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Describe the ANA standards and scope of practice for gerontological nursing.

Question 21

Type: MCMA

A gerontological nurse is planning an educational program to discuss the current and anticipated nursing staffing needs of the future. What should be included in the presentation?

Standard Text: Select all that apply.

1. More nurses will be needed to work in assisted living care settings.

2. The number of nursing homes has begun to increase over the last 10 years.

3. The number of nurses employed in hospital settings has increased since 1980.

4. Adding nurses has no impact on the long-term health of nursing home residents.

5. More complex nursing skills are needed to provide care in long-term care and rehabilitative care facilities.

Correct Answer: 1,5

Rationale 1: There is an increase in assistive care settings in the United States. More nurses will be needed to work in this care setting.
Reference: Page 31

Rationale 2: The current nursing home occupancy rate is 86%, and the number of beds and nursing home residents began to decline in 1999.
Reference: Page 31

Rationale 3: Hospitals remain the major employer of nurses, although the number of nurses employed in other sectors has increased.
Reference: Page 31

Rationale 4: Adding nurses to provide care will reduce the mortality rate and improve the nutritional status of patients in long-term care facilities.
Reference: Page 31

Rationale 5: Patients in long-term care and rehabilitation care facilities are more ill because hospital lengths of stays have decreased. The patients are being admitted to long-term care facilities with more health problems.
Reference: Page 31

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify components of the long-term care system.

Question 22

Type: MCMA

The nurse is planning care for an older patient with chronic illnesses. After formulating nursing diagnoses, what will guide the nurse when selecting interventions for the patients care?

Standard Text: Select all that apply.

1. Intervention linked to the desired outcome

2. Acceptance of the intervention to the patient

3. Assurance that the intervention is appropriate

4. Knowledge, experience, and skill of the nurse

5. Applicability of the intervention to teaching

Correct Answer: 1,2,3,4

Rationale 1: After formulating nursing diagnoses, nursing interventions will be selected based upon the linkage to the desired outcome.
Reference: Page 36

Rationale 2: After formulating nursing diagnoses, nursing interventions will be selected based upon acceptance of the intervention to the patient.
Reference: Page 36

Rationale 3: After formulating nursing diagnoses, nursing interventions will be selected based upon assurance that the intervention is appropriate.
Reference: Page 36

Rationale 4: After formulating nursing diagnoses, nursing interventions will be selected based upon the knowledge, experience, and skill of the nurse.
Reference: Page 36

Rationale 5: After formulating nursing diagnoses, nursing interventions are not selected upon the applicability of the intervention to teaching.
Reference: Page 36

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5. Apply the use of functional health patterns in the formulation of a nursing diagnosis.

Question 23

Type: MCSA

The nurse is planning care for a patient admitted for surgery with the primary nursing diagnosis being Knowledge Deficit related to pre- and postoperative care. Which goal statement is the most appropriate for this diagnosis?

1. The nurse will administer the prescribed medications.

2. The patient will understand the prescribed medications.

3. The patient will be afebrile during the postoperative period.

4. The patient will verbalize the purpose of preoperative medications prior to surgery.

Correct Answer: 4

Rationale 1: The statement The nurse will administer the prescribed medications is a nursing goal and not a patient goal.
Reference: Pages 35-36

Rationale 2: The statement The patient will understand the prescribed medications is not measurable.
Reference: Pages 35-36

Rationale 3: The statement The patient will be afebrile during the postoperative period does not address the problem of knowledge deficit.
Reference: Pages 35-36

Rationale 4: The statement The patient will verbalize the purpose of preoperative medications prior to surgery is specific to the nursing diagnosis, patient focused, and measurable.
Reference: Pages 35-36

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5. Apply the use of functional health patterns in the formulation of a nursing diagnosis.

Question 24

Type: MCSA

An older patient who is still physically active complains of progressive inability to maintain the home. The patient wants to research other living options and has significant financial resources. What should the nurse recommend to help meet the patients living needs?

1. Adult day care

2. Retirement community

3. Skilled-nursing facility

4. Residential care facility

Correct Answer: 2

Rationale 1: Adult day care is an option for people with multiple comorbidities or people who need daytime supervision and activities. This type of setting would not be appropriate for the patient.
Reference: Page 40

Rationale 2: A retirement community is a senior citizen community that ranges in size, scope of services, types of apartments, and different levels of activities. This is the type of facility in which the patient would most benefit.
Reference: Page 40

Rationale 3: A skilled-nursing facility is a place where skilled care is provided to residents by nurses. The care might be subacute or chronic. This setting would not be appropriate for the patient.
Reference: Page 40

Rationale 4: A residential care facility is like a rest home, usually in a large private home that has been converted to provide rooms for residents who can provide most of their own personal care but might need help with laundry, meals, and housekeeping. This type of setting would not be appropriate for the patient.
Reference: Page 40

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify components of the long-term care system.

Question 25

Type: MCMA

An older patient with end stage renal failure has stage 4 pressure ulcers on both heels and is losing weight. The patient expresses a desire to stop all care but the family is insisting that everything be done to help the patient recover. Which aspects of ethical decision making will the nurse use to help the patient and family plan future care?

Standard Text: Select all that apply.

1. Patient finances

2. Patient assessment

3. Patient preferences

4. Home environment

5. Competing interests

Correct Answer: 2,3,5

Rationale 1: Patient finances are not a part of the ethical decision-making process.
Reference: Page 43

Rationale 2: The patient assessment to include the patients condition, medical problems, nursing diagnosis, prognosis, treatment goals, and treatment recommendations is a part of the ethical decision-making process.
Reference: Page 43

Rationale 3: The patient preferences, specifically understanding of the health condition, views on quality of life, values regarding treatment, and advance directives, are a part of the ethical decision-making process.
Reference: Page 43

Rationale 4: The home environment is not a part of the ethical decision-making process.
Reference: Page 43

Rationale 5: Competing interests, specifically the interests of the family, healthcare providers, healthcare organization, and futile utilization of scarce resources is a part of the ethical decision making process.
Reference: Page 43

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8. Summarize effective communication techniques appropriate for use with the older adult.

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