TEST BANK For Ebersole and Hess Gerontological Nursing and Healthy Aging 6th Edition by Touhy Verified Chapter's 1 - 28 Complete

Test Bank Ebersole and Hess’ Gerontological Nursing & Healthy Aging
6th Edition
by Theris A. Touhy, and Kathleen F Jet
Chapter 1 – 28
Test Bank Ebersole and Hess’ Gerontological Nursing & Healthy Aging
6th Edition
Chapter 01: Introduction to Healthy Aging

Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 6th
Edition
MULTIPLE CHOICE
1. A man is terminally ill with end-stage prostate cancer. Which is the best statement about
this man’s wellness?
a.
Wellness can only be achieved with aggressive medical interventions.
b.
Wellness is not a real option for this client because he is terminally ill.
c.
Wellness is defined as the absence of disease.
d.
Nursing interventions can help empower a client to achieve a higher level
of wellness.
ANS: D
Nursing interventions can help empower a client to achieve a higher level of wellness; a
nurse can foster wellness in his or her clients. Wellness is defined by the individual and is
multidimensional. It is not just the absence of disease. A wellness perspective is based on the
belief that every person has an optimal level of health independent of his or her situation or
functional level. Even in the presence of chronic illness or while dying, a movement toward
wellness is possible if emphasis of care is placed on the promotion of well-being in a
supportive environment.
PTS: 1 DIF: Apply REF: p. 7 TOP: Nursing Process:

Diagnosis MSC: Health Promotion and Maintenance
N R I G B . C M
2. In differentiating between he alUth aSnd wNe llTne ss in hOe alth
care, which of the following statements is true?
a.
Health is a broad term encompassing attitudes and behaviors.
b.
The concept of illness prevention was never considered by previous generations.
c.
Wellness and self-actualization develop through learning and growth.
d.
Wellness is impossible when one’s health is compromised.
ANS: A
Health is a broad term that encompasses attitudes and behaviors; holistically, health includes
wellness, which involves one’s whole being. The concept of illness prevention was never
considered by previous generations; throughout history, basic self-care requirements have
been recognized. Wellness and self-actualization develop through learning and growth—as
basic needs are met, higher level needs can be satisfied in turn, with ever-deepening richness
to life. Wellness is possible when one’s health is compromised—even with chronic illness,
with multiple disabilities, or in dying, movement toward a higher level of wellness is
possible.
PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation
MSC: Health Promotion and Maintenance
3. Which racial or ethnic group has the highest life expectancy in the United States?
a.
Native Americans
b.
African Americans
c.
Hispanic Americans
d.
Asian and Pacific Island Americans
Chapter 02: Cross-Cultural Caring and Aging
Edition
MULTIPLE CHOICE
1. Which of the following is a true statement about differing health belief systems?
a.
Personalistic or magicoreligious beliefs have been superseded in Western minds
by biomedical principles.
b.
In most cultures, older adults are likely to treat themselves using
traditional methods before turning to biomedical professionals.
c.
Ayurvedic medicine is another name for traditional Chinese medicine.
d.
The belief that health depends on maintaining a balance among opposite
qualities is characteristic of a magicoreligious belief system.
ANS: B
Older adults in most cultures usually have had experience with traditional methods that have
worked as well as expected. After these treatments fail, older adults turn to the formal health
care system. Even in the United States, it is common for older adults to pray for cures or
wonder what they did to incur an illness as punishment. The Ayurvedic system is a
naturalistic health belief system practiced in India and in some neighboring countries. This
belief is characteristic of a holistic or naturalistic approach.
PTS: 1 DIF: Understand REF: p. 16-17

TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance
N R I G B . C M
2. Which of the following consi deUra tiSo nsNis mTo st li kOel y to be
true when working with an interpreter?
a.
An interpreter is never needed if the nurse speaks the same language as the patient.
b.
When working with interpreters, the nurse can use technical terms or metaphors.
c.
A patient’s young granddaughter who speaks fluent English would make the
best interpreter because she is familiar with and loves the patient.
d.
The nurse should face the patient rather than the interpreter.
ANS: D
The nurse should face the patient rather than the interpreter is a true statement; the intent is to
converse with the patient, not with a third party about the patient. Many reasons may prevent
the patient from speaking directly to a nurse. Technical terms and metaphors may be difficult
or impossible to translate. Cultural restrictions may prevent some topics from being spoken of
to a grandparent or child.

TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment
3. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and
refuses to remain in the bed. Which intervention should the nurse use to promote and
maintain his health?
a.
Have the health care provider speak to him.
b.
Use principles of the holistic health system.
c.
Ask about his perceptions and treatment ideas.
d.
Consult with a practitioner of Chinese medicine.
ANS: C
Using the LEARN model (listen with sympathy to the patient’s perception of the problem,
explain your perception of the problem, acknowledge the differences and similarities,
recommend treatment, and negotiate agreement), the nurse gathers information from the
patient about cultural beliefs concerning health care and avoids stereotyping the patient. In
the assessment, the nurse determines what the patient believes about caregiving, decision
making, treatment, and other pertinent health-related information. Speaking with the health
care provider is premature until the assessment is complete. Unless he accepts the beliefs,
principles of the holistic health system can be potentially unsuitable and insulting for this
patient. Unless he accepts the treatments, consulting with a practitioner of Chinese medicine
can also be unsuitable and insulting for this patient.
PTS: 1 DIF: Apply REF: p. 18

TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
4. Which action should the nurse take when addressing older adults?
a.
Speak in an exaggerated pitch.
b.
Use a lower quality of speech.
c.
Use endearing terms such as “honey.”
d.
Speak clearly.
ANS: D
Some health professionals demonstrate ageism, in part because providers tend to see many
frail, older persons and fewer of those who are healthy and active. Providers should not
assume that all older adults are hearing or mentally impaired. The most appropriate action
when addressing an older aduNlt wRoulId beGto Bsp.eaCk cMlearly. Examples of
U S N T O
unintentional ageism in language are an exaggerated pitch, a demeaning emotional tone,
and a lower quality of speech.

5. The nurse prepares an older woman, who is Polish, for discharge through an interpreter
and notes that she becomes tense during the instructions about elimination. Which
intervention should the nurse implement?
a.
Move on to the discussion about medication.
b.
Ask the older woman how she feels about this topic.
c.
Instruct the interpreter to repeat the instructions.
d.
Have the older woman repeat the instructions for clarity.
ANS: B
When working with an interpreter, the nurse closely watches the older adult for nonverbal
communication and emotion regarding a specific topic and therefore validates the assessment
about the older adult’s tension before proceeding. Because the nurse notices her tension, the
nurse temporarily suspends the preparation to validate her assessment. If the nurse proceeds
and the older adult is uncomfortable discussing elimination, then important instructions can
be missed, leading to adverse effects for the older adult. Repeating the instructions can
aggravate the older adult’s discomfort. Instructing the older adult to repeat the nurse’s
instruction ignores her needs.
PTS: 1 DIF: Apply REF: p. 18-19
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
6. The nurse plans care for an older African American man who is from Jamaica and resides
in New York City. Which should the nurse include in planning care?
a.
Attribute his illness to breaking a voodoo.
b.
Help him improve social relationships.
c.
Maintain blood pressure below 120/70 mm Hg.
d.
Review the principles of the magicoreligious system.
ANS: C
Because African Americans tend to be at risk for cardiovascular disease and hypertension,
the nurse plans to maintain the patient’s blood pressure at or below the current
recommendation by the American Heart Association. The nurse can be incorrectly assuming
that he practices and believes in the magicoreligious system. The nurse should assess his
spiritual beliefs and determine how much they influence his attitudes toward Western health
care. The magicoreligious system maintains social relationships in good condition to prevent
illness; however, if the older adult does not follow this cultural practice, then this goal can be
unsuitable. The older adult may not believe in this system; therefore, the information can be
irrelevant.
PTS: 1 DIF: Apply REF: p. 18-19 TOP: Nursing Process:

Planning MSC: Safe, Effective Care Environment
7. Which health belief system uses treatments to repair a body part?

a.
Holistic .
b.
Biomedical
c.
Personalistic
d.
Magicoreligious
ANS: B
Because dysfunction or a structural abnormality is thought to cause disease, the biomedical
system believes in repairing the structural abnormality. The holistic system holds that health
is attained through balance. The personalistic system uses treatments such as meditation,
fasting, and praying. The magicoreligious system is the same as the personalistic system.
PTS: 1 DIF: Understand REF: p. 17

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment
8. A nurse is caring for a culturally diverse patient who has missed follow-up appointments
with the primary care provider three times over the past year. The patient has a chronic
illness that requires periodic monitoring of blood test values. The patient tells the nurse:
“You don’t understand—in my culture, we don’t do things like that. I cannot be troubled
with worrying about appointments in the future; I deal with each day as it comes.” The nurse
understands which of the following about the patient’s culture?
a.
The culture does not value Western medicine.
b.
The culture has a different orientation to time than Western medicine.
c.
The culture is an interdependent culture.
d.
The culture does not believe in preventative care.
ANS: B
Time orientation is a culturally constructed factor. Westernized medical care is future
oriented. Conflicts between future oriented Westernized medical care and those with a
present or past time orientation may arise. Patients are likely to be labeled as noncompliant
for failing to keep appointments.
PTS: 1 DIF: Understand REF: p. 15-17 TOP: Nursing Process:

Planning MSC: Safe, Effective Care Environment
9. A paper on culture and illness would be likely to include the statement that
a.
culture is the same as ethnicity.
b.
ethnic groups always share common geographic origin and religion.
c.
ethnicity involves recognized traditions, symbols, and literature.
d.
most members of an ethnic group exhibit identical cultural traits.
ANS: C
Ethnicity is a complex phenomenon that includes traditions, symbols, literature, folklore, food
preferences, and dress. It is a shared identity. Ethnicity is more than just culture. It is social
differentiation based on culture. Even within ethnic groups, there is considerable diversity.
PTS: 1 DIF: Remember REF: p. 12 TOP: Teaching and Learning

MSC: Psychosocial Integrity
10. A home care nurse is caring for an older patient from a different culture who is bedbound
and high risk for development of a pressure ulcer. The nurse discusses the plan of care with
the patient’s daughter, emphasizing the importance of turning every 2 hours, and posts a
turning clock on the wall. When the nurse returns later in the week, the turning clock has
been
removed, and the patient’s daNuUghRteSr IreNpoGrtTs Bth.atCsOheMturns her mother
occasionally. She states, “I am taking very good care of my mother. You just don’t
understand—our ways do not
involve doing things on schedules.” The best response by the nurse is:
a.
“You must follow my guidelines and turn her every 2 hours, or I will not be able
to take care of her.”
b.
“I understand that you value your culture, but culture cannot stop you
from providing good care to your mother.”
c.
‘I understand that you care very much for your mother. Perhaps caring for her
is too much for you.”
d.
“How can we best work together to provide the best care for your mother?”
ANS: D
In providing cross-cultural care, it is important that the nurse work with the patient and
family and listen carefully and find a way to include the values and beliefs of the patient in
the plan of care.
PTS: 1 DIF: Analyze REF: p. 15

TOP: Communication and Documentation MSC: Psychosocial Integrity
11. An older patient learns that she has metastatic cancer. The patient states: “I must have
angered God.” This is an example of which type of belief?
a.
Biomedical
b.
Magicoreligious
c.
Naturalistic
d.
Ayurvedic
ANS: B
Magicoreligious beliefs view illness as caused by actions of a higher authority. Biomedical
beliefs view disease as a result of abnormalities in structure and function and disease caused
by intrusion of pathogens into the body. Naturalistic beliefs are based on the concepts of
balance; health is seen as a sign of balance. Ayurvedic beliefs are of the oldest known
paradigm in the naturalistic system; illness is seen as an imbalance.
PTS: 1 DIF: Remember REF: p. 17

12. The term health disparity is defined as

a.
the systematic elimination of the culture of another resulting in decreased wellness.
b.
differences in health outcomes among groups.
c.
the difference between an expected incidence and prevalence and that
which actually occurs in a comparison population group.
d.
the existence of more than one group with differing values and perspective.
ANS: B
Health disparities are defined as differences in health outcomes among groups. Cultural
destructiveness is defined as the systematic elimination of the culture of another. Health
inequities are defined as the difference between an expected incidence and prevalence and
that which actually occurs in a comparison population group. Cultural diversity is defined as
the existence of more than one group with differing values and perspective.

MSC: Psychosocial Integrity .
MULTIPLE RESPONSE
1. The nurse is assessing an older adult from a culture different than the nurse’s by asking
questions from the explanatory model for culturally sensitive assessment. Which
question(s) should the nurse ask to follow this model? (Select all that apply.)
a.
How can we negotiate to solve the problem?
b.
What treatment can improve your condition?
c.
Should we try my plan first to see if it helps?
d.
Can we discuss differences in our plans now?
e.
How long have you experienced the problem?
f.
Who, other than me, can make you feel better?
ANS: B, E, F
Asking about potential therapies is a question from the explanatory model and asks what the
individual believes will help clear up the problem. The nurse asks about the duration of the
problem as a part of applying the explanatory model. The nurse asks about other disciplines
that the individual believes can be therapeutic. This question is based on the LEARN model.

2. A nurse caring for older adults must be aware of which consequences of ageism in
language? (Select all that apply.)
a.
Reduced sense of self
b.
Poor nutritional intake
c.
Lowered sense of self-competence
d.
Decreased memory performance
ANS: A, C, D
Some health professionals demonstrate ageism, in part because providers tend to see many
frail, older persons and fewer of those who are healthy and active. Consequences of
ageism have been identified as a reduced sense of self, lowered self-esteem, lowered sense
of
self-competence, and decreased memory performance. Poor nutritional intake has not
been identified as a consequence.

3. Which factor(s) is/are associated with the provision of culturally competent care? (Select
all that apply.)
a.
Cultural awareness
b.
Cultural knowledge
c.
Cultural skills
d.
Cultural connections
e.
Knowledge of specific details of traditions and practices of all the
different cultures
ANS: A, B
As nurses move toward cultuNral cRomIpeteGnceB, t.heCy inMcrease their cultural
U S N T O
awareness, knowledge, and skills. Cultural competence means having the skills to put cultural
knowledge to use in assessment, communication, negotiation, and intervention. Cultural
connections have
not been identified as a factor.

4. A nurse completes a cultural assessment of an older adult who is being admitted to an

assisted living facility. Reasons for completing a cultural assessment include (Select all that
apply.)
a.
culture guides decision making about health, illness, and preventive care.
b.
culture provides direction for individuals on how to interact during health
care encounters.
c.
culture impacts attitudes toward aging.
d.
all members of a culture react in the same way in similar situations.
e.
knowledge of culture eliminates health care disparities.
ANS: A, B, C
Although knowledge of culture has the potential to optimize care, not all individuals will
respond in the same way to a specific situation. Knowledge of an individual’s culture will not
eliminate health care disparities.
PTS: 1 DIF: Understand REF: p. 15-16 TOP: Teaching and Learning

5. A nurse in the ambulatory care setting is preparing to do an interview with a
non–English-speaking client. The nurse secures an interpreter. To have the most effective
interview, the nurse should do which of the following? (Select all that apply.)
a.
Look and speak to the interpreter.
b.
Use technical terminology to ensure accuracy.
c.
Allow more time for the interview.
d.
Watch the client’s nonverbal communication.
e.
Through the interpreter, check whether the client understands the communication.
ANS: C, D, E
For the most effective interview the nurse should look and speak directly to the client; avoid
the use of jargon and technical terminology; observe the client’s nonverbal communications;
and clarify understanding by asking the client to state in his or her own words what he or
she understood, facilitated by the interpreter. The interview will naturally take longer.
PTS: 1 DIF: Remember REF: p. 18-19

.
ANS: C
As shown in Figure 1.4, Hispanic men and women have the highest life expectancy of all. In
2011, for those of Hispanic origin of any race, the overall life expectancy at 65 years of age
was 20.7 more years in 2011 (19.1 years for men and 21.8 years for women).

4. Historical influences that have shaped the lives of the majority of the in-between cohort in
the United States today include which of the following?
a.
Influenza epidemic of 1918
b.
World War I
c.
Child rearing in the Depression
d.
World War II
ANS: D
Those who are in the in-between cohort in 2016 were born between 1915 and 1945. The men
were likely to have fought in World War II. The last of the Holocaust survivors are in this
group. A person who survived the influenza epidemic would be at least 98 years old in 2016
and therefore would be considered old-old or a centenarian. Most of those who are of the
in-between cohort had not reached childbearing age by the end of the Depression. Individuals
in the in-between cohort would not have been old enough to fight in World War II.

5. According to researchers, whNich RchaIractGeristBic.dCo mMost centenarians share?
a.
Female U S N T O
b.
Hispanic
c.
Living in rural
areas
d.
Located in the Midwestern states
ANS: A
Based on the U.S. census report of 2010, centenarians were overwhelmingly white, female,
and living in the urban areas of the Southern states.

6. Which nursing intervention is a holistic approach to an older adult?

a.
Performs glucose testing during the weekly worship service
b.
Wheels ambulatory adults to exercise when running late
c.
Assigns female nurses to older women who are Islamic
d.
Allows older adults in a nursing home to eat meals alone
ANS: C
The nurse uses a holistic approach to the care of an older female adult who is Islamic because
the woman and her family are more likely to be willing participants in a therapeutic regimen
that respects a tenet of their culture. Interrupting an older adult’s worship with glucose testing
can be interpreted as a lack of respect for spiritual needs. The nurse can provide for and
respect the physical and spiritual aspects of the older adult’s life by testing for glucose before
the service begins. In transporting ambulatory adults to the exercise program in wheelchairs
to save time, the nurse disregards the need for self-esteem and exercise, both important
aspects of physical well-being. Ambulatory adults can walk with assistance, if needed, to
exercise programs and can benefit from the additional activity and independence. The nurse
can be tempted to allow an older adult to eat meals alone in his or her room if this will
motivate the person to eat or if the older adult has dysphasia and is embarrassed. However,
although focusing on physical needs, the nurse ignores psychosocial and other aspects of
health and well-being.

7. An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL.
Which nursing intervention is most likely to assist this man in achieving his highest level
of wellness?
a.
Instruct him about increasing dietary fiber.
b.
Ask the health care provider for a low-fat diet.
c.
Schedule a consultation for him with the dietitian.
d.
Review a menu with him to choose suitable foods.
ANS: D
The nurse collaborates with the older adult to choose suitable foods, which is likely to be an
effective nursing interventionNtUoRheISlp GaNn oTlder aduOlt with hyperlipidemia achieve
optimal
health and well-being; it gives him some control over the regimen and thus engages him in
the process of lowering serum cholesterol. Informing the older man about dietary fiber offers
no control to him because he is not part of the decision. Nursing interventions developed with
the older adult’s collaboration are most likely to help the older adult achieve health and
wellness. Collaborating with the health care provider for a low-fat diet is a reasonable
approach to help this man with hyperlipidemia to achieve health and wellness. However, he is
more likely to have motivation and enthusiasm for a therapeutic regimen over which he has
had some control. Scheduling a consultation with a dietitian is a reasonable approach to an
older adult with hyperlipidemia and is a part of a multifaceted approach to optimizing his
health.
However, the older adult is more likely to engage in a regimen over which he has input.
PTS: 1 DIF: Analyze REF: p. 7 TOP: Nursing Process: Planning

8. Which approach requires the nurse to integrate and balance all aspects of an individual’s
life into the plan of care?
a.
Holistic nursing
b.
Healthy People 2020
c.
Maslow’s hierarchy of human needs
d.
Orem’s self-care requirements
ANS: A
Holistic nursing integrates all aspects of an individual’s life into the plan of care by
balancing an individual’s internal and external environment with psychosocial, spiritual,
cultural, and physical processes. Healthy People 2020, an updated document from 2000 that
outlines the goals for achieving health in this country, is a mandate for health care
professionals to follow with 467 objectives in 28 focus areas. Maslow’s hierarchy of human
needs provides a basis for understanding individuals in context and for ranking nursing
assessments, diagnoses, goals, and interventions in order of importance. Dorothea Orem’s
self-care requirements lists human needs, including the need for air, fluids, nutrition,
hygiene, elimination, activity, comfort, relief from suffering, and skin integrity. The nurse
helps individuals meet these needs to achieve optimal health and wellness.

9. The nurse plans activities for older women born between 1920 and 1930 and who reside in
an assisted-living facility. Which is the best intervention for the nurse to implement?
a.
Have them bake cookies twice a week.
b.
Conduct interviews for specific interests.
c.
Arrange dog and cat visits from volunteers.
d.
Take them to the library for guest speakers.
ANS: B
The nurse conducts individual interviews with the women to determine their interests and to
avoid generalizing; as people live longer, they become more and more unique. Because most
of these women are in their 80s and 90s were born between 1920 and 1930 and have
generally spent their lives as homemakers, the nurse presumes to know what activities they
will enjoy.
The nurse avoids arranging group activities until individual interests are determined. In
addition, the nurse must assess NUforR SIalleG
Nrgie Ts and inOdividual fears of animals before
B.C
exposing an
older adult to a pet visit. Unless it is organized on a voluntary basis, the nurse avoids
arranging visits by guest speakers. In addition, the nurse will assess each older woman before
an outside visit to avoid embarrassing events, including incontinence and hearing and vision
problems.

10. Which of the following issues in the care of older adults are identified in Healthy
People 2020?
a.
Delineating nursing staffing levels in long term care
b.
Eradicating pressure ulcers in all care settings
c.
Identifying minimum levels of training for people who care for older adults
d.
Instituting mandatory training in identification of elder abuse for all caregivers
of older adults
ANS: C
Identifying minimum training levels for people who care for older adults is one of the issues
identified in Healthy People 2020. The rest of the issues are not discussed in Healthy
People 2020.

Test Bank Ebersole and Hess’ Gerontological
Nursing & Healthy Aging 6th Edition
by Theris A. Touhy, and Kathleen F Jet
Chapter 1 – 28
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Chapter 03: Biological Theories of Aging and Age-Related Physical Changes
Edition
MULTIPLE CHOICE
1. Decreased functioning of which physical structure is likely to result in decreased

metabolism in older adults?
a.
Kidney
b.
Thyroid gland
c.
Brain
d.
Skeleton
ANS: B
Secretion of thyroid hormones tends to decrease with age, resulting in a greater likelihood of
a slower metabolism, hypothyroidism, and thinning hair and nails. Decreased kidney function
leads to decreased glomerular filtration rate and the ability of the kidneys to concentrate urine
and clear waste. Decreasing brain function tends to result in decreased cognitive functioning.
Osteoclastic activity tends to decrease with age, increasing the risk for osteopenia and
osteoporosis.

TOP: Nursing Process: Assessment MSC: Physiological Integrity
2. An older female patient is reading a large-print magazine and states that reading is difficult
for her in the evening. Which intervention should the nurse implement?
a.
Put a high-intensity lamp N aUtRtheS
IheGNad oTf her beOd.
b.
Explain to her that the gray-yellow ring around her cornea, arcus senilis,
is interfering with visual acuity.
c.
Put more powerful tubes in the fluorescent room lights.
d.
Examine her retinas for signs of damage.
ANS: A
The pupils become gradually smaller with age; therefore, the eye requires three times as much
light. A high-intensity light on the object of interest is more effective than increasing the
overall room illumination. The arcus senilis does not affect vision. The patient is describing a
gradual overall change, not the more localized or sudden effects of macular degeneration or
retinal detachment.

3. Aging ordinarily leads to decreases in which of the following?

a.
Creatinine clearance and insulin secretion
b.
Blood carbon dioxide and saliva production
c.
Left ventricle-wall thickness and skin healing time
d.
Serum triiodothyronine (T3) and gastric pepsin
ANS: D
Serum T3 and pepsin secretion both decrease with aging. Creatinine clearance declines, but
insulin secretion normally remains stable. Saliva production decreases, but blood carbon
dioxide normally remains unchanged. Left ventricle wall thickness and skin healing time
both increase with aging.

4. Which change in the skin is abnormal in an older person?

a.
Thinner and more fragile skin
b.
Red, swollen 3-day-old wound
c.
Greater number of freckles
d.
Loss of hair on the extremities
ANS: B
Although the skin of an older person may require 48 to 72 hours to mount an initial
inflammatory response to a wound, increasing redness after that time, particularly with
purulent discharge, is a sign of infection. This change is normal as ridges in the skin are lost.
Melanin distribution becomes more uneven with age. Hair is commonly lost from the legs and
other areas of older adults. Hair loss from the legs is not a sign of peripheral vascular disease.

5. The nurse designs a group exercise program at a senior center. Which room should the
nurse choose for the program?
a.
Room with a beautiful hardwood floor tastefully appointed with throw rugs
b.
Spacious room with no wNinUdoRwSsIbNutGwTitBh .fluCoOreMscent
lighting and a natural stone floor
c.
Room with a hardwood floor and large windows overlooking a garden area
d.
End room with a linoleum floor and a fan for ventilation to compensate for
the room’s broken air conditioner
ANS: C
The hardwood floor provides an even surface. If the daylight from the large windows causes a
glare problem, then curtains may be used. Throw rugs can slide underfoot and can lead to a
fall, particularly when the sense of balance has declined with age. Fluorescent lighting can
lead to a glare problem, and the irregularities of the natural stone floor can lead to a fall. The
linoleum floor also presents a glare problem, and overheating is a risk in older persons who
have a reduced sweat-gland response to heat.

6. The latest trends in medicine encourage health care providers to prescribe nutrient-dense
foods and exercise to prevent or delay the shortening of telomeres. On which biological
theory of aging are these practices based?
a.
Genetic research
b.
Caloric restriction
c.
Oxidative stress
d.
Cross-link
ANS: A
Genetic researchers have found that telomeres shorten with each cellular reproduction and
continue to do so until the cell dies. Selected animal studies since the 1930s conclude that
calorie restrictions of 30% can lead to a longer life expectancy, slower metabolism, lower
body temperature, and delay of age-related disorders. The pacemaker theory, which is also
known as the neuroendocrine control theory, holds that critical functions of selected
endocrine glands slow and can halt with age. The cross-link theory suggests that aging is a
result of the stiffening of proteins caused by cross-linking, leading to stiffer joints, rougher
skin, and decreased cellular elasticity.

7. During a nursing assessment, an older adult tells the nurse about increasing loss of
balance. Further assessment indicates musculoskeletal changes. Which patient teaching
should the nurse implement to address musculoskeletal reasons for the loss of balance?
a.
Exercise with light weights.
b.
Stand on one foot at a time while supported.
c.
Train with the use of sit-ups.
d.
Work out in a swimming pool.
ANS: B
The loss of balance from a musculoskeletal perspective is usually caused by a loss of core
muscle strength; thus, the nurse suggests standing on one foot at a time while holding onto a
chair back, if necessary, and working to increase the duration of the exercise. Lifting weights
helps increase muscle strength. Sit-ups are contraindicated for older adults because they put
tremendous amounts of stressNonRtheIlumGbarBsp.iCne. MLow-impact aerobic
U Sand endurance.
exercise helps improve conditioning

TOP: Nursing Process: Implementation MSC: Teaching and Learning
8. Which age-related change contributes to anorexia and weight loss in older adults?
a.
Excessive saliva
b.
Fewer taste buds
c.
Wearing dentures
d.
Softened tooth enamel
ANS: B
The number of taste buds declines with age and can decrease the enjoyment of food, which
can result in less motivation to eat and a resulting weight loss or loss of appetite. Saliva
production tends to decrease with age. As long as dentures fit properly and the wearer
practices good oral hygiene, wearing dentures does not necessarily contribute to anorexia and
weight loss. Older adults tend to lose enamel.

9. A nurse is caring for an older adult who asks the following: “I have heard that it is important
to eat a diet that is high in fruits and vegetables to age successfully. Is that correct?” The
nurse considers which of the following theories of aging when responding to the older adult’s
question?
a.
Oxidative stress theory
b.
Immunological theory
c.
Free radical theory
d.
Telomere theory
ANS: C
Although the intake of supplemental antioxidants is deleterious to one’s health, there is
evidence that diets inclusive of natural antioxidants, such as those high in fruits and
vegetables or a Mediterranean diet rich in red wine and olive oil, are healthful.

TOP: Nursing Process: Implementation MSC: Physiological Integrity
10. The family member of a patient asks a nurse if vitamin C will prevent aging. In formulating
a response, the nurse considers which of the following theories?
a.
Free radical theory
b.
Immunological theory
c.
d.
Telomere theory
ANS: A
The free radical theory posits that aging is a result of random damage from free radicals.
Research is ongoing on the ability of substances with antioxidant effects to counter the
actions
of free radicals. For many yeNarUs, RitSwIasNtGhoTuBgh.t CthOatMconsumption of
supplemental antioxidants, such as vitamin C, could delay of minimize the effects of aging.

11. A community health nurse provides an annual flu prevention workshop at a local senior
center. The activities include a lecture on preventing infections, which includes hand
washing and limiting exposure to individuals who are ill, as well as an influenza
immunization clinic. The nurse is basing her activities on what theory of aging?
a.
Free radical theory
b.
Immunologic theory
c.
d.
Telomere theory
ANS: B
The immunologic theory of aging describes changes in cells of the immune system, which
make an older person more susceptible to infection. Prevention of infection is very important
in older adults and can be accomplished by education and immunization.

12. A nurse is caring for an older patient in the hospital who reports: “I am worried because
simple tasks such as balancing my checkbook seem to take me longer. Is there
something wrong with me?” The best response by the nurse is:
a.
“As you age, normal changes in the brain occur that make central processing
take longer, so don’t worry.”
b.
“You have every reason to be concerned. This is an abnormal finding; we need
to contact your physician.”
c.
“As you age, changes in the brain lead to decreased intellectual performance,
so don’t worry.”
d.
“Any changes in function are a cause for worry. You need to be
evaluated immediately.”
ANS: A
As one ages, central processing slows down, which may make performance of tasks slower.
This is not an abnormal finding in older adults. Intellectual performance without brain
dysfunction remains constant. Many changes in function are part of normal aging.

13. An older woman was seen in her physician’s office after falling at home. The patient
receives a comprehensive assessment, and it is determined that she has a positive urine
culture and is started on antibiotic therapy for a urinary tract infection (UTI). The patient is
surprised at the diagnosis. The woman reported that she had experienced some pain on
urination the previous day but did not think that she had a UTI because her temperature was
only 99°F. One reason why the patient may not have developed a higher temperature is
a.
the patient’s UTI was not yet ser ious eno u gh to cause a significant increase in
body temperature.
NU R S NI T G OB . C M
b.
normal age-related changes to the immune system function affect an older
person’s response to illness; a low-grade fever may signify serious illness.
c.
older adults do not run fevers when they are ill.
d.
this patient likely has an alteration to her immune system that impacts her
response to infection.
ANS: B
Change in immune function affect an older person’s response to illness consistent with the
immunologic theory of aging. Older adults typically have lower core body temperatures. A
lack of fever cannot be used to rule out infection. The nurse needs to consider the patient
from a holistic perspective. A recent fall is often an atypical presentation of a serious illness
or infection.

MULTIPLE RESPONSE
1. Which factor(s) associated with aging contribute(s) to the high incidence of type 2
diabetes mellitus in older adults? (Select all that apply.)
a.
Fewer T lymphocytes
b.
Less lean muscle mass
c.
Decreased thyroid function
d.
Decreased physical activity
e.
Left ventricular hypertrophy
f.
Decreased insulin sensitivity
ANS: B, C, D, F
Less lean muscle mass means that the body has fewer insulin receptor sites; thus, glucose
circulates in the blood stream longer, leading to hyperglycemia and type 2 diabetes mellitus.
Decreased thyroid function decreases the metabolic rate. If the metabolic rate decreases
without a corresponding decrease in caloric intake, then the body consumes more food than it
needs for its metabolic rate, and hyperglycemia occurs. Decreased physical activity
contributes to type 2 diabetes in two ways. First, a less active person has less lean muscle
mass than an active person. Second, physical activity helps metabolize glucose; if activity
decreases and food consumption does not decrease, then hyperglycemia occurs. Insulin
sensitivity decreases with age and increases the need for insulin in older adults. To prevent
hyperglycemia, older adults must increase physical activity and decrease food consumption.
Fewer T lymphocytes are associated with age-related changes caused by autoimmune
reactions wherein the body recognizes itself as a foreign substance and works to destroy it.
Type 1 diabetes mellitus is considered an autoimmune disorder. Left ventricular hypertrophy
is not directly related to the increased incidence of type 2 diabetes in older adults; however,
if hypertrophy leads to exercise intolerance, then it can be related to an increased incidence
of type 2 diabetes.

2. When caring for an older man patient, the nurse is aware that which changes are
N R IsysGUtemSandNagiTng? (SeOlect all that apply.)
associated with the male reproductive
a.
Testes soften.
b.
Seminiferous tubules thicken.
c.
Sperm count decreases.
d.
Ejaculation is slower.
e.
Incontinence is common.
ANS: A, B, D
Although men have the ability to produce sperm throughout their lives, they also experience
changes in the functioning of the reproductive and the urogenital organs in later life. The
changes are usually more subtle and noticed only as they accumulate, beginning when men
are in their 50s. The testes atrophy and soften. The seminiferous tubules thicken, and
obstruction caused by sclerosis and fibrosis can occur. Although sperm count does not
decrease, fertility may be reduced because of a higher number of sperm lack motility or have
structural abnormalities. Erectile changes are also seen; more stimulation is needed to
achieve a full erection, ejaculation is slower and less forceful, and refractory periods are
longer.
Incontinence is not a normal age-related change.

3. A nurse performs an assessment of an older adult’s oral cavity. Which of the

following findings are normal age related changes? (Select all that apply.)
a.
Missing teeth
b.
Recession of gums
c.
A white film on the tongue
d.
Decreased saliva production
e.
Gums that bleed easily
ANS: A, B, D
There are many age-related changes in the oral cavity. With wear and tear, teeth lose enamel
and dentin and become more vulnerable to decay. Without care, teeth may be lost. Gums
recede, and there is a decrease in saliva production. Bleeding gums is indicative of infection,
and a white film on the tongue is also indicative of an infection.

4. A nurse is caring for an older adult in the hospital who reports decreased hearing. Which
of the following interventions should the nurse use when communicating with this patient?
(Select all that apply.)
a.
Raise the pitch of the voice when speaking with the patient.
b.
Speak very slowly using simple words when speaking to the patient.
c.
Face the patient when speaking.
d.
Decrease background noise when speaking with the patient.
e.
Obtain a sign language interpreter to speak with the patient.
ANS: C, D
With normal age-related hearing loss, the patient can still hear, so a sign language interpreter
would not be appropriate. In addition, it is not known whether or not this patient is able to
communicate in sign language. Presbycusis, age-related hearing loss, is primarily the loss of
the ability to hear high-frequeNncyRsoIundGs. TBhe.reCforeM, raising the pitch of the
voice would not help the situation.U S N Tvery slowly and using simple words may be
Speaking
seen as demeaning to the patient. It is important to face the patient and to decrease
background noise. Facing the
patient is helpful if the patient reads lips.

11. An older man asks a nurse: “How do you define aging? Do I meet the criteria of a senior
citizen?” The nurse understands that one can define aging in many different manners. If
the nurse chooses to define aging as “social aging,” the nurse would consider which of the
following aspects?
a.
The man retired from his job as a police officer.
b.
The man takes six different medications multiple times over the course of the day.
c.
The man walks with a rolling walker.
d.
The man celebrated his 66th birthday.
ANS: A
Social aging is determined by changes in roles. Taking multiple medications multiple
times over the course of the day and walking with a rolling walker are functional
determinants of aging. Age refers to chronological aging.

12. The holistic health movement has impacted health care in which of the following ways?
a.
It has focused health care on disease prevention.
b.
It has reshaped how health and health care are perceived.
c.
It has improved access to health care.
d.
It has introduced numerous alternative modalities into health care.
ANS: B
The holistic paradigm has reshaped how health and health care are perceived. Wellness is
seen as a state of being which can be defined anywhere along the continuum of health.
N R I G B.C M
PTS: 1 U S NREF:
DIF: Understand T p. 7 TOP: Teaching and Learning
MULTIPLE RESPONSE
1. According to Healthy People 2020, older adults have been identified as a priority, with a
goal to improve their health, function, and quality of life. Identify the targeted chronic focus
areas for improvement. (Select all that apply.)
a.
Diabetes
b.
Arthritis
c.
Congestive heart failure
d.
Dementia
e.
Cancer
f.
Pressure ulcers
ANS: A, B, C, D
In a push toward wellness, older adults were identified as a priority area for the first time.
The targeted chronic areas of focus were identified as diabetes, arthritis, congestive heart
failure, and dementia.
PTS: 1 DIF: Remember REF: p. 8 TOP: Nursing Process: Planning

2. Identify the Healthy People 2020 emerging issues in the health of older adults. (Select all
that apply.)
a.
Coordinating care for the older adult population
b.
Assisting older adults in the management of their own care
c.
Identifying levels of training for those caring for older adults
d.
Making community resources available for older adults
e.
Increase in health disparities for rural older adults
ANS: A, B, C
According to United States Department of Health and Human Services’ Healthy People 2020,
emerging issues in the health of older adults include coordinating care, helping older adults
manage their own care, establishing quality measures, identifying minimum levels of training
for people who care for older adults, and researching and evaluating appropriate training to
equip providers with the tools they need to meet the needs of older adults.
PTS: 1 DIF: Remember REF: p. 8 TOP: Nursing Process:

Planning MSC: Health Promotion and Maintenance
3. Researchers hypothesize that most super-centenarians survive and are in good health due
to which of the following factors? (Select all that apply.)
a.
They have a different genetic makeup than other older adults have.
b.
They tend to live in wealthier areas of the world.
c.
The exact cause of this phenomenon is not known.
d.
Contributing factors to their good health include quality medical care
and improved social conditions.
e.
They have large extended families to assist in their care.
ANS: C, D .
The exact cause of super-centenarians’ longevity is not known; researchers describe it as
attributable to “rare and unpredictable reasons.” Contributing factors include medical care
and improved sociopolitical conditions. There is no known difference in biological or
sociological factors between super-centenarians and other older adults. Super-centenarians
exist all over the world.

4. The nurse in an assisted living facility (ALF) is preparing a lecture on aging for the
residents. The philosophy of the ALF is to approach aging from the viewpoint of health.
Based on this philosophy, the nurse includes which of the following topics? (Select all that
apply.)
a.
“The Many Chronic Illnesses of Aging”
b.
“Channeling Your Inner Strength Toward Wellness”
c.
“Maximizing Function As You Age”
d.
“Conserving Your Strength As You Age”
e.
“Keep Moving, Maintain Your Mobility”
ANS: B, C, D
A wellness perspective is based on the belief that every person has an optimal level of
wellness independent of functional ability. This viewpoint approaches aging with an
emphasis on resilience, strength, resources, and capabilities rather than focusing on existing
pathological conditions.
PTS: 1 DIF: Analyze REF: p. 6-7 TOP: Teaching and Learning
.
Chapter 04: Psychosocial, Spiritual, and Cognitive Aspects of Aging
Edition
MULTIPLE CHOICE
1. In which context are members of a cohort described when using the age-stratification
theory to explain the effect of similar events, conditions, and circumstances?
a.
Historical
b.
Biological
c.
Sociological
d.
Chronological
ANS: A
In the age-stratification model, historical context is used to understand members of a cohort
in terms of similar events, conditions, and circumstances and the effect these have on the
group as a whole. A good example of such a cohort is older adults who lived through World
War II.
Biological context is not important in considering the age-stratification theory. The
age-stratification theory is a sociological theory of aging that uses historical context
to
describe cohorts. Chronological context of a cohort will span a range, but historical context is
what describes the cohort.
PTS: 1 DIF: Knowledge REF: p. 42

TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
2. An older patient who was just diagnosed with a terminal disease states, “All my life I
R IaUGbouB.C
attended church, but I am stillNworried St whNat wTill hapOpen after death.” The
nurse’s best response
is which of the following?
a.
“The unknown may be frightening. Do you want to talk about this?”
b.
“Religious people know that God is a good God.”
c.
“People that have had near-death experiences say it is peaceful.”
d.
“You must feel good about attending church most of your life.”
ANS: A
“Often the unknown is very frightening” uses the reflective technique to identify the patient’s
feelings regarding the fear of the unknown. “Religious people know that God is a good God”
denies the patient’s feelings. “People that have had near-death experiences say it is peaceful”
focuses on the experience of others. “You must feel good about attending church most of
your life” ignores the patient’s concern about death.

TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
3. The nurse plans care for older adults who are in good health but isolated from their families.
If the nurse’s goal is to move the adults toward gerotranscendence, which intervention should
the nurse use in the plan of care?
a.
Give a daily tea party for the group.
b.
Call each family to encourage visiting.
c.
Assist them to resume midlife patterns.
d.
Help each person with individual activities.
ANS: D
In Tornstam’s theory, aging offers the potential for gerotranscendence, a culmination of an
individual’s life, wisdom, and spiritual growth that allows older adults to live contentedly
with and without social activities. An older adult spends more time on meditation and solitude
and less time on materialism and self-consciousness about body image. Individual activities
or self-selected activities are satisfactory. Solitude is satisfactory. Midlife patterns are no
longer relevant to contentment.

Planning MSC: Psychosocial Integrity
4. The nurse observes older women learning advanced knitting techniques. The nurse
concludes that this learning activity is suitable for these women because it accomplishes
which of the following?
a.
Helps maintain joint flexibility
b.
Improves the group’s cohesiveness
c.
Provides a needed social opportunity
d.
Adds to their existing knowledge base
ANS: D
Learning advanced techniques is a suitable activity for older adults because it builds on
knowledge they already have. Furthermore, this activity is suitable because it is concrete and
practical for experienced knitters to develop advanced skills. Joint flexibility is a physical
activity and not necessarily a learning activity. The members share enjoyment of knitting;
other than being women and older, the group has no special bond on which to build. The
need for socializing is not evident.
N R I G B.C M
PTS: 1 U
DIF: Apply S NREF:
T p. 50 TOP: Nursing Process: Evaluation
5. The nurse at a nursing home wants to help decrease the risk of Alzheimer’s disease (AD)
in the residents. Which should the nurse do to implement this goal?
a.
Keep the curtains open in their rooms.
b.
Offer beads for them to string on yarn.
c.
Show movies that the residents choose.
d.
Assist residents with ambulation to meals.
ANS: D
Engaging in physical activity and social interaction are associated with a lower risk for AD.
Keeping the curtains open can make a resident’s room more pleasant but is likely to be
counterproductive in lowering the risk; brightening the room can entice the resident to stay in
the room and decrease social interaction. Stringing beads is a passive and sedentary activity
and therefore unlikely to decrease the risk for AD; physical activity is associated with a
lower risk for AD. Watching movies is a sedentary but not a mentally stimulating activity for
an adult with a normal intelligence.

6. Which physiological change in the brain is the reason the nurse allows more time
for answering questions with older adults?
a.
Increased secretion of cholinesterase
b.
Decreased secretion of neurotransmitters
c.
Loss of spinal cord and brainstem neurons
d.
Atrophy of dendrites in the cerebral cortex
ANS: D
Dendrites are the receiving end of neurons (receiving electrochemical signals) and the
branched ends extending from the cell body. The atrophy of dendrites contributes to slower
thought processes with aging because the synapses are impaired; this changes the
transmission of neurotransmitters that are vital in the transmission of an electrical impulse
from neuron to neuron. The secretion of cholinesterase, the enzyme that inactivates
acetylcholine in the synapse, does not increase with aging. Changes in the transmission of
neurotransmitters are associated with the atrophy of dendrites. The spinal cord and the
cerebral cortex lose neurons with age, the cerebral cortex more than the spinal cord.

7. The nurse provides opportunities for nursing home residents to read aloud to others.
Which cognitive skill is this nursing intervention most likely to improve?
a.
Verbal fluency
b.
Logical analysis
c.
Object naming
d.
Visuospatial skills
ANS: A
Allowing residents to read aloud helps improve and maintain verbal fluency because it
provides an opportunity to prNacUtiRceStIheNseGsTkiBlls.. CROeaMding aloud does
not usually require analysis. Reading is unlikely to improve object recall unless displaying
objects is part of the
reading. Visuospatial skills require the ability to perceive the relationship of objects in terms
of the space each object occupies; reading is unlikely to improve this skill.

8. Mandatory retirement at age 65 years is consistent with which theory of aging?

a.
Role theory
b.
Disengagement theory
c.
Age-stratification theory
d.
Social exchange theory
ANS: B
Disengagement theory states that in the natural course of aging, the individual does and
should withdraw from society to allow for the transfer of power to younger generations.

9. An older woman retires after a long career as an elementary school principal and begins to
volunteer in the local library reading to children. The older woman is very pleased with
her volunteer activities. This is consistent with which theory of aging?
a.
Role theory
b.
c.
d.
ANS: A
Role theory posits that self-identity is believed to be defined by one’s role in society.
Successful aging means that as one role is completed, it is replaced by another or
comparative value to the individual.

10. An older married couple move to a continuing care retirement community. The older
woman who was always very social and outgoing quickly joins an exercise group, a book
club, and a knitting circle. The older man who was always very solitary adopts a routine of a
long daily walk and registers for an online course in creative writing. The behaviors of the
older couple are consistent with which theory of aging?
a.
Activity theory
b.
Continuity theory
c.
d.
ANS: B
Continuity theory proposes that individuals develop and maintain a consistent pattern of
behavior over a lifetime. Aging, as an extension of earlier life, reflects a continuation of the
patterns of roles, responsibilities, and activities. Personality influences the roles and activities
chosen and the level of satisfaction drawn from these. Successful aging is associated with
one’s ability to maintain and NcoUnRtinSuIe NprGevTioBu.s bCeOhMaviors and roles.
11. A retirement community is divided into different communities with different activities
available for the residents of each community. There is one community for individuals
ages 65 to 74 years, one for individuals ages 75 to 85 years, and one community for
individuals older than age 85 years. This is consistent with which theory of aging?
a.
Role theory
b.
c.
d.
ANS: C
Age-stratification theory is based on the belief that aging can be best understood by
considering the experiences of individuals as members of cohorts with similarities to others in
the same group.

MULTIPLE RESPONSE
1. Which statements are true about aging and the brain? (Select all that apply.)
a.
Most areas of the brain do not lose brain cells.
b.
Memory decline is inevitable as people age.
c.
Basic intelligence remains unchanged with age.
d.
The brain does not continue to make new brain cells.
e.
There are decrements in the ability to process information.
ANS: A, C, E
Most areas of the brain do not lose brain cells. Although older adults may lose some nerve
connections, this can be part of the reshaping of the brain that comes with experience. Basic
intelligence remains unchanged with age, and older adults should be provided with
opportunities for continued learning. There are decrements in the ability to process
information. Many people reach older age and have no memory problems. Having a healthy
diet and participation in physical exercise, stimulating mental activity, socialization, and
stress management help brain health.

2. The nurse is admitting a patient to a long-term care facility. During the admission, the
patient verbalizes a concern about getting dementia now that he is in a nursing home. In
which activities should the nurse encourage the patient to participate to maintain brain
health? (Select all that apply.)
a.
Physical exercise
b.
Stimulating mental activity
c.
Socialization
d.
Increasing dietary intake
e.
Crossword puzzles NURSINGTB.C
ANS: A, B, C, E
Many people reach older age and have no memory problems. Having a healthy diet and
participation in physical exercise, stimulating mental activity, socialization, and stress
management help brain health. Puzzles are a cognitive stimulating activity. An increase in
dietary intake has not been shown to influence brain health.
PTS: 1 DIF: Apply REF: p. 50-51 TOP: Nursing Process:

3. A nurse in an assisted living facility is planning an educational program on exercise for

the residents. The nurse needs to consider which of the following when planning the
activity? (Select all that apply.)
a.
Very simple language must be used so that the residents will understand
the material.
b.
Large size fonts must be used on all written material provided to the residents.
c.
The educational program should be provided in a quiet area without
excessive background noise.
d.
The material discussed should focus only on the consequences of failure
to exercise.
e.
The material discussed should build on the prior knowledge of the residents.
ANS: B, C, E
When educating older adults, one needs to pay attention to potential sensory deficits common
in this population such as vision and hearing. Older adults do not normally experience a
decline in intelligence. When teaching older adults, it is beneficial to present practical
information that builds on the prior knowledge of the participants. There is no evidence that
older adults learn better by focusing on the effects of nonadherence.
PTS: 1 DIF: Apply REF: p. 51 TOP: Nursing Process: Planning

4. Which of the following are true statements about older adults and use of
computer technology? (Select all that apply.)
a.
Older adults comprise the fastest growing population using computers and
the Internet.
b.
Older adults tend to be reluctant to use social networking sites.
c.
Older adults perceive the Internet as a valuable resource.
d.
Older adults do not routinely use the Internet to connect with their health
care providers.
e.
Older adults have much difficulty learning to use technology.
ANS: A, C
Older adults comprise the fastest growing population using computers and the Internet. Older
women comprise the fastest growing group using social networking sites such as Facebook,
Twitter, and Myspace. Older adults perceive the Internet as a valuable resource and use it to
communicate with friends, families, and health care providers and access health-related
information. There is no evidence that older adults have difficulty learning to use technology.
PTS: 1 DIF: U nder stan d REF: p . 52 TOP: Nursing Process: Planning

N R I
MSC: Health Promotion and MaUintenSancNe TG O B. C M
5. A nurse in a long-term care facility is using the TimeSlips program with a group of
cognitively impaired older adults. The nurse is using which of the following
techniques? (Select all that apply.)
a.
Provides a picture for all group members to look at and use to create a story
b.
Records the number of correct answers that each participant provides
c.
Records the responses of all participants
d.
Compliments each member for his or her contribution to the story
e.
Reads the story back during the session, noting the contributions of
each participant
ANS: A, C, D, E
Using the TimeSlips format, group members looking at a picture are encouraged to create a
story about the picture. All contributions are encouraged and welcomed, there are no right or
wrong answers, and everything that the individuals say is included in the story and written
down by the scribe. Stories are read back to the participants during the session using their
names to identify their contributions. At the beginning of each session, the story from the last
session is read to the participants. Care is taken to compliment each member for his or her
contribution to the wonderful story. There are no right or wrong answers.

6. An older adult who lives in an assisted living facility tells a nurse that she is engaged in
life review. The nurse understands which of the following about life review? (Select all
that apply.)
a.
Life review is only useful at the very end of an individual’s life as he or she
is close to death.
b.
Life review and reminiscence are the same phenomenon.
c.
Life review is a highly personal activity.
d.
Life review can help an individual change course or set new goals.
e.
Life review can be helpful to an individual experiencing a depressive episode.
ANS: C, D, E
Life review is considered more of a formal therapy technique than reminiscence and takes a
person through his or her life in a structured and chronological order. Life review should
occur not only when we are old or facing death but also frequently throughout our lives. This
process can assist us to examine where we are in life and change our course or set new goals.
Life review may be especially important for older people experiencing depressive symptoms.
Life review is a highly personal activity.

.
Chapter 05: Gerontological Nursing and Promotion of Healthy Aging
Edition
MULTIPLE CHOICE
1. Identify the best statement about gerontological nursing.

a.
Nurses have only recently become involved in the care of older adults.
b.
Gerontological care was the second specialty in which the American
Nurses Association (ANA) offered a certification program.
c.
Purposes of gerontological nursing include the promotion of health and support
for maximal independence.
d.
ANA certification is available only for gerontological nurses in research positions.
ANS: C
Promoting health and fostering independence are purposes of the practice, as reflected, for
example, in the ANA Scope and Standards. Nurses have always cared for older patients. The
ANA’s gerontological nursing certification program was the organization’s first and includes
a variety of positions, such as nurse practitioners, clinical specialists, researchers, and
administrators.
PTS: 1 DIF: Remember REF: p. 56-57, 60

2. Which gerontological nursing organization welcomes nurses from all

educational backgrounds? .
a.
The National Gerontological Nursing Association (NGNA)
b.
The National Conference of Gerontological Nurse Practitioners (NCGNP)
c.
The National Association of Directors of Nursing Administration in Long-
Term Care (NADONA/LTC)
d.
The American Society on Aging (ASA)
ANS: A
The NGNA was formed specifically for all levels of nursing personnel: registered nurses
(RNs), licensed practical nurses (LPNs), licensed vocational nurses (LVNs), and certified
nursing assistants (CNAs). The NCGNP is, as its name implies, limited to nurse
practitioners. The NADONA/LTC is, as its name implies, limited to directors and assistant
directors of nursing. The ASA is an interdisciplinary organization not limited to nurses.

3. Which is an accurate statement regarding gerontological nursing education?

a.
Gerontological nursing content has long been integrated into the curriculum of
the typical school of nursing.
b.
Undergraduate nursing programs extensively cover gerontological nursing
in dedicated courses, comparable with the coverage of psychiatric nursing.
c.
When content is integrated throughout a curriculum, less than 25% is devoted
to geriatric care.
d.
Accreditation of a nursing program guarantees that appropriate amounts of
gerontological nursing content are included in the curriculum.
ANS: C
When content is integrated throughout the curriculum, less than 25% of the content is devoted
to geriatric care. Only recently has gerontological nursing content begun to appear in nursing
school curricula. Most nursing schools still do not have such courses. At present, no
minimum requirements exist for the coverage of care of older adults.

4. Based on current demographic data, which of the following statements identifies a

predictive trend regarding the health care needs of society?
a.
Most nurses will not need to care for older persons.
b.
More nursing services will be required to serve the needs of the population
older than 85 years of age.
c.
Fewer nurses will be needed to care for older adults.
d.
Older adults expect their quality of life to be less than that of earlier generations
at their ages.
ANS: B
Projections are that 20% of the American population will be older than 65 years of age by
2050, with those older than 85 years showing the greatest increase in numbers. Most nurses
can expect to care for older people during the course of their careers. By 2050, the United
Nations predicts that more Americans will be older than the age of 60 years than those
younger than the age of 15 years. Older people are better educated and more affluent and
expect a higher quality of life than their elders had at their age.
N R I G B.C M
PTS: 1 U S
DIF: Remember NREF:
T p. 56
5. A case manager is likely to have how many years of nursing education?

a.
1 to 1.5
b.
4 to 6
c.
2
d.
8 or more
ANS: C
A case manager typically has a bachelor’s or master’s degree. This amount of training is
typical for a licensed practical nurse, who typically practices at a nursing home or on a home
nursing staff. This amount of training, resulting in an associate’s degree in nursing, is typical
for an associate registered, who is typically found on hospital, home, and nursing home
staffs. A nurse with 8 or more years of education, as well as a doctorate, is typically involved
in research and teaching.

6. An older man is transferred to a hospice facility with end-stage disease. Which is a

suitable nursing intervention for this older adult and his family according to the goals of
long-term care?
a.
Decrease the analgesic dose to prevent sedation.
b.
Provide a basin and towels for morning self-care.
c.
Inform family members about strict visiting hours.
d.
Facilitate family rituals related to death and dying.
ANS: D
To promote comfort and dignity, the nurse facilitates the enactment of family wishes, rituals,
or religious practices related to death and dying. To promote comfort, the gerontological
nurse administers medications as prescribed and avoids restricting analgesic agents to patients
regardless of the setting or the nurse’s personal views. Although fostering independence is
within the scope of the gerontological nursing practice, the nurse should assess the older adult
and family before assuming that he will want or be able to perform self-care. Although
hospice can have regular visiting hours, the older adult may need his family at the bedside for
comfort, strength, or companionship. Thus, to provide comfort and promote dignity, the
gerontological nurse adapts visiting hours to suit the older adult’s needs.
PTS: 1 DIF: Apply REF: p. 60, 62

7. A nursing home executive interviews registered nurses to fill a full-time position for direct
patient care to maintain the standards of eldercare. Which nurse should the nursing home
hire?
a.
Nurse from a certified college
b.
Nurse with 15 years of experience
c.
Certified gerontological nurse
d.
Gerontological nurse practitioner
ANS: B
A certified gerontological nurse receives education and training to care for older adults,
assuring the nursing home anNdUthRe SpuIbNliGc tThBat .thCe OnuMrse has mastered
the specialized skills and knowledge to care for older adults according to gerontological
nursing standards. A nurse
educated in a certified college does not necessarily have specialty education and training in
gerontology. A nurse with 15 years of experience might have no experience with gerontology
and offers no proof of specialized knowledge or skills. Although a gerontological nurse
practitioner receives specialized education and training in gerontology, these nurses provide
primary care in a nursing home.

8. Mezey and Fulmer (2002) justify gerontological nursing research and the work
of gerontological advanced practice nurses by concluding the following:
a.
Other scientists devalue gerontological nursing research.
b.
The research influences outcomes from nursing care in a positive way.
c.
Gerontological care is expensive but required in long-term care.
d.
Gerontological nursing research is well known to practicing nurses.
ANS: B
The practices of advanced practice nurses, who base their practice on nursing research, have
resulted in positive older adult outcomes and cost effectiveness. The scientific community
widely accepts the research. Advanced practice nurses generate positive outcomes and are
cost effective in many settings. Mezey and Fulmer believe the goal of gerontological nursing
is to disseminate the knowledge from gerontological nursing research to all nurses and to
have the knowledge applied to their practices.
PTS: 1 DIF: Understand REF: p. 60-61 TOP: Nursing Process:

Diagnosis MSC: Health Promotion and Maintenance
9. The gerontological nurse collaborates with the wound care team about an older patient
who has an ulcer. How is this nurse demonstrating leadership in the care of older people?
a.
Assessing older adults effectively
b.
Facilitating access to eldercare programs
c.
Coordinating members of the health care team
d.
Empowering older adults to manage chronic illness
ANS: C
The nurse demonstrates leadership in the care of older adults by initiating and coordinating
collaboration with the wound care team to improve the health of an older adult. Screening and
assessing are only indirectly related to collaboration. In this case, the nurse’s collaborative
efforts are unrelated to facilitating access to a program. Thus far, the nurse has not educated
or trained this patient in wound care.
PTS: 1 DIF: Apply REF: p. 63 TOP: Nursing Process: Evaluation

10. Which organization had the lNarUgeRstSrIolNe GinTeBnh.anCcOinMg the specialty of

gerontological nursing?
a.
American Association of Retired Persons (AARP)
b.
John Hartford Foundation
c.
Medicare
d.
Mutual of Omaha Insurance
ANS: B
The most significant influence in enhancing gerontological nursing has been the work of the
Hartford Institute for Geriatric Nursing, funded by the John A. Hartford Foundation. The
foundation seeks to shape the quality of the nation’s health care for older Americans by
promoting geriatric nursing excellence to both the nursing profession and the larger health
care community. Initiatives in nursing education, nursing practice, nursing research, and
nursing policy include enhancing geriatrics in nursing education programs through curricular
reform and faculty development and the development of nine Centers of Geriatric Nursing
Excellence. AARP is a foundation that helps struggling seniors by being a force for change
on the most serious issues they face today. Medicare is a national social insurance program,
administered by the U.S. federal government since 1965, that guarantees access to health
insurance for Americans ages 65 years and older and younger people with disabilities. Mutual
of Omaha is a Fortune 500 mutual insurance and financial services company based in Omaha,
Nebraska.

11. Which of the following is true about the Nurse Competence in Aging (NCA) initiative?
a.
It was developed to support the professional development and leadership growth
of nurses who provide care to older adults in long-term care.
b.
It developed resources for nurses to access evidence-based information on
topics related to the care of older adults.
c.
It provides predoctoral and postdoctoral scholarships for study and research
in geriatric nursing.
d.
It developed the first certification in gerontological nursing.
ANS: B
The NCA initiative provided grant and technical assistance to more than 50 specialty nursing
organizations, developed a free web-based comprehensive gerontological nursing resource
center (ConsultGeriRN.org) where nurses can access evidence-based information on topics
related to the care of older adults, and conducted a national gerontological nursing
certification outreach. Sigma Theta Tau’s Center for Nursing Excellence in Long-Term Care
sponsors the Geriatric Nursing Leadership Academy and offers a range of products and
services to support the professional development and leadership growth of nurses who
provide care to older adults in long-term care. The ANA developed the gerontological
certification exam.

12. The vision of Nurses Improving Care for Health System Elders (NICHE) is
a.
to ensure that all older adults are only cared for by nurses who are certified
in gerontological nursing.
b.
to decrease the cost of care for hospitalized older adults.
c. N R I G B.C
to increase access to care foUr adSu ltsNa gTe 6 4 y eaOrs and older.
d.
for patients 65 years and older to be given sensitive and exemplary care.
ANS: D
The vision of NICHE is for all patients 65 years and older to be given sensitive and
exemplary care.

MULTIPLE RESPONSE
1. Advanced practice nurses have demonstrated the most significant impact in improving
which of the following for older adults? (Select all that apply.)
a.
Health outcomes
b.
Length of stay
c.
Cost effectiveness
d.
Reimbursement measures
e.
Interprofessional communication
ANS: A, C
Advanced practice nurses have demonstrated their skill in improving health outcomes and
cost effectiveness. Many of these advanced practice nurses have nursing facility practices
managing complex care of frail older adults in collaboration with interprofessional teams.
This role is well established, and positive outcomes include increased patient and family
satisfaction, decreased costs, less frequent hospitalizations and emergency department visits,
and improved quality of care. Reimbursement measures and interprofessional communication
have not been identified as areas that advanced practice nurses have demonstrated their skill
in improving.
PTS: 1 DIF: Remember REF: p. 60 TOP: Nursing Process: Evaluation

2. The ANA Scope and Standards of Gerontological Nursing (2010) addresses which of
the following? (Select all that apply.)
a.
The skills and knowledge required to address gerontological patient needs
b.
The levels of gerontological nursing practice
c.
Requirements for certification as a gerontological nurse
d.
Standards of gerontological nursing practice
e.
Continuing education requirements for gerontological nurses
ANS: A, B, D
The ANA Scope and Standards of Gerontological Nursing (2010) provides a comprehensive
overview of the scope of gerontological nursing, the skills and knowledge required to
address the full range of needs related to the process of aging, and the specialized care of
older adults as a group and as individuals. The document also identifies levels of
gerontological nursing practice (basic and advanced) and standards of clinical gerontological
nursing care and
gerontological nursing performance. Certification requirements and continuing
education requirements are not R I GU. B.CS N T O
N addressed
3. In the document “Recommended Baccalaureate Competencies and Curricular Guidelines

for the Nursing Care of Older Adults” developed by the American Association of Colleges
of Nursing and the Hartford Institute for Geriatric Nursing, New York University,
recommendations include which of the following? (Select all that apply.)
a.
Provision of a free-standing course in gerontology within the curriculum
b.
Integration of gerontological content throughout the curriculum
c.
Requirement of gerontological certification for all students before completion of
a BSN program
d.
Structured clinical experiences with older adults across the continuum of care
e.
Faculty with expertise in gerontological nursing
ANS: A, B, D, E
Best practice recommendations for nursing education include provision of a stand-alone
course, as well as integration of content throughout the curriculum so that gerontology is
valued and viewed as an integral part of nursing care. It is important to provide students
with nursing practice experiences caring for elders across the health–wellness continuum.
Faculty with expertise in gerontological nursing is an important recommendation.

4. Which of the following organizations have interdisciplinary membership? (Select all

that apply.)
a.
Gerontological Society of America
b.
National Gerontological Nurses Association
c.
American Society on Aging
d.
Association of Gerontology in Higher Education
e.
National Association Directors of Nursing Administration in Long-Term Care
ANS: A, C, D
The Gerontological Society of America, American Society on Aging, and Association of
Gerontology in Higher Education are all interdisciplinary organizations. The National
Gerontological Nurses Association and National Association Directors of Nursing
Administration in Long-Term Care are nursing organizations.

5. Common iatrogenic complications for hospitalized older adults include (Select all that apply.)
a.
delirium.
b.
new-onset incontinence.
c.
acute myocardial infarction.
d.
hip fracture.
e.
falls.
ANS: A, B, E
Common iatrogenic complicaNtionRs inIcluGde fBun.ctCionMal decline,
pneumonia, delirium, new-onsetUincontinence,
S N malnutrition, pressure ulcers,
medication reactions, and falls.

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Test Bank Ebersole and Hess’ Gerontological Nursing & Healthy Aging

Chapter 01: Introduction to Healthy Aging

PTS: 1 DIF: Apply REF: p. 7 TOP: Nursing Process:

PTS: 1 DIF: Understand REF: p. 16-17

PTS: 1 DIF: Understand REF: p. 18-19

PTS: 1 DIF: Apply REF: p. 18

PTS: 1 DIF: Apply REF: p. 15

PTS: 1 DIF: Apply REF: p. 18-19 TOP: Nursing Process:

7. Which health belief system uses treatments to repair a body part?

PTS: 1 DIF: Understand REF: p. 17

PTS: 1 DIF: Understand REF: p. 15-17 TOP: Nursing Process:

PTS: 1 DIF: Remember REF: p. 12 TOP: Teaching and Learning

PTS: 1 DIF: Analyze REF: p. 15

PTS: 1 DIF: Remember REF: p. 17

12. The term health disparity is defined as

PTS: 1 DIF: Remember REF: p. 13 TOP: Teaching and Learning

PTS: 1 DIF: Apply REF: p. 14

PTS: 1 DIF: Apply REF: p. 15

PTS: 1 DIF: Apply REF: p. 15

4. A nurse completes a cultural assessment of an older adult who is being admitted to an

PTS: 1 DIF: Understand REF: p. 15-16 TOP: Teaching and Learning

PTS: 1 DIF: Remember REF: p. 18-19

PTS: 1 DIF: Understand REF: p. 6

PTS: 1 DIF: Understand REF: p. 5

PTS: 1 DIF: Remember REF: p. 5

6. Which nursing intervention is a holistic approach to an older adult?

PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation

PTS: 1 DIF: Analyze REF: p. 7 TOP: Nursing Process: Planning

PTS: 1 DIF: Remember REF: p. 7

PTS: 1 DIF: Analyze REF: p. 5

PTS: 1 DIF: Remember REF: p. 8 TOP: Teaching and Learning

This is a bank of tests (study questions) to help you

1. Decreased functioning of which physical structure is likely to result in decreased

PTS: 1 DIF: Understand REF: p. 32

PTS: 1 DIF: Apply REF: p. 35

3. Aging ordinarily leads to decreases in which of the following?

PTS: 1 DIF: Understand REF: p. 30-31

4. Which change in the skin is abnormal in an older person?

PTS: 1 DIF: Understand REF: p. 27

PTS: 1 DIF: Apply REF: p. 35

PTS: 1 DIF: Understand REF: p. 22-26

PTS: 1 DIF: Apply REF: p. 28

PTS: 1 DIF: Remember REF: p. 32-33

PTS: 1 DIF: Apply REF: p. 23-26

PTS: 1 DIF: Apply REF: p. 23-26

PTS: 1 DIF: Apply REF: p. 23-26

PTS: 1 DIF: Analyze REF: p. 34

PTS: 1 DIF: Analyze REF: p. 37

PTS: 1 DIF: Understand REF: p. 31-32

PTS: 1 DIF: Understand REF: p. 32

3. A nurse performs an assessment of an older adult’s oral cavity. Which of the

PTS: 1 DIF: Understand REF: p. 32-33

PTS: 1 DIF: Apply REF: p. 36

PTS: 1 DIF: Understand REF: p. 7

PTS: 1 DIF: Remember REF: p. 8 TOP: Nursing Process: Planning

PTS: 1 DIF: Remember REF: p. 8 TOP: Nursing Process:

PTS: 1 DIF: Understand REF: p. 4-5

PTS: 1 DIF: Knowledge REF: p. 42

PTS: 1 DIF: Apply REF: p. 48

PTS: 1 DIF: Apply REF: p. 43 TOP: Nursing Process:

PTS: 1 DIF: Apply REF: p. 50 TOP: Nursing Process:

PTS: 1 DIF: Understand REF: p. 49

PTS: 1 DIF: Understand REF: p. 49 TOP: Nursing Process: Evaluation