Ebersole And Hess Gerontological Nursing And Healthy Aging 4 Edition by Touhy – Jett-Test Bank
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Sample
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Chapter 3: Care Across the Continuum
Test Bank
MULTIPLE CHOICE
1. An
older female resident in the residential facility keeps a large collection of
personal items and photographs of her late husband on her bedside table, but
the nursing assistant and resident frequently argue about this. Why should the
nurse intervene between the resident and the nursing assistant?
|
a. |
Resident is attempting to
maintain her sense of personal space. |
|
b. |
Resident needs to accept
the reality of her spouse’s death. |
|
c. |
Resident’s argumentative
nature can indicate early dementia. |
|
d. |
Clutter from all the
personal items is a safety and liability risk. |
ANS: A
A thoughtful nurse respects and supports the resident’s
boundaries. Even if the resident needed to accept the reality of her spouse’s
death, the resident’s grief process and personal space should be respected.
Although the resident’s argumentative nature can indicate early dementia, the
resident’s behavior can also be understood as a healthy defense of personal
space. Although the rationale of the nurse assistant is probably that the
clutter from all the personal items is a safety and liability risk, the
assistant should realize that this resident is entitled to the personal use of
her personal space.
PTS:
1
DIF:
Apply
REF: 12
TOP: Nursing Process: Evaluation
MSC: Psychosocial Integrity
2. Which
statement is true about
living arrangements for older adults?
|
a. |
Older adults are more
independent in their own homes than in a residential community. |
|
b. |
The increase in real estate
values makes home ownership essential to security. |
|
c. |
Program for All-Inclusive
Care for the Elderly (PACE) is a community alternative to nursing home care
for frail older adults. |
|
d. |
Florida is an example of a
naturally occurring retirement community (NORC). |
ANS: C
PACE is an alternative to nursing home care for frail older
people who want to live independently in the community with a high quality of
life. Although relief from the burden of home maintenance can free a person for
more independent living, this statement can or cannot be accurate, depending on
the real estate market at the time. In addition, taxes and maintenance costs
have also risen. A NORC is an organization formed by older adults living at
home in geographic proximity to each other to provide supportive services for
each other.
PTS:
1
DIF: Understand REF: 5
TOP: Nursing Process:
Assessment MSC:
Safe, Effective Care Environment
3. As
the nurse admits an older woman to a long-term care facility from her home of
50 years, she mistakes the nurse for her daughter. Which diagnosis does the
nurse use to plan care for this woman?
|
a. |
Hypoxia as a result of
chronic disease |
|
b. |
Relocation stress syndrome |
|
c. |
Alzheimer disease (AD) |
|
d. |
Attention-seeking behavior |
ANS: B
Relocation, especially if sudden, causes stress that may lead to
altered mental status. Many conditions other than hypoxia can cause altered
mental status, including relocation stress. Many conditions other than AD can
cause altered mental status, including relocation stress. The nurse has no
confirmatory evidence to regard the older woman’s error as something other than
a mistake; in addition, it can be understood as relocation stress syndrome.
PTS:
1
DIF: Apply
REF:
16
TOP: Nursing Process: Diagnosis
MSC: Safe, Effective Care Environment
4. Which
statement is true about
residential living for older adults?
|
a. |
A residential care facility
is the new term for a nursing home. |
|
b. |
An assisted living facility
(ALF) must have an registered nurse (RN) on staff. |
|
c. |
Administrators are
realizing that their duty is to care for the residents as people. |
|
d. |
A “granny flat” is an
apartment in a high-rise building reserved for seniors. |
ANS: C
The movement is under way from an institution-centered culture
to a person-centered one. A residential care facility houses older adults who
cannot live independently but do not need the round-the-clock, complex care
capabilities of a nursing home. In most states, ALFs are not required to
provide skilled nursing. A “granny flat” is the term used in Australia for a
small, prefabricated housing unit where an older adult can live separately
from, but close to, family on family property.
PTS:
1
DIF: Understand REF: 12-13
TOP: Nursing Process:
Assessment MSC:
Safe, Effective Care Environment
5. A
family that has three small children prepares to move an older female parent
into their home knowing that she stays up all night. The nurse helps the family
prepare for the change. Which part of planning should the nurse indicate is the
family’s priority?
|
a. |
Sharing household
responsibilities |
|
b. |
Preparing the house for her
arrival |
|
c. |
Helping her use her skills
and talents |
|
d. |
Setting limits on nighttime
activities |
ANS: B
To reduce the risk of injury and falls, the family’s priority is
to prepare the house for an older adult’s arrival including preparing the
parent’s private space, removing hazards, providing adequate lighting,
installing handrails where necessary, and completing other safety measures. In
addition, the parent needs to prepare mentally for the challenges presented
when the children create new safety hazards for an older adult, such as spills
and leaving toys on the floor. Sharing household responsibilities should be
part of the preparation; however, safety concerns are more important. Helping
the older adult to use her skills and talents provides meaningful activities;
however, safety concerns are more important. Setting limits on her nighttime
activities is important preparation to avoid conflicts; however, safety
concerns are the priority.
PTS:
1
DIF: Analyze
REF: 3
TOP: Nursing Process: Planning
MSC: Safe, Effective Care Environment
6. A
resident of a long-term care facility has been asking to have the drain in the
bathroom sink repaired for 2 months. The nurse responds by saying that when
they move to the new building, the sinks will work very well. Which right of a
resident of a long-term care facility has the nurse violated?
|
a. |
Right to be free of all
forms of abuse |
|
b. |
Right to be transferred for
appropriate reasons |
|
c. |
Right to voice grievances
and have them remedied |
|
d. |
Right to information about
conditions and treatments |
ANS: C
The nurse has violated the resident’s right to voice a grievance
and to have the problem fixed. If the residents were moving into the new building
in a few days, then the nurse’s response might be suitable; however, without
specifying a time limit, the nurse has violated the resident’s right to voice a
grievance and have it remedied. A clogged sink is not abuse. The resident is
not going to be transferred; all of the residents are moving to a new facility.
A resident’s condition or treatments are not mentioned by the resident.
PTS:
1
DIF:
Apply
REF: 29 Text Box 3-5
TOP: Nursing Process:
Evaluation
MSC: Safe, Effective Care Environment
7. A
nursing home is converting to a person-centered culture from an
institution-centered culture. Which nursing intervention will be suitable in
the new culture?
|
a. |
Maintain consistent
resident assignments. |
|
b. |
Provide structured
activities for the residents. |
|
c. |
Assign nursing assistants
to perform bathing. |
|
d. |
Determine mealtime on the
basis of staffing levels. |
ANS: A
As part of a person-centered culture, nurses should have
consistent resident assignments to establish rapport with their residents and
become familiar with their unique qualities and preferences. Activities
structured by the staff are part of the institution-centered culture. Assigning
assistants to perform bathing is part of the institution-centered culture
because it focuses on tasks. Schedules are determined for the staff’s
convenience as part of the institution-centered culture.
PTS:
1
DIF:
Apply
REF: 12-13 | Text Box 3-6 on 30
TOP: Nursing Process:
Evaluation
MSC: Safe, Effective Care Environment
8. The
nurse prepares to transfer an older adult to a long-term care facility and
calls the facility to give a report. Which nursing actions are the
responsibilities of the transferring nurse and the receiving nurse?
|
a. |
Incorporating patient goals
into the plan |
|
b. |
Ensuring the patient is
stable for transfer |
|
c. |
Supplying patient documents
for planning |
|
d. |
Providing continuity of
care during the transfer |
ANS: D
A shared responsibility of the sending and the receiving nurses
or care team is to regard the transition as a transfer versus a discharge and
to provide continuous and consistent nursing care throughout the transfer
phase. To accomplish this, the two nurses or groups must have clear,
comprehensive communication. The receiving nurse incorporates patient goals
into the plan. The sending nurse ensures that the patient is stable for the
transfer to prevent decompensation during the trip or shortly after arrival at
the new facility. The sending nurse is responsible for providing clear,
comprehensive, and complete patient documentation.
PTS:
1
DIF: Understand REF: 12-15
TOP: Nursing Process:
Assessment MSC:
Safe, Effective Care Environment
9. The
nurse assesses a resident who was transferred yesterday from an acute care
hospital. Which should the nurse assess to determine whether this individual is
under stress from the transfer?
|
a. |
Length of the resident’s
stay in the acute care facility |
|
b. |
Availability of disposition
options before the transfer |
|
c. |
Presence of familiar people
throughout the transfer |
|
d. |
Tour of the new facility
shortly after transfer |
ANS: B
To help assess the resident for stress, the nurse reviews the
sequence of events that led to the relocation including whether the resident
had relocation options and what those options were before relocation. If the
resident played an active role in the choice of facilities and had several
available options, then the resident is likely to experience less stress upon
relocation. The length of stay in the acute care facility is an unreliable
index of stress in a resident who has been recently relocated. The presence of
familiar people is an unreliable predictor of relocation stress. Touring the
new facility is an unreliable predictor of relocation stress; if the tour is
conducted too soon or when the resident is in pain, tired, or distracted, then
the resident is unlikely to benefit from the tour.
PTS: 1
DIF:
Apply
REF: 32 Text Box 3-8
TOP: Nursing Process:
Assessment MSC:
Psychosocial Integrity
10. Which
is characteristic of relocation stress syndrome in a resident of a long-term
care facility?
|
a. |
Agitation |
c. |
Caring family |
|
b. |
Apprehension |
d. |
Hallucinations |
ANS: B
Apprehension is a major defining characteristic of stress
relocation syndrome. Agitation is uncharacteristic of stress relocation
syndrome. An inadequate support system is characteristic of this syndrome.
Hallucinations are uncharacteristic of this syndrome.
PTS:
1
DIF: Remember REF: 16
TOP: Nursing Process:
Assessment MSC:
Psychosocial Integrity
11. A
nurse completing a hospital discharge to home understands that which of the
following interventions is most important before discharge.
|
a. |
Medication reconciliation |
|
b. |
Providing a list of
community resources |
|
c. |
Contacting a durable
medical equipment facility |
|
d. |
Educating the client on
appropriate range-of-motion exercises |
ANS: A
Medication reconciliation is the most important intervention to
complete before discharge. Medication discrepancies are the most prevalent
adverse event after hospital discharge and the most challenging component of a
successful hospital-to-home transition. Nurses’ attention to an accurate
prehospital medication list, medication reconciliation during hospitalization
and at discharge, and patient and family education about medications are required
to enhance safety. Educating the client on appropriate range-of-motion
exercises, providing a list of community resources, and contacting a durable
medical equipment facility are all important and should be completed as well,
but medication reconciliation should be the priority.
PTS:
1
DIF:
Apply
REF: 13-22| 22 Box Safety Alert
TOP: Nursing Process: Implementation
MSC: Safe, Effective Care Environment
MULTIPLE RESPONSE
1. A
family is touring selected nursing homes in preparation for their mother’s
future. Which qualities of a nursing home should the family include if they
decide on a person-centered nursing home? (Select all that apply.)
|
a. |
Staff members cover all
nursing units. |
|
b. |
Residents and families have
a council. |
|
c. |
Residents choose
stimulating activities. |
|
d. |
Staff members respond to
residents’ needs. |
|
e. |
Group activities are
scheduled on the hour. |
|
f. |
Staff members help
residents stay well-groomed. |
ANS: B, C, D, F
A characteristic of a person-centered culture is family and
resident councils to discuss resident issues, needs, and solutions. A second
characteristic of a person-centered culture is residents choosing their own
activities to suit their interests. A third characteristic of a person-centered
culture is a responsive staff that promptly meets resident needs. A fourth
characteristic of a person-centered culture is assisting residents to maintain
their appearance and to stay well-groomed. Consistent nursing assignments are a
characteristic of a person-centered culture. Predetermined schedules are
characteristic of an institution-centered culture.
PTS:
1
DIF: Understand REF: 12 Box 3-4
TOP: Nursing Process:
Assessment MSC:
Safe, Effective Care Environment
2. An
elder-friendly community includes components that: (Select all that apply.)
|
a. |
Address basic needs |
|
b. |
Optimize physical health |
|
c. |
Provide financial
assistance |
|
d. |
Maximize independence |
|
e. |
Provide social engagement |
ANS: A, B, D, E
Components of an elder-friendly community include addressing
basic needs, optimizing physical health and well being, maximizing independence
for the frail and disabled, and providing social and civic engagement.
Elder-friendly communities do not provide financial assistance.
PTS:
1
DIF: Understand REF: 2
TOP: Nursing Process:
Assessment MSC:
Safe, Effective Care Environment
3. Which
home modification interventions are designed to enhance the ability of older
adults to remain in their homes? (Select
all that apply.)
|
a. |
A 36-inch-wide doorway |
|
b. |
Entryways with less than
two steps |
|
c. |
Electrical outlets at chest
level |
|
d. |
A bathroom on the first
floor |
ANS: A, D
Many state and local governments are assessing the community and
designing interventions to enhance the ability of older people to remain in
their homes and familiar environments. Home design features such as
36-inch-wide doorways and hallways, a bathroom on the first floor, an entry
with no steps, outlets at wheelchair level, and reinforced walls in bathrooms
to support grab bars.
PTS:
1
DIF: Understand REF: 2
TOP: Nursing Process:
Assessment MSC:
Safe, Effective Care Environment
Chapter 4: Culture and Aging
Test Bank
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