Question

Chapter 4

A 60-year-old woman enjoys orienting new young women and men at work. She thoroughly enjoys being a teacher and mentor and thinks she should pass down her legacy of knowledge, wisdom, and skills to the younger generation.

1. The gerontological nurse recognizes that the woman is involved in the behavior described by Erikson as

A.   generativity.

B.   ego integrity.

C.   identification.

D.   valuing wisdom

2. What is the purpose of a legacy?

3. Older adults comprise the fastest growing population using computers and the Internet.

A.   True

B.   False

4. Describe the concept of healthy cognitive aging (healthy brain aging). How can gerontological nurses assist older adults to enhance cognitive health and vitality?

5. Spirituality must be considered a significant factor in understanding healthy aging.

A.   True

B.   False

Chapter 2

The gerontological nurse uses the Heritage Assessment tool as part of an integral component of a complete physical and health assessment. An 86-year-old Asian American woman tells the gerontological nurse she immigrated to the United States from China in 1940. The woman speaks English but has lived in a Chinese neighborhood since she arrived in the United States.

1. The gerontological nurse plans care for the patient with the knowledge that

A. the patient will have special needs because she practices Buddhism.

B. the care that the family provides for the patient will be more important to her than the care the gerontological nurse provides.

C. the patient should be questioned with regard to health practices she uses that may be different from those of the American culture.

D. because the patient has lived in the United States for many years, it will not be necessary to make special considerations in her care.

2. In predicting the cultural profile of future populations of older adults, it would be accurate to say

A.   greater diversity will be apparent.

B.   there will be little difference among various groups.

C.   few individuals will speak a language other than English.

D.   full assimilation will be completed.

3. Explain how a gerontological nurse can become more culturally proficient.

4. Explain the concept of ageism. Give examples using intentional ageism and
   unintentional ageism.

5. The belief that “all old people are forgetful” is an example of which of the following obstacles to cross-cultural caring?

A.   Cultural blindness

B.   Ethnocentrism

C.   Disparities

D.   Stereotyping

Chapter 7

A 69-year-old woman has been hospitalized for a planned surgical procedure. She had a total knee replacement because of degenerative joint disease. She is about to be discharged home with home health physical therapy. The discharge planner approaches her to discuss her options. She is very concerned about how the services will be paid for because she is living on a fixed income with only her Social Security benefits. Her primary insurance is Medicare.

1. Which portion of Medicare covers home health care services?

2. What are the criteria for Social Security eligibility in the United States?

3. Describe the Medicare and Medicaid coverage of health care.

4. Gerontological nurses who are consulted by clients about legal issues should attempt to provide legal advice.

A.   True

B.   False

Chapter 26

A 69-year-old man recently retired from the refinery. He is not very happy about being in retirement, but his health deteriorated to the point that he could no longer continue to work. He and his wife (68 years old) have been married for 51 years. They have three children and seven great-grandchildren, but all live out of state.

Over the past year, however, the wife has experienced significant health issues, including being diagnosed with hypertension, type 2 diabetes, and being 30 lb overweight. The husband has been experiencing increased levels of stress in response to the constant demands placed on him as the primary caregiver to his wife.

The husband is visiting his wife who is in a subacute care facility undergoing rehabilitation for physical weakness resulting from a stroke. The gerontological nurse finds the man lying in bed with his wife, caressing her.

1. The gerontological nurse considers the developmental needs of the older adult by

A.   telling the husband that his behavior could upset or harm his wife.

B.   asking the husband to leave because his behavior is not acceptable.

C.   closing the door and ensuring that the couple is not disturbed for as long as possible.

D.   informing the client and her husband that behavior appropriate in the home is not appropriate in a health care facility.

2. Which of the following is a true statement regarding aging and sexuality?

A.   Sexuality is important as long as one is not institutionalized.

B.   One’s sexuality can give meaning to life and bolster security, belonging, and esteem.

C.   The sexual emphasis in later life is on procreation.

D.   One cannot possess sexual health if widowed.

3. Define the term fictive kin and identify who would be considered a fictive kin.

4. Describe life transitions that occur in late life.

5. Which of the following statements is true regarding grandparenthood?

A.   Grandparenthood is an outdated role since the industrial revolution.

B.   The role of parent is usually subordinate to the grandparent role.

C.   In recent years, grandparents often have become the primary caregivers of their grandchildren.

D.   Grandparents tend to be less involved with their grandchildren than are great-grandparents with their great-grandchildren.

Chapter 10

A 76-year-old Hispanic woman is seen at the clinic where she is diagnosed with protein malnutrition. She is 5’1” tall and weighs 94 lb.

1. To teach the older adult about meeting dietary needs, the gerontological nurse should

A.   ask the older adult to describe her typical dietary intake.

B.   focus on the use of protein combinations of beans and rice.

C.   stress the need for using liquid protein supplements.

D.   encourage the older adult to increase milk and meat intake as primary protein sources.

2. The gerontological nurse should be aware of numerous factors affecting fulfillment of the older adult’s nutritional needs. Identify these factors.

3. To determine the underlying factors relating to the undernourishment of an older adult client, the most appropriate question by the gerontological nurse is which of the following?

A.   “Are you taking any medications that alter your taste or tolerance of foods?”

B.   “Do you have a history of any mal-absorption diseases?”

C.   “Can you give me an example of what you normally eat throughout the day?”

D.   “Do you have a way to get to a grocery store to buy your food?”

Chapter 14

A 76-year-old female client is transferred to the cardiac surgery unit from the cardiac intensive care unit (ICU). She had an aortic valve replacement with a mechanical valve and a two-vessel coronary artery bypass graft (CABG) 12 days ago, which was complicated by an intraoperative left cerebrovascular accident (CVA). Her postsurgical course was complicated by delirium while she was in the ICU, and she is now taking Ativan around the clock. Her nursing admission assessment documents that she was alert and oriented to person, place, time, and situation and independent in all activities of daily living (ADLs). She has a past medical history of hypertension, atrial fibrillation, and congestive heart failure (CHF).

On admission to the cardiac surgery unit, you note that she is oriented to person only; needs maximum assistance with ADLs; and needs a two-person assist to get out of bed to the chair and to the bedside commode, which means she is incontinent because it takes too long to get to the commode. The transfer summary states that she needs to be fed and that she consumes approximately 50% of her meals. The only significant changes in her medical condition are worsened CHF, requiring an increase in her diuretic. Her medications include Lasix, digoxin, captopril, and Tylenol for pain. Her skin assessment reveals the following: stage III pressure ulcer on her sacrum, eschar on left heel, and a right heel that feels “boggy” to touch. Her Braden Scale score is 13.

1. Identify the factors that make this client at high risk of developing pressure ulcers.

2. How often should this client have skin assessments?

3. List the six risk factors that are part of the Braden Scale for predicting pressure sore risk.

Answer 1

Chapter 4

Erikson's stages of psychosocial development are based on Freud's psychosexual theory. Erikson proposed that we are motivated by the need to achieve achieve competence in certain areas of our lives. All people go through a series of 8 stages. Here the 60 year old woman is the stage of generativity. If successful in this task one establishes oneself and contributes in meaningful ways for the future and future generations.

Legacy in simple terms is something that is passed from one generation to next and often refers to gift and money. But it's not only the wealth , the small acts of kindness without any expectation, special place in heart of a person are important. The purpose of legacy is to keep your ideas and knowledge alive even after your time. Legacy is more about sharing what you have learned , not just what you have earned.

True. Older adults are fastest growing population in technology use. Studies says that there 55% increase in just under 2 decades.

A normal cognitive aging process is associated with declines in certain cognitive abilities, such as processing speed and certain memory, language,Visio spatial and executive function abilities. The worlds population is aging and promoting healthy cognitive aging is a public health priority and challenge. Physical activity is modifiable life style factor which helps in cognitive health of older adults with/without cognitive impairment. Healthy cognitive aging is high priority research because of the devastating personal, family and societal costs of illness such as Alzheimer's disease. Healthy aging exercises and meditation will help to reduce the occurance of abnormal cognitive aging.

Gerontological nurses can support healthy aging and maximum functioning of older adults by giving them advise on their lifestyle changes that should be made. Moderate physical activity ( walking or gardening), performing cognitively stimulating tasks ( playing chess or crosswords), being socially active and consuming balanced healthy diet has beneficial effect in older adults to improve cognitive function.

True. Spirituality and religious participation are highly correlated with positive successful aging, as much as diet, exercise, mental stimulation and self efficacy. Spirituality has positive effects on the quality of life and end of life.

Chapter 2

The gerontological nurse plans care for the patient with the knowledge that the patient should be questioned with regard to health practices she uses that may be different from those of the American culture. This is because though she is living in America for long she lived in a Chinese neighbourhood.

In predicting the cultural profile of future population of older adults there will be little difference among various groups.

For a nurse to achieve cultural competency and promote respect , according to Anderson , is to gain the patient's trust for a stronger nurse-patient relationship. This requires sensitivity and effective verbal a and non verbal communication. Nurses have to interact with patients from different cultural backgrounds. To be more culturally aware :

• think beyond race and ethnicity
• learn by asking
• make local connections
• pay attention to non verbal behaviours
• exchange stories

Ageism is the prejudice , stereotyping and discrimination against people on the basis of their age. Ageism is widespread and an insidious practice which has harmful effects on the health of older adults.

Intentional ageism- Ideas , attitude or rules that are carried out with the knowledge that they are biased against persons or group based on their older age. Example: not hiring someone based on older age , scam artists prey upon the vulnerabilities of older adults.

Unintentional ageism- Ideas , attitude or rules that are carried out without the knowledge that they are biased against persons or group based on their older age. Examples are ageism experienced in everyday life.

option d- stereotyping. It's the generalised belief about a particular group or class of people.

Chapter 7

Home Health care service is normally covered by Part B in Medicare. Part A provides coverage in certain circumstances after you are in a hospital.

Eligibility for social security: compiling credits when you pay social security tax. Workers qualify for social security retirement benefits when they reach 40 lifetime credits. Benefits are available at age of 62.

Medicare is a federal program that provides healthcare if you are 65+ or under 65 having disability,no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income.

False. It should be done by the legal advisor.