Test Bank for Ebersole and Hess Gerontological Nursing and Healthy Aging, Second Canadian Edition

Chapter 02: Gerontological Nursing History, Education, and Roles Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 2nd Canadian Edition MULTIPLE CHOICE 1. Which of the following statements best identifies gerontological nursing? a. Nurses have only recently become involved in the care of the older person. b. Gerontological care, while important, is the smallest specialty group within the Canadian Nurses Association (CNA). c. The purposes of gerontological nursing include promotion of health and support for maximal function. d. Canadian Nurses Association certification is available only for gerontological nurses in research positions. ANS: C Feedback A B C D Incorrect. Nurses have always cared for older-person patients. Incorrect. Gerontological care is the largest specialty group within the Canadian Nurses Association. Correct. Promoting health and fostering independence are purposes of the practice, as reflected, for example, in the Canadian Gerontological Nursing Association’s Standards of Practice. Incorrect. The CNA certification program includes a variety of positions, such as nurse practitioners, clinical specialists, researchers, and administrators. DIF: Knowledge REF: 17-18 OBJ: 1 TOP: NCLEX: Health Promotion and Maintenance 2. Which one of the following Canadian Gerontological Nursing Association Standards of Practice recognizes that certain behaviours are not necessarily related to pathology, but instead may be related to the circumstances within the physical or social environment surrounding older persons? a. Physiological health b. Relationship care c. Responsive care d. Health system ANS: C Feedback A B C Incorrect. Physiological health assists clients to maintain homeostatic regulation through assessment and management of physiological care to minimize adverse events associated with medications, diagnostic or therapeutic procedures, health care–associated infections, or environmental stressors. Incorrect. Relationship care occurs when gerontological nurses develop and preserve therapeutic relationship care. Correct. The responsive care approach recognizes that certain behaviours are not D necessarily related solely to pathology, but instead may be related to circumstances within the physical or social environment surrounding well older persons and those with dementia, and may be an expression of unmet need. Incorrect. Health system focuses on the economic and political influences that provide or facilitate care that supports access to and benefit from the health care delivery system. DIF: Knowledge REF: 16 (Box 2-5) OBJ: 2 TOP: NCLEX: Health Promotion and Maintenance 3. Which of the following 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 cover gerontological nursing extensively in dedicated courses, comparable to the coverage of psychiatric nursing. c. Issues most lacking in gerontological nursing education include faculty not being supportive and students lacking interest in this area of nursing. d. Accreditation of a nursing program guarantees that appropriate amounts of gerontological nursing content are included in the curriculum. ANS: C Feedback A B C D Incorrect. Only recently has gerontological nursing content begun to appear in nursing school curricula. Incorrect. Most nursing schools still do not have courses dedicated to gerontological nursing. Correct. The most evident issues that are most lacking in gerontological nursing education are lack of expertise in nursing faculty, nonsupportive nursing faculty, the belief that gerontological nursing content is integrated throughout the nursing program, and students’ lack of interest in this area of nursing. Incorrect. At present, there are no minimum requirements for coverage of care of older persons. DIF: Knowledge REF: 19-20 OBJ: 6 TOP: NCLEX: Health Promotion and Maintenance 4. What was the first formal action taken by the Canadian Gerontological Nursing Association (CGNA) in relation to gerontological nursing? a. The CGNA established the first provincial gerontological nursing association. b. The CGNA established gerontological nursing standards. c. The CGNA created the Canadian Association of Older Adults. d. The CGNA formed the Canadian Association of Gerontology. ANS: B Feedback A B Incorrect. In Canada, the first provincial gerontological nursing association was formed in Ontario in 1974, prior to the establishment of the CGNA in 1983. Correct. In 1987, gerontological nursing standards were established by the C D CGNA. Incorrect. The Canadian Association of Older Adults does not exist. Incorrect. The Canadian Association of Gerontology was founded in 1971, 14 years before the Canadian Gerontological Nursing Association (CGNA) was founded. DIF: Knowledge REF: 14 OBJ: 2 TOP: NCLEX: Health Promotion and Maintenance 5. A male older person is transferred to a hospice facility with end-stage disease. Which of the following is a suitable nursing intervention for this older person and his family, according to the Canadian Gerontological Nursing Association’s Standards of Practice? 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 Feedback A B C D Incorrect. To promote comfort, the gerontological nurse administers medication as prescribed and avoids restricting analgesia to patients regardless of the setting or the nurse’s personal views. Incorrect. Although fostering independence is within the scope of gerontological nursing practice, the nurse should assess the older person and family before assuming the older person will want or be able to perform self-care. Incorrect. Although hospice can have regular visiting hours, the older person 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 person’s needs. Correct. To promote dignity, the nurse facilitates enactment of family wishes, rituals, or religious practices related to death and dying. This nursing action relates to Standard III: Responsive care, and Standard IV: Relationship care. DIF: Application REF: 16 OBJ: 2 TOP: NCLEX: Safe and Effective Care Environment 6. A nursing home executive interviews RNs to fill a full-time position for direct patient care, to maintain the standards of older-person care. Which nurse should the nursing home hire? a. A nurse from a certified university b. A certified gerontological nurse c. A nurse with 15 years of experience d. A gerontological nurse practitioner ANS: B Feedback A B Incorrect. A nurse educated in a certified university does not necessarily have specialty education and training in gerontology. Correct. A certified gerontological nurse receives education and training to care C D for older persons, assuring the nursing home and the public that the nurse has mastered the specialized skills and knowledge to care for older persons according to gerontological nursing standards. Incorrect. A nurse with 15 years’ experience might have no experience with gerontology and offers no proof of specialized knowledge or skills. Incorrect. Although a gerontological nurse practitioner receives specialized education and training in gerontology, the nurse being hired provides primary care in a nursing home. DIF: Application REF: 18 OBJ: 4 TOP: NCLEX: Safe and Effective Care Environment 7. The gerontological nurse collaborates with the wound care team about an older person who has an ulcer. How is this nurse demonstrating leadership in the care of an older person? a. The nurse is screening and assessing older persons effectively. b. The nurse is facilitating access to older person care programs. c. The nurse is coordinating members of the health care team. d. The nurse is empowering older persons to manage chronic illness. ANS: C Feedback A B C D Incorrect. Screening and assessing are only indirectly related to collaboration. Incorrect. In this case, the nurse’s collaborative efforts are unrelated to facilitating access to a program. Correct. The nurse demonstrates leadership in the care of older persons by initiating and coordinating collaboration with the wound care team to improve the health of an older person. This action is congruent with Standard IV: Relationship care of the CGNA’s Standards of Practice. Incorrect. Thus far, the nurse has not educated or trained this client in wound care. DIF: Application REF: 18 OBJ: 5 TOP: NCLEX: Safe and Effective Care Environment 8. Gerontological nurses may be generalists or specialists. In order to prepare a nurse generalist, which of the following nursing practices experience would be the most meaningful and helpful? a. Working with older persons experiencing chronic health conditions found in acute care settings b. Working with older persons across the continuum of care c. Working with older persons in long-term care facilities, because this is where most older persons reside d. Working with older persons in home care, because the goal is to keep them in their homes as long as possible ANS: B Feedback A Incorrect. Working with older persons experiencing chronic health conditions B C D found in acute care settings is important, but it is only one aspect of caring for older persons. Correct. To prepare nurse generalists, it is important to provide nursing practice experiences with older persons across the continuum of care, not just in acute and long-term care settings. Incorrect. Working with older persons in long-term care facilities is important, but it is only one area of caring for older persons. Incorrect. Working with older persons in home care is important, and it is important to keep older persons in their familiar environment as long as they are safe and can be effectively cared for in their homes, but it is only one area of caring for older persons. DIF: Comprehension REF: 22 TOP: NCLEX: Health Promotion and Maintenance OBJ: 6 9. Mrs. Jaciuk, 70 years of age, was admitted to the hospital after a recent fall in her home. Her left cheek is bruised and she complains that her left leg is very sore. After assessment and undergoing a CT scan of her head and an X-ray of her left leg, the physician is ready to discharge her home because there is no evidence of a fracture. Mrs. Jaciuk starts to cry when the nurse enters the room and she begs the nurse to allow her to stay, because she has no one at home and she fears she may fall again. What should the nurse consider when addressing Mrs. Jaciuk? a. Allow Mrs. Jaciuk to express her feelings. b. Understand that hospitals are dangerous places for older persons. c. Speak with the physician and request that Mrs. Jaciuk be allowed to stay another day. d. Instruct Mrs. Jaciuk about fall prevention, based on the Registered Nurses’ Association (RNAO) Best Practice Guideline. ANS: B Feedback A B C D Incorrect. Encouraging Mrs. Jaciuk to express her feelings is important, but this will not address the underlying issue of hospitals being a dangerous place for older persons. Correct. Hospitals are dangerous places for older persons: 34% experience functional decline and iatrogenic complications (29% to 38%), a rate three to five times higher than the rate for younger patients. Incorrect. Requesting that Mrs. Jaciuk be allowed to stay one more day does not address the issue that older persons’ hospital stay should be as brief as possible. Incorrect. While providing Mrs. Jaciuk with evidence-informed practice information related to falls is valuable, it does not address the potential complications older persons are susceptible to if they stay in hospital. DIF: Analysis REF: 18 OBJ: 5 TOP: NCLEX: Safe and Effective Care Environment 10. Leadership in long-term care settings requires balancing the needs of the residents with the well-being of the staff. The turnover rate of Health Care Aides (HCAs) in long-term care facilities is almost 100%. You are working in a long-term care facility and have identified that whenever a particular HCA is unhappy with an assignment, the entire unit has a bad day. Which action should the unit nurse take first to correct this situation? a. Meet with the HCA to find out why the HCA is so unhappy. b. Place the HCA on probation for the negative behaviour. c. Discuss with the HCA the perceived attitude and the way it affects the unit. d. Suspend the HCA until the behaviour improves. ANS: C Feedback A B C D Incorrect. Meeting with the HCA to find out why she is so unhappy may lead to a long, drawn out, unproductive meeting. Incorrect. Placing the HCA on probation may only exacerbate the negative behaviour and does not address the behaviour. Correct. The first step is an informal meeting with the HCA to discuss the HCA’s attitude and how it affects the staff. The manager should document the conversation. Incorrect. Suspension may only create more disharmony among the other HCAs, even if the individual behaving badly has been removed. The unit nurse must remember that turnover rate is approaching 100% and does not serve the residents well. DIF: Analysis REF: 20 OBJ: 5 TOP: NCLEX: Health Promotion and Maintenance