Test Bank For Advanced Practice Nursing in the Care of Older Adults 2nd Edition Kennedy-Malone

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Test Bank For Advanced Practice Nursing in the Care of Older Adults 2nd Edition Kennedy-Malone

Advanced Practice Nursing in the Care of Older Adults 2nd Edition Kennedy-Malone Test Bank

Chapter 1. Changes With Aging
• The nurse explains that in the late 1960s, health care focus was aimed at the

older adult because:

  • disability was viewed as unavoidable.
  • complications from disease increased mortality.
  • older adults needs are similar to those of all adults.
  • preventive health care practices increased longevity.

    ANS: D

    Increased preventive health care practices, disease control, and focus on wellness helped people live longer.

    DIF: Cognitive Level: Comprehension REF: 2 OBJ: 2
    TOP: Aging Trends KEY: Nursing Process Step: Implementation
    MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

  • The nurse clarifies that in the terminology defining specific age groups, the term aged refers to persons who are:
  • 55 to 64 years of age.
  • 65 to 74 years of age.
  • 75 to 84 years of age.
  • 85 and older.

    ANS: C

    The term aged refers to persons who are 75 to 84 years of age. DIF: Cognitive Level: Comprehension REF: 2, Table 1-1 OBJ: 1 TOP: Age Categories KEY: Nursing Process Step: Implementation

    MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

• The nurse cautions that ageism is a mindset that influences persons to:

  • discriminate against persons solely on the basis of age.
  • fear aging.
  • be culturally sensitive to concerns of aging.
  • focus on resources for the older adult.

ANS: A

Ageism is a negative belief pattern that influences persons to discriminate against persons solely on the basis of age and can lead to destructive behaviors toward the older adult.

DIF: Cognitive Level: Comprehension REF: 5
OBJ: 3 TOP: Ageism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

  • The nurse points out that the most beneficial legislation that has influenced health care for the older adult is:
  • Medicare and Medicaid.
  • elimination of the mandatory retirement age.
  • the Americans with Disabilities Act.
  • the Drug Benefit Program.

    ANS: A
    The broadest sweeping legislation beneficial to the older adult is Medicare and Medicaid.

    DIF: Cognitive Level: Application REF: 16 OBJ: 6

    TOP: Legislation KEY: Nursing Process Step: Implementation MSC: NCLEX: N/A

    • The nurse clarifies that a housing option for the older adult that offers the privacy of an apartment with restaurant-style meals and some medical and personal care services isthe:
    • government-subsidized housing.
    • long-term care facility.
    • assisted-living center.
    • group housing plan.

      ANS: C

      Assisted-living arrangements offer the privacy of an apartment or condominium with meals prepared and served, limited medical care, and a variety of personal services.

      DIF: Cognitive Level: Application REF: 14 OBJ: 9 TOP: Housing Options KEY: Nursing Process Step:

Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation

  • The 75-year-old man who has been hospitalized following a severe case of pneumonia is concerned about his mounting hospital bill and asks if his Medicare coverage will pay for his care. The nurses most helpful response is Yes. Medicare:
  • pays 100% of all medical costs for persons older than 65.
  • Part B pays hospital costs and physician fees.
  • Part A pays for inpatient hospital costs.
  • Part D pays 80% of the charges made by physicians.

    ANS: C

    Medicare Part A pays inpatient hospital costs, Part B pays 80% of physicians charges, and Part D helps defray prescription drug costs.

    DIF: Cognitive Level: Application REF: 16 OBJ: 6

    TOP: Medicare Provisions KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping

and Adaptation

  • The daughter of a patient who has been diagnosed with terminal cancer asks which documents are required to allow her to make health care decisions for her parent. The nurses most informative response is:
  • Advance directives indicate the degree of intervention desired by the patient.
  • A Do Not Resuscitate document signed by the patient transfers authority to the next of kin.
  • A durable power of attorney for health care transfers decision-making authority for health care to a designated person.
  • A living will transfers authority to the physician. ANS: C

    A durable power of attorney for health care transfers the authority for decision making to a designated person.

    DIF: Cognitive Level: Application REF: 19 OBJ: 11

    TOP: Advance Directives KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

• The daughter of a resident in a long-term care facility is frustrated with her 80-year-old mothers refusal to eat. The nurse explains that the refusal to eat is a behavior that is an:

  • effort to maintain a portion of independence and self direction.
  • indication of approaching Alzheimer disease.
  • effort to gain attention.
  • indication of the dislike of the institutional food.

    ANS: A

    Loss of independence and control is a significant issue for the older adult. Some residents will exercise whatever control they may retain.

    DIF: Cognitive Level: Application REF: 21 OBJ: 11

    TOP: Loss of Independence KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

• The nurse clarifies that the conditions of a living will go into effect when:

  • the patient declares that desire in writing.
  • a family member indicates the desire for curative therapy to cease.
  • two physicians agree in writing that the criteria in the living will have been met.
  • the physician and a family member agree that the criteria in the living will have been met.

    ANS: C

    Two physicians must agree in writing that the criteria of the living will have been met before the document can go into effect.

    DIF: Cognitive Level: Application REF: 19 OBJ: 11

    TOP: Living Wills KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

  • In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce hospital costs by:
  • classifying various diagnoses as ineligible for hospitalization.
  • allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis.
  • specifying particular physicians to treat specified diagnoses.
  • using frequency of a particular diagnosis to set a payment schedule.

    ANS: B

DRGs set up a system of preset hospitalization time and payment on the basis of the admitting diagnosis.

DIF: Cognitive Level: Comprehension REF: 16 OBJ: 6
TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

  • When discussing extended care with a patient who has had a hip replacement andneeds physical therapy, the nurse would recommend a(n):
  • basic care facility.
  • skilled care facility.
  • subacute care facility.
  • assisted-living residence.

    ANS: B

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