Gerontological Nursing 8th Edition by Charlotte – Test Bank

Gerontological Nursing 8th Edition by Charlotte – Test Bank

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 1
Chapter: 7
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing process
Objective: 1
Page and Header: 87, Introduction
1. Mr. C., aged 82 years, has always lived independently in the house that he and his late wife purchased over 50 years ago. Mr. C. has experienced few health problems, and for that reason his recent falls in the home comes as a surprise to himself and his children. What should the nurse who is providing primary care for Mr. C. first do in this situation?
A) Arrange a family meeting to organize supervision for Mr. C. during high-risk times.
B) Perform a comprehensive musculoskeletal assessment of Mr. C.
C) Investigate what community resources might be appropriate and available to Mr. C.
D) Elicit from Mr. C. what he perceives to be the causes of and potential solutions to his falls.
Ans: D
Feedback:
Answer D best reflects an acknowledgment that Mr. C likely has both the skills and strategies to address his problem. Answers A, B, and C are less holistic in approach and would not be the nurse’s initial response to the situation.

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 2
Chapter: 7
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication
Objective: 1
Page and Header: 88, Holistic Gerontological Care
2. A nurse who provides care on the palliative unit of a large teaching hospital has been working with an older adult client who is dying of lung cancer with liver metastases and has generated good rapport with both the client and his family. Which of the following statements best exemplifies a holistic approach to nursing care?
A) “Our goal is to keep you pain-free to the best of our ability, so don’t hesitate to request additional pain medications.”
B) “I will raise the possibility of palliative radiation treatment when your oncologist is next in.”
C) “I’m wondering what feelings you have around being at this stage of your life.”
D) “I’ll make sure that both the social worker and physical therapist come by in the next day or so.”
Ans: C
Feedback:
Answer C encompasses concerns around the client’s presence or absence of peace at this stage in life and supersedes immediate medical or logistical concerns. Answers A, B, and D represent valid nursing actions but are less indicative of the holistic scope of nursing practice.

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 3
Chapter: 7
Client Needs: D4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Teaching/learning
Objective: 2
Page and Header: 88, Holistic Gerontological Care
3. Mrs. D, age 77, has been recently diagnosed with type 2 diabetes mellitus. Which of the following questions by her nurse is most indicative of a holistic approach to gerontological nursing care?
A) “How do you anticipate this affecting your lifestyle and your daily routines?”
B) “Would you like me to show you a few different glucometers so that you can choose one that works for you.”
C) “Can I arrange for you to meet with a dietitian to go over some nutrition tips?”
D) “When would be a good time for me to teach you about skin care and diabetes?”
Ans: A
Feedback:
Answer A addresses the impact of the diagnosis on the client’s lifestyle and quality of life, concerns that are central to holistic nursing care. Answers B, C, and D address valid components of care for the client, but are less indicative of a holistic approach.

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 4
Chapter: 7
Client Needs: B
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Teaching/learning
Objective: 2
Page and Header: 89, Health Promotion–Related Needs
4. A community health nurse has been invited to speak to a group of older adults in the context of the local community center. Which of the following nursing actions best reflects an approach that emphasizes the importance of health promotion in gerontological nursing care?
A) A teaching session on the signs and symptoms of stroke, along with current treatment modalities.
B) An educational presentation on the importance of prostate screening for men and mammography for women.
C) A class that presents the beneficial effects of regular exercise and practical methods for integrated exercise into daily routines.
D) A presentation on the issue of elder abuse and ways to identify and prevent it.
Ans: C
Feedback:
Exercise is one of the clearest examples of health promotion. Teaching on a particular diagnosis such as stroke, a screening program addressing prostate and breast health and psychosocial issues such as elder abuse are certainly valid, but are less clearly indicative of health promotion in nursing care.

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 5
Chapter: 7
Client Needs: B
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Teaching/learning
Objective: 2
Page and Header: 90, Health Challenges–Related Needs
5. After a lifetime of good health, a 72-year-old man has been found to have severe hypertension. What can his nurse do that most clearly prioritizes the role of monitoring that nurses play in the management of health challenges?
A) Liaising between his family physician and his cardiologist to ensure that appointments do not conflict and communication is maintained.
B) Guiding the client toward the purchase of a home blood pressure cuff and keeping up to date on his regular readings.
C) Teaching the client about lifestyle changes that his condition necessitates and that will ensure his high level of function.
D) Educating the client about the basic pathophysiology that underlies his condition.
Ans: B
Feedback:
Monitoring entails tracking the status of a client’s health condition, as could be done by using a BP cuff and staying abreast of results. Answer A indicates a coordination role, while answers C and D reflect coaching and education, respectively.

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 6
Chapter: 7
Client Needs: B
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing process
Objective: 3
Page and Header: 90, Knowledge, Experience, and Skills
6. Nurse J provides care for numerous older adult clients in the context of her work as a community health nurse. Which of her following clients is displaying a deficit in knowledge, experience, and skills that has the potential to compromise his or her health?
A) A 79-year-old female client who has dysphagia (difficulty swallowing) following her recent stroke.
B) Mrs. H, age 78, who states that she lost all hope since her husband’s death 5 months prior and no longer wants to stay active.
C) An 89-year-old man who has recently lost the ability to climb stairs due to the exacerbation of his congestive heart failure.
D) Mr. I, recently diagnosed with diabetes, who shows an inability to manipulate his glucometer and test strips.
Ans: D
Feedback:
Mr. I demonstrates an inability to perform the necessary skills for health care. Answers A and C indicate a lack of physical ability while answer B suggests a lack of desire to take action.

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 7
Chapter: 7
Client Needs: B
Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Nursing process
Objective: 3
Page and Header: 90, Desire and Decision to Take Action
7. In which of the following situations would the care team be most likely justified in superseding the desires of the older adult client in question?
A) Mrs. J persists in smoking cigarettes despite her emphysema and dependence on oxygen by nasal prongs.
B) Mr. L is adamantly opposed to placement in a care facility, despite his progressing dementia and tendency to leave his stove turned on.
C) Mrs. B, though denying suicidal ideation, is depressed and has cloistered herself in her apartment for many months.
D) Mr. E, despite his family’s wishes, does not want any treatment for his recently diagnosed brain tumor.
Ans: B
Feedback:
Desires of clients may be superseded by professional judgment in actual or suspected cases of mental incompetence, of which dementia may be an example. Answers A, C, and D are examples of situations where the desires of older adults, though likely detrimental, would ultimately be respected.

Origin: Chapter 7- Holistic Model for Gerontological Nursing, 8
Chapter: 7
Client Needs: A1
Cognitive Level: Comprehension
Difficulty: Difficult
Integrated Process: Nursing process
Objective: 4
Page and Header: 91, Gerontological Nursing Processes
8. Which of the following statements provides the clearest justification for the performance of gerontological nursing intervention?
A) The client does not possess the requisites to meet his or her needs independently.
B) The client is deemed by health professionals, in their professional judgment, to be in a compromised health state.
C) The client expresses a desire for assistance with self-care.
D) The client engages in behaviors that are not compatible with good health.
Ans: A
Feedback:
When the older adult does not have the requisites to meet needs independently, however, nursing interventions are needed. While interventions may well be performed in situations characterized by answers B, C, and D, answer A is the broadest principle that would supersede the others cited.