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Gerontologic nursing is a specialty area of nursing that provides care for the elderly in our population. What goal of care should a gerontologic nurse prioritize when working with this population?
- A. Helping older adults determine how to reduce their use of external resources
- B. Helping older adults use their strengths to optimize independence
- C. Helping older adults promote social integration
- D. Helping older adults identify the weaknesses that most limit them
Correct Answer: B
Rationale: Gerontologic nursing is provided in acute care, skilled and assisted living, community, and home settings. The goals of care include promoting and maintaining functional status and helping older adults identify and use their strengths to achieve optimal independence. Goals of gerontologic nursing do not include helping older adults promote social integration or identify their weaknesses. Optimal independence does not necessarily involve reducing the use of available resources.
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Nurses and members of other health disciplines at a states public health division are planning programs for the next 5 years. The group has made the decision to focus on diseases that are experiencing the sharpest increases in their contributions to the overall death rate in the state. This team should plan health promotion and disease prevention activities to address what health problem?
- A. Stroke
- B. Cancer
- C. Respiratory infections
- D. Alzheimers disease
Correct Answer: D
Rationale: In the past 60 years, overall deaths, and specifically, deaths from heart disease, have declined. Recently, deaths from cancer and cerebrovascular disease have declined. However, deaths from Alzheimers disease have risen more than 50% between 1999 and 2007.
You are caring for an 82-year-old man who was recently admitted to the geriatric medical unit in which you work. Since admission, he has spoken frequently of becoming a burden to his children and staying afloat financially. When planning this patients care, you should recognize his heightened risk of what nursing diagnosis?
- A. Disturbed thought processes
- B. Impaired social interaction
- C. Decisional conflict
- D. Anxiety
Correct Answer: D
Rationale: Economic concerns and fear of becoming a burden to families often lead to high anxiety in older people. There is no clear indication that the patient has disturbed thought processes, impaired social interaction, or decisional conflict.
An elderly patient, while being seen in an urgent care facility for a possible respiratory infection, asks the nurse if Medicare is going to cover the cost of the visit. What information can the nurse give the patient to help allay her concerns?
- A. Medicare has a copayment for many of the services it covers. This requires the patient to pay a part of the bill.
- B. Medicare pays for 100% of the cost for acute-care services, so the cost of the visit will be covered.
- C. Medicare will only pay the cost for acute-care services if the patient has a very low income.
- D. Medicare will not pay for the cost of acute-care services so the patient will be billed for the services provided.
Correct Answer: A
Rationale: The two major programs that finance health in the United States are Medicare and Medicaid, both of which are overseen by the Centers for Medicaid and Medicare Services (CMS). Both programs cover acute-care needs such as inpatient hospitalization, physician care, outpatient care, home health services, and skilled nursing care in a nursing. Medicare is a plan specifically for the elderly population, and Medicaid is a program that provides services based on income.
A gerontologic nurse is overseeing the care that is provided in a large, long-term care facility. The nurse is educating staff about the significant threat posed by influenza in older, frail adults. What action should the nurse prioritize to reduce the incidence and prevalence of influenza in the facility?
- A. Teach staff how to administer prophylactic antiviral medications effectively.
- B. Ensure that residents receive a high-calorie, high-protein diet during the winter.
- C. Make arrangements for residents to limit social interaction during winter months.
- D. Ensure that residents receive influenza vaccinations in the fall of each year.
Correct Answer: D
Rationale: The influenza and the pneumococcal vaccinations lower the risks of hospitalization and death in elderly people. The influenza vaccine, which is prepared yearly to adjust for the specific immunologic characteristics of the influenza viruses at that time, should be administered annually in autumn. Prophylactic antiviral medications are not used. Limiting social interaction is not required in most instances. Nutrition enhances immune response, but this is not specific to influenza prevention.
You are the nurse caring for a 91-year-old patient admitted to the hospital for a fall. The patient complains of urge incontinence and tells you he most often falls when he tries to get to the bathroom in his home. You identify the nursing diagnosis of risk for falls related to impaired mobility and urinary incontinence. The older adults risk for falls is considered to be which of the following?
- A. The result of impaired cognitive functioning
- B. The accumulation of environmental hazards
- C. A geriatric syndrome
- D. An age-related health deficit
Correct Answer: C
Rationale: A number of problems commonly experienced by the elderly are becoming recognized as geriatric syndromes. These conditions do not fit into discrete disease categories. Examples include frailty, delirium, falls, urinary incontinence, and pressure ulcers. Impaired cognitive functioning, environmental hazards in the home, and an age-related health deficit may all play a part in the episodes in this patients life that led to falls, but they are not diagnoses and are, therefore, incorrect.