Chapter 01: Trends and Issues
Williams: Basic Geriatric Nursing, 7th Edition

MULTIPLE CHOICE

	1.	What fact explains the shift of health care focus toward the older adult in the late 1960s?
a.	Disability was viewed as unavoidable.	
b.	Complications from disease increased mortality.	
c.	Older adults’ needs are similar to those of all adults.	
d.	Preventive health care practices increased longevity.	

ANS:	D

	2.	To what age group does the term “aged” apply?
a.	55–64 years of age	
b.	65–74 years of age	
c.	75–84 years of age	
d.	85 and older	

ANS:	C

	3.	Which is true of ageism?
a.	It is discrimination against persons solely on the basis of age.	
b.	It causes a person to fear aging.	
c.	It involves the use of cultural sensitivity to address concerns of aging.	
d.	It focuses on resources for the older adult.	

ANS:	A

	4.	What is the most beneficial legislation that has influenced health care for the older adult?
a.	Medicare and Medicaid	
b.	Elimination of the mandatory retirement age	
c.	The Americans with Disabilities Act	
d.	The Drug Benefit Program	

ANS:	A

	5.	What housing option for the older adult offers the privacy of an apartment with restaurant-style meals and some medical and personal care services?
a.	Government-subsidized housing	
b.	Long-term care facility	
c.	Assisted-living center	
d.	Group housing plan	

ANS:	C

	6.	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. What would be the most helpful response by the nurse?
a.	Medicare Part C pays 50% of all medical costs for persons older than 65.	
b.	Medicare Part B pays hospital costs and physician fees.	
c.	Medicare Part A pays for inpatient hospital costs.	
d.	Medicare Part D pays 80% of the charges made by physicians.	

ANS:	C

	7.	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. Which response would provide the most accurate information to the daughter?
a.	Advance directives indicate the degree of intervention desired by the patient.	
b.	A ‘Do Not Resuscitate’ document signed by the patient transfers authority to the next of kin.	
c.	A durable power of attorney for health care transfers decision-making authority for health care to a designated person.	
d.	A living will transfers authority to the physician.	

ANS:	C

	8.	The daughter of a resident in a long-term care facility is frustrated with her 80-year-old mother’s refusal to eat. Which response would be the most appropriate?
a.	The refusal to eat is an effort to maintain a portion of independence and self-direction.	
b.	The refusal to eat is an indication of approaching Alzheimer disease.	
c.	The refusal to eat is an effort to gain attention.	
d.	The refusal to eat is an indication of the dislike of the institutional food.	

ANS:	A

	9.	When do the conditions of a living will go into effect?
a.	When the patient declares that desire in writing	
b.	When a family member indicates the desire for curative therapy to cease	
c.	When two physicians agree in writing that the criteria in the living will have been met	
d.	When the physician and a family member agree that the criteria in the living will have been met	

ANS:	C

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

ANS:	B

	11.	Which facility would be recommended for a patient who has had a hip replacement and needs physical therapy?
a.	Basic care facility	
b.	Skilled care facility	
c.	Subacute care facility	
d.	Assisted-living residence	

ANS:	B

	12.	The 80-year-old woman who is recovering from a stroke is being sent to a skilled care facility. She is concerned about the expense. The nurse can decrease anxiety by explaining that Medicare will cover extended-care facility costs for what period of time?
a.	A period of 30 days	
b.	A period of 45 days for physical therapy	
c.	A period of 100 days for needed skilled care	
d.	Until she is able to be discharged home	

ANS:	C

	13.	Which senior citizen political action group uses volunteers and lobbyists to advance the interests of older adults?
a.	American Association of Retired Persons (AARP)	
b.	National Council of Senior Citizens (NCSC)	
c.	National Alliance of Senior Citizens (NASC)	
d.	Gray Panthers	

ANS:	A

	14.	Which caregiver could be found guilty of elder abuse?
a.	A daughter who uses her mother’s Social Security money to purchase her mother’s medication	
b.	A son who puts an alarm on the front door to prevent his mother from wandering out of the house	
c.	A wife who allows her mentally competent husband to refuse to take a bath for a week	
d.	A son who uses his mother’s checking account funds to purchase alcohol for himself	

ANS:	D

	15.	What is the most frequent response to elder abuse by the abused older adult?
a.	Anger	
b.	Physical retaliation	
c.	Notification of authorities	
d.	Nothing at all	

ANS:	D

	16.	What reason is often stated by nurses today for not seeking careers in gerontology?
a.	The physical work is too difficult.	
b.	Their technical skills are not used.	
c.	There is too much challenge.	
d.	There are limited options for employment.	

ANS:	B

	17.	“Baby boomers” is a term used to classify which of the following persons?
a.	Those who entered school in 1945	
b.	Those who served in the military in World War II	
c.	Those who were born between 1946 and 1964	
d.	Those who were eligible for Social Security benefits in 2000	

ANS:	C

	18.	What type of abuse is demonstrated by restraining an older adult in a recliner?
a.	Physical abuse	
b.	Neglect	
c.	Emotional abuse	
d.	Self-neglect	

ANS:	A

	19.	Which type of elder abuse is demonstrated by the nonprovision of medical care?
a.	Physical abuse	
b.	Neglect	
c.	Emotional abuse	
d.	Self-neglect	

ANS:	B

	20.	Which type of elder abuse is demonstrated by a health care worker telling a nursing home resident she will be left without a call light if she continues to use it excessively.
a.	Physical abuse	
b.	Neglect	
c.	Emotional abuse	
d.	Self-neglect	

ANS:	C

MULTIPLE RESPONSE

	1.	The nurse is aware that a person’s attitude about aging is influenced mainly by his or her __________. (Select all that apply.)
a.	life experiences	
b.	income level	
c.	level of education	
d.	current age	
e.	occupation	

ANS:	A, D

	2.	Gerontology encompasses application to __________. (Select all that apply.)
a.	appropriate housing	
b.	health care	
c.	public education	
d.	business ventures	
e.	government-sponsored pensions	

ANS:	A, B, C, D

	3.	Medicare Part C allows eligible persons to receive Medicare benefits via the services of private insurance companies through which of the following? (Select all that apply.)
a.	Health maintenance organization (HMO)	
b.	Preferred provider organization (PPO)	
c.	Provider-sponsored organization (PSO)	
d.	Private fee for service organization (PFFS)	
e.	Medical service organization (MSO)	

ANS:	A, B, C, D

	4.	Which emotional response would be expected from a family who is coping with an aging loved one’s diminishing abilities and increased care needs? (Select all that apply.)
a.	Grief	
b.	Anger	
c.	Frustration	
d.	Loss	
e.	Resentment	

ANS:	A, B, C, D

	5.	What characteristics are typical for a caregiver of an aging family member? (Select all that apply.)
a.	32 years of age	
b.	Female	
c.	Having full-time employment	
d.	Having a care recipient older than 70	
e.	Giving care for an average of 4 years	

ANS:	B, C, D, E

	6.	Which are indicators of self-neglect in the aging person? (Select all that apply.)
a.	Misbalanced checkbook	
b.	Reduced personal hygiene	
c.	Increased alcohol consumption	
d.	Irritability	
e.	Loss of weight	

ANS:	A, B, C, E

	7.	The nurse reminds a group of prospective caregivers that elder abuse may take the form of __________. (Select all that apply.)
a.	caring for physical needs	
b.	misappropriation of finances	
c.	psychological intimidation	
d.	emotional depersonalization	
e.	abandonment	

ANS:	B, C, D, E

	8.	Research by the National Institute on Aging found which of the following to be correct? (Select all that apply.)
a.	Older patients receive less information regarding health management than younger patients.	
b.	Information on lifestyle changes were directed at younger people.	
c.	Older patients were denied timely appointments for evaluation of acute illnesses.	
d.	Rehabilitation programs offered limited services to the older adult.	
e.	Older patients receive less evaluation and fewer treatment options for acute illnesses.	

ANS:	A, B, D, E

	9.	The Nursing Competence in Aging initiative advocates enhancing nurses’ __________. (Select all that apply.)
a.	knowledge in gerontics	
b.	skills in geriatrics	
c.	opportunities for employment	
d.	political sensitivity for the older adult	
e.	attitudes related to the older adult	

ANS:	A, B, E

COMPLETION

	1.	The nurse clarifies that the term that refers to the promotion of high-level functioning and supportive care to older adults is __________.

ANS:	gerontics

	2.	The nurse reminds a patient who was born in 1965 that eligibility for full Social Security benefits for persons of this age is now the age of __________.

ANS:	67

	3.	The nurse clarifies that the point at which a person on Medicaid Part D must assume full cost of medication is called the ____________________.

ANS:	donut hole