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Andersons Caring for Older Adults Holistically 6th Edition Dahlkemper Test Bank

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Andersons Caring for Older Adults Holistically 6th Edition Dahlkemper Test Bank

ISBN-13: 978-0803645493

ISBN-10: 080364549X

 

Description

Andersons Caring for Older Adults Holistically 6th Edition Dahlkemper Test Bank

ISBN-13: 978-0803645493

ISBN-10: 080364549X

 

 

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Below you will find some free nursing test bank questions from this test bank:

Chapter 12: Environments of Care

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   What is the goal of an environmental assessment?

1) Promote independent function.
2) Establish an older adult’s housekeeping abilities.
3) Detect reasons to admit an older adult to a long-term care facility.
4) Assist the family with documenting reasons they should seek durable power of attorney.

 

 

____     2.   After admitting an 86-year-old resident to a retirement community, the nurse assisted with transitioning to the new home, arranged Meals on Wheels, provided a list of local physicians, and made arrangements for the community Welcome Wagon to make a visit. What type of care did the nurse perform?

1) Hospice
2) Transpersonal caring
3) Micromanaging the client
4) Environmental management

 

 

____     3.   When entering an older patient’s home the nurse notices that the room is very warm. What patient behavior should the nurse attribute to the environment?

1) Hunger
2) Lethargy
3) Talkativeness
4) Being motivated

 

 

____     4.   The nurse is visiting an assisted living facility to help an older person decide if she wants to relocate to this environment. Which observation should the nurse question as being desirable for this person?

1) Lack of community lounge
2) Garden with benches and chairs
3) Recreation room with a television and magazines
4) Residents visiting in the common areas on each floor

 

 

____     5.   The nurse determines that one apartment in an assisted living facility would not be appropriate for a person who relies on a wheelchair. What did the nurse observe to make this determination?

1) Bath tub with shower
2) Absence of throw rugs
3) Oversized door openings
4) Handicapped-accessible commode

 

 

____     6.   Which would NOT be included in an environmental safety risk assessment?

1) Noting clutter and throw rugs
2) Medication storage and date of medications
3) Noting electrical wiring, frayed cords, and hot extension cords
4) Sorting through older adults’ mail to see if they are paying their bills on time

 

 

____     7.   Which intervention increases the functionality of the environment?

1) Installing grab bars in the bathroom
2) Padding the bed for an incontinent older adult
3) Changing light bulbs to energy-saving, low-wattage bulbs
4) Inserting an indwelling catheter so that the older adult does not have to get out of the chair to void

 

 

____     8.   If the nurse is evaluating the home of an elderly person who has had a total hip replacement, what areas should be considered as being the most important?

1) Friendliness of the neighbors
2) The safety of the neighborhood and the internal safety of the home
3) If emergency medical services are available in the event that the patient falls
4) The accessibility of a grocery store and drug store and the availability of a working telephone

 

 

____     9.   While conducting a home assessment the nurse identifies safety issues in the patient’s bathroom. What did the nurse assess to make this determination?

1) Grab bars in the shower
2) Grab bars around the commode
3) Throw rug absent from the floor
4) Cord for electric shaver crossing over the sink

 

 

____   10.   The nurse notes that an older patient smokes. What would be imperative for this patient to have in the home?

1) Functioning smoke alarms
2) Electric cooking appliances
3) Water in every room of the house
4) Telephone number for the fire department

 

 

____   11.   An older patient is hospitalized with a broken hip after falling in the home. What should the nurse discuss as a priority when making a home visit?

1) The time the patient goes to sleep at night
2) The location of the pharmacy that the patient uses
3) Asking someone to take the patient’s toy poodle
4) When the patient expects the mail to be delivered each day

 

 

____   12.   What does the respect for personal space and privacy help develop?

1) A climate of caring
2) Nursing assessments
3) A comprehensive care plan
4) Customer satisfaction with nursing care

 

 

____   13.   Which is NOT a component of a caring climate?

1) Privacy
2) Dependence
3) Personal space
4) Activity and involvement

 

 

____   14.   An older person who used to work until midnight doesn’t go to sleep until 3:00 a.m. and likes to stay in bed until 11:00 a.m. The facility that the patient lives in provides breakfast at 8:00 a.m. What should the nurse do to ensure that this patient’s nutritional needs are being met?

1) Wake the patient up for breakfast at 8:00 a.m.
2) Stop the delivery of a breakfast tray for this patient.
3) Have the breakfast tray delivered with the lunch tray.
4) Place the breakfast tray aside to be warmed up when the patient wakes up.

 

 

____   15.   An older patient is being admitted to an extended care facility for several weeks for extensive wound care and hemodialysis. What should be done to personalize this patient’s living area during this time?

1) Dress the patient in personal clothing.
2) Place the patient’s toilet articles in the bathroom.
3) Keep the patient’s slippers on the floor next to the bed.
4) Ask family to bring in a favorite picture to place on the bedside table.

 

 

____   16.   An older patient with terminal cancer is being discharged back to his home. What service should be recommended to this patient’s family for care?

1) Hospice
2) Nursing home
3) Adult day services
4) Skilled nursing facility

 

 

____   17.   A spouse is the primary caregiver for an 80-year-old ill patient. The spouse does not want to place the patient in a nursing facility but is experiencing extreme exhaustion. What should the nurse recommend to the spouse?

1) Respite care
2) Senior center
3) Hospitalization
4) Home health nursing

 

 

____   18.   An older patient who lives alone is recovering from total hip replacement surgery with the plan to return home. The patient’s sister will be staying for 1 week after discharge. Which referral is appropriate for this patient?

1) Hospice
2) Senior center
3) Home health services
4) Skilled nursing facility

 

 

____   19.   Which is a criterion for hospice services?

1) A cancer diagnosis
2) Lack of family support
3) Terminal disease process
4) Chronic disease with acute exacerbation

 

 

____   20.   Which is NOT a part of hospice care?

1) Personal care services
2) Funeral arrangement services
3) Family counseling and support
4) Ongoing support for families after the person’s death

 

 

____   21.   An older person is increasingly confused from Alzheimer’s disease and the spouse is unable to continue to care for the patient at home. What referral should be made for the patient?

1) Hospitalization
2) Retirement center
3) Skilled nursing facility
4) Intermediate nursing facility

 

 

____   22.   A 78-year-old patient is distressed over the high maintenance costs of a large home. What should be recommended as a living alternative for the patient?

1) Senior center
2) Retirement center
3) Skilled nursing facility
4) Intermediate nursing facility

 

 

____   23.   Who directs the care and instruction for an LPN providing home care services?

1) The physician
2) The family and patient
3) The registered nurse (RN) case manager
4) The secretary at the agency who makes the assignments

 

 

____   24.   What would be the LPN’s primary responsibilities in an adult day services center?

1) Medications and meals
2) Activities and teaching
3) Assessments and medications
4) Meal preparation and activity planning

 

 

____   25.   In which environment does the nurse require some level of creativity because of a limitation of equipment and supplies?

1) Hospice
2) Home care
3) Adult day services
4) Retirement communities

 

 

____   26.   A patient is interested in adult day services. What should the nurse remind the patient about the financing of these services?

1) Medicare pays for these services.
2) Medicare does not pay for these services.
3) Medicaid does not pay for these services.
4) Personal insurance pays for these services.

 

 

____   27.   The nurse is preparing to make a visit to the home of an older patient newly diagnosed with heart failure. How much time should the nurse plan to spend with the patient?

1) Less than an hour
2) A complete 8-hour day
3) Between 4 and 6 hours
4) As much time as needed to provide treatments

 

 

____   28.   The nurse is hired to staff a community care clinic. Which type of care should the nurse expect to provide to older community members?

1) Vaccinations
2) Routine physicals
3) Wellness activities
4) Available resources

 

 

____   29.   For which person would an assisted living community be an appropriate choice?

1) A non-ambulatory terminally ill patient
2) A completely independent and ambulatory older adult
3) A non-ambulatory, very frail person with a serious chronic illness
4) An ambulatory patient who has a chronic condition that requires medication

 

 

____   30.   What type of care would the nurse provide in an assisted living community?

1) Preparing meals
2) Helping with laundry
3) Assisting with daily grooming
4) Assessing medication responses

 

 

____   31.   A participant in an adult day services program tells the nurse that she needs to start on insulin every day to help manage her diabetes. What should the nurse make a priority for this patient?

1) Ability to self-inject the medication
2) Importance of having the eyes checked every year
3) Need to see the primary care physician every 3 months
4) Frequency of checking capillary blood glucose levels at home

 

 

____   32.   Which observation should the nurse question in a person who is a participant in an adult services program?

1) Laughing while watching a comedy movie
2) Walking slowly to the bathroom with a walker
3) Helping clean up materials used to make posters
4) Changing from actively participating in an activity to sleeping in a chair

 

 

____   33.   The nurse notices that an older participant in adult day services asks for leftover food to take home every day. What should the nurse suggest as assistance for this participant?

1) Meals on Wheels
2) Menus of restaurants that deliver
3) Telephone numbers of grocery stores that deliver
4) Names of caregivers willing to come into the home and cook for the person

 

 

____   34.   An 86-year-old patient is diagnosed with relocation-related stress. Which is a symptom of this disorder?

1) Attending all available activities in the facility
2) Watching television and visiting with other residents in the day room
3) Exhibiting increased confusion and wandering behavior at night
4) Refusing to take a tub bath and washing himself at the sink in his room

 

 

____   35.   What intervention would help decrease stress related to relocation?

1) Having residents eat their meals in the dining room
2) Taking residents on a tour of the facility and introducing them to all of the caregivers
3) Spending an afternoon reviewing all of the facility policies and procedures that relate to resident care
4) Encouraging residents to discuss bringing some of their furniture and personal belongings with their families

 

 

____   36.   What should be a part of the environment for a confused resident of a nursing facility?

1) A standardized appearance
2) A stark and unstimulating atmosphere
3) Sensory stimulation through colors, furniture, and wall coverings
4) A home-like, familiar atmosphere with the resident’s own belongings

 

 

____   37.   What should be done on the first day that a new resident is in a nursing facility?

1) Introduce the new resident to all of the staff in the unit.
2) Encourage the resident to go to the afternoon bingo game.
3) Help the resident make the environment cozy and home-like.
4) Accompany the resident to the dining room at lunch to meet all the residents of the floor.

 

 

____   38.   An older person is argumentative and refuses to sit with family members during dinner because the discussion will be about the patient’s upcoming relocation to an assisted living facility. What is this older person demonstrating?

1) Conflict
2) Rigidity
3) Noncompliance
4) Transitional stress

 

 

____   39.   An older patient needing hemodialysis three times a week and extensive wound care is unable to be cared for at home by family members. The patient agrees to be admitted to a skilled nursing facility but refuses to talk with any of the staff or family members who come to visit. What should be done to assist this patient?

1) Transport the patient to the recreation room.
2) Nothing. The patient will adjust in time.
3) Have the staff introduce themselves one at a time.
4) Encourage placement of personal items to be easily viewed.

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____   40.   While visiting the home of an older patient who recently became widowed the nurse determines that the patient has a strong support system. What occurred that caused the nurse to make this determination? Select all that apply.

1) Delivery person rang the doorbell
2) Paid caregiver was doing the laundry
3) Daughter was visiting with her mother
4) Neighbor came over to bring a pot of soup
5) Friend telephoned to ask for the best time to visit

 

 

____   41.   Which behaviors indicate that a new resident of a nursing facility is experiencing relocation trauma? Select all that apply.

1) Agitation
2) Acting out
3) Poor appetite
4) Hallucinations
5) Disorientation

 

Chapter 12: Environments of Care

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 1. Discuss the role of the licensed practical nurse (LPN) as an environmental manager.

Chapter page reference: 212

Heading: Environmental Management

Integrated Processes: Nursing Process: Planning

Client Need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Promoting Health

Difficulty: Easy

  Feedback
1 Environmental assessments are performed to identify problems and potential problems. A plan for alternatives or correcting the problem is developed to support the functional ability of the older person.
2 The goal of an environmental assessment is not to assess housekeeping abilities.
3 The goal of an environmental assessment is not to detect reasons to admit an older adult to a long-term care facility.
4 The goal of an environmental assessment is not to assist the family with documenting reasons they should seek durable power of attorney.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 1. Discuss the role of the licensed practical nurse (LPN) as an environmental manager.

Chapter page reference: 213

Heading: Think Like a Nurse

Integrated Processes: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Promoting Health

Difficulty: Moderate

  Feedback
1 Hospice care is provided to patients who are terminally ill.
2 Dr. Jean Watson, author of The Science of Human Caring theory, refers to transpersonal caring as a holistic approach on caring about all aspects of the person’s life, including the environment.
3 Micromanaging is not a type of care.
4 Environmental management begins with an assessment of the environment. The nurse provided much more than environmental care.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 1. Discuss the role of the licensed practical nurse (LPN) as an environmental manager.

Chapter page reference: 213

Heading: Environmental Management

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Promoting Health

Difficulty: Moderate

  Feedback
1 A warm room is not identified as affecting appetite.
2 If a room is too warm the patient may demonstrate lethargy.
3 A warm room is not identified as affecting communication level.
4 A warm room is not likely to be motivating.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 1. Discuss the role of the licensed practical nurse (LPN) as an environmental manager.

Chapter page reference: 212

Heading: Environmental Management

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Promoting Health

Difficulty: Moderate

  Feedback
1 When assessing an assisted living facility the nurse should question if there is an area for residents to socialize with family and friends.
2 A garden with benches and chairs would be a pleasant location to socialize.
3 A recreation room with a television and magazines would be a pleasant place to spend time with friends or family.
4 Visiting in a common area on each floor would be a pleasant place to talk with family and friends.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 1. Discuss the role of the licensed practical nurse (LPN) as an environmental manager.

Chapter page reference: 213

Heading: Environmental Management

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Promoting Health

Difficulty: Moderate

  Feedback
1 A bath tub with shower would be difficult for the person who uses a wheelchair to use.
2 Absence of throw rugs would be desirable.
3 Oversized door openings would be desirable.
4 A handicapped-accessible commode would be desirable.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 2. Describe at least two components of the physical environment that nurses need to consider.

Chapter page reference: 213

Heading: Safety

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Safety

Difficulty: Moderate

  Feedback
1 Noting clutter and throw rugs is an appropriate component of the environmental assessment.
2 Medication storage and date of medications is an appropriate component of the environmental assessment.
3 Noting electrical wiring, frayed cords, and hot extension cords is an appropriate component of the environmental assessment.
4 It is inappropriate to review anyone’s mail without permission. Regarding bill payments, ask a family member to review the older adult’s mail.

 

 

PTS:   1                    CON:  Safety

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 2. Describe at least two components of the physical environment that nurses need to consider.

Chapter page reference: 213

Heading: Environmental Management

Integrated Processes: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Safety

Difficulty: Moderate

  Feedback
1 Grab bars in the bathroom can be installed to enable an older adult to get into and out of the shower or tub. Grab bars can also assist with balance during transfers.
2 Padding the bed might be viewed as increasing functionality of the environment by preventing the whole bed from becoming soiled, but a toileting program, urinal or bedpan, or bedside commode would be more appropriate for increasing function.
3 Light bulbs need to have increased wattage to promote vision for older adults.
4 An indwelling catheter is inappropriate simply to decrease toileting and ambulation.

 

 

PTS:   1                    CON:  Safety

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 2. Describe at least two components of the physical environment that nurses need to consider.

Chapter page reference: 213

Heading: Safety

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Safety

Difficulty: Moderate

  Feedback
1 Neighbor friendliness is important but not the most important area to assess.
2 The safety of the neighborhood and the internal safety of the home would be the most important for the nurse to assess.
3 Emergency medical services access is important but the goal is for the patient to not need this service.
4 Shopping areas are not the most important areas to assess for safety. A working telephone is important.

 

 

PTS:   1                    CON:  Safety

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 2. Describe at least two components of the physical environment that nurses need to consider.

Chapter page reference: 213

Heading: Safety

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Safety

Difficulty: Moderate

  Feedback
1 Grab bars in the shower would be desirable.
2 Grab bars around the commode would be desirable.
3 Absence of throw rugs would be desirable.
4 Electrical cords crossing over a water source could be a safety hazard.

 

 

PTS:   1                    CON:  Safety

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 2. Describe at least two components of the physical environment that nurses need to consider.

Chapter page reference: 213

Heading: Safety

Integrated Processes: Nursing Process: Planning

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Safety

Difficulty: Moderate

  Feedback
1 Because the patient smokes in the home it would be imperative for the patient to have functioning smoke alarms.
2 Electric cooking appliances are not necessary.
3 It is unrealistic for there to be a water source in every room in the house.
4 Having the telephone number for the fire department would be important, however, the patient should be able to call emergency services through 911.

 

 

PTS:   1                    CON:  Safety

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 2. Describe at least two components of the physical environment that nurses need to consider.

Chapter page reference: 213

Heading: Safety

Integrated Processes: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Safety

Difficulty: Moderate

  Feedback
1 The time the patient goes to sleep is not an issue.
2 The location of the pharmacy that the patient uses is not an issue.
3 The patient’s toy poodle may be a safety hazard. The pet could get under foot, causing the patient to fall.
4 The time the patient’s mail is delivered is not a safety issue.

 

 

PTS:   1                    CON:  Safety

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 3. Discuss the aspects included in a climate of caring.

Chapter page reference: 213

Heading: Climate of Caring

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing Roles; Promoting Health

Difficulty: Easy

  Feedback
1 The climate of caring is supported with respect for the older adult’s privacy and need for personal space.
2 Respect for personal space and privacy is used to promote a total caring climate that is not just specific to nursing assessments.
3 Respect for personal space and privacy is used to promote a total caring climate that is not just specific to care plans.
4 Respect for personal space and privacy is used to promote a total caring climate that is not just specific to satisfaction with nursing care.

 

 

PTS:   1                    CON:  Nursing Roles | Promoting Health

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 3. Discuss the aspects included in a climate of caring.

Chapter page reference: 213

Heading: Climate of Caring

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Knowledge [Remembering]

Concept: Nursing Roles; Promoting Health

Difficulty: Easy

  Feedback
1 Privacy is a part of a caring environment.
2 A caring climate promotes an older person’s function at the highest possible level of independence. Fostering dependence is not part of a caring climate.
3 Personal space is a part of a caring environment.
4 Activity and involvement are parts of a caring environment.

 

 

PTS:   1                    CON:  Nursing Roles | Promoting Health

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 3. Discuss the aspects included in a climate of caring.

Chapter page reference: 214

Heading: Stimulation and Personalization

Integrated Processes: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Nutrition; Nursing Roles; Promoting Health

Difficulty: Moderate

  Feedback
1 Waking the patient up for a meal at 8:00 a.m. would interrupt the patient’s sleep.
2 The patient’s meal should not be stopped or held.
3 Receiving two trays for one meal is inappropriate.
4 Setting the tray aside to be warmed up when the patient wakes up is the best action and personalizes the care the patient needs.

 

 

PTS:   1                    CON:  Nutrition | Nursing Roles | Promoting Health

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 3. Discuss the aspects included in a climate of caring.

Chapter page reference: 214

Heading: Stimulation and Personalization

Integrated Processes: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Nursing Roles; Promoting Health

Difficulty: Moderate

  Feedback
1 Wearing personal clothing will not personalize the patient’s space.
2 Placing toilet articles in the bathroom will not personalize the patient’s space.
3 Keeping the slippers on the floor will not personalize the patient’s space.
4 Having a favorite picture on the bedside table helps to personalize the patient’s space.

 

 

PTS:   1                    CON:  Nursing Roles | Promoting Health

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 219

Heading: Hospice

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Basic Care and Comfort

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

 

  Feedback
1 Hospice care generally involves services provided in the home to an older adult and the family members.
2 The patient would have to leave the home for nursing home care.
3 Adult day services are programs that provide more social and interpersonal care than personal care.
4 The patient would have to leave the home for skilled nursing care.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 217

Heading: Settings of Care

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Basic Care and Comfort

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Respite care is a service for caregivers who need time away from their family member. The respite worker usually comes into the home to provide care for the older adult.
2 The senior center might be a place for the spouse to go while the respite worker cares for the patient.
3 Hospitalization would be inappropriate for the spouse.
4 Home health care requires that the patient, not the spouse, have a skilled need for services.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 218

Heading: Home Care

Integrated Processes: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 The patient does not have a terminal illness.
2 A senior center would not be able to provide the level of care the patient needs at this time.
3 Home health services include skilled nursing, physical therapy, and home health assistants.
4 Skilled nursing might be needed after the sister leaves but not before.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 219

Heading: Hospice

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Health Care System

Difficulty: Easy

  Feedback
1 Not everyone who has a cancer diagnosis is dying.
2 Lack of family support does not qualify for hospice.
3 Hospice services are designed to provide support to dying people and their families.
4 Acute exacerbation of a chronic disease process does not meet the criteria for hospice care.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 219

Heading: Hospice

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Health Care System

Difficulty: Easy

  Feedback
1 Hospice provides personal care services.
2 Hospice volunteers or workers often assist a person in expressing his or her desires for funeral plans, but they do not arrange funerals.
3 Hospice provides family counseling and support.
4 Hospice provides ongoing support for families after the person’s death.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 220

Heading: Nursing Homes

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Hospitalization is inappropriate because the patient is not experiencing a life-threatening process that needs intensive medical evaluation and treatment.
2 A retirement center would not provide enough supervision for the patient.
3 Because of increasing confusion, a skilled nursing facility would be the most appropriate placement.
4 An intermediate care facility would not provide enough supervision for the patient.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 219

Heading: Assisted Living Environment

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Senior centers are activity centers, not living alternatives.
2 A retirement center is a supportive living environment. Residents maintain their independence but are free of maintenance worries, can receive housekeeping services, and can even choose to have meals prepared in a central dining room.
3 A skilled nursing facility requires the patient to have a functional need, not simply the inability to maintain the home financially.
4 An intermediate care facility requires the patient to have a functional need, not simply the inability to maintain the home financially.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 218

Heading: Home Care

Integrated Processes: Nursing Process: Planning

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Health Care System

Difficulty: Easy

  Feedback
1 The physician does not direct the care or provides instruction to the LPN.
2 The family and patient do not direct the care or provide instruction to the LPN.
3 The LPN works directly under the supervision of the RN case manager.
4 The secretary making the assignments does not direct the care or provide instruction to the LPN.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 217

Heading: Adult Day Services

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Meal preparation is not a primary activity of the LPN.
2 Activities would not be a primary activity of the LPN.
3 In an adult day services center, the LPN’s major responsibility is the dispensing and supervision of client medication and assessing the subtle changes that may occur.
4 Meal preparation and activity planning would not be primary activities of the LPN.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 218

Heading: Home Care

Integrated Processes: Nursing Process: Planning

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Supplies and equipment are not frequently limited with hospice care.
2 Working in patients’ homes requires the nurse to be creative and to learn some improvisation. Supplies and equipment are frequently limited.
3 Supplies and equipment are not frequently limited in adult day services.
4 Supplies and equipment are not frequently limited in retirement communities.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  2

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 217

Heading: Adult Day Services

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Medicare does not cover adult day services.
2 Medicare is not an option to pay for adult day services.
3 Medicaid may cover adult day services through the waiver program.
4 Personal insurance is not identified as a payer for adult day services.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 218

Heading: Home Care

Integrated Processes: Nursing Process: Planning

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 A home-care visit is rarely less than 1 hour in length.
2 The home-care nurse does not provide 8 hours of care.
3 Four to six hours of care is extremely long for a home-care visit.
4 A home-care visit will take as much time as needed to ensure prescribed treatments are provided.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 219

Heading: Community-Based Care

Integrated Processes: Nursing Process: Planning

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Vaccinations would be more appropriate for children.
2 Routine physicals would be applicable for all patients, not specifically for older patients.
3 Wellness activities would be applicable for all patients, not specifically for older patients.
4 In a community clinic the nurse uses assessment skills and provides information on resources available in the community to meet the older person’s needs.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 4. Identify at least four settings in which nursing care for older adults is provided.

Chapter page reference: 220

Heading: Assisted Living Environment

Integrated Processes: Nursing Process: Planning

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Non-ambulatory terminally ill patients should be treated by hospice care.
2 A completely independent and ambulatory adult does not need the services of an assisted living community and probably should forego the cost of such a placement until it is needed.
3 Non-ambulatory patients with serious chronic conditions should be treated in a hospital or skilled nursing facility.
4 Assisted living communities generally require residents to be ambulatory and fairly independent. Taking medication for a chronic condition does not bar a person from an assisted living facility.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 5. Describe how nurses in various care settings meet the needs of older adults.

Chapter page reference: 220

Heading: Assisted Living Environment

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 The nurse would not help with meal preparation.
2 The nurse would not help with patient laundry.
3 The nurse would not help with daily grooming.
4 The nurse would assess medication responses.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 5. Describe how nurses in various care settings meet the needs of older adults.

Chapter page reference: 217

Heading: Adult Day Services

Integrated Processes: Nursing Process: Planning

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 The older patient may not be able to self-inject the medication. This would be the priority for the patient.
2 Annual eye examinations are important for all older patients and not just specifically for someone who is starting on insulin.
3 Routine physical examinations are important for all older patients and not just someone who is starting on insulin.
4 Additional teaching about diabetes management can occur after the nurse knows that the patient can safely self-administer the insulin at home.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 5. Describe how nurses in various care settings meet the needs of older adults.

Chapter page reference: 217

Heading: Adult Day Services

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Laughing while watching a comedy movie would be expected behavior.
2 Walking slowly with a walker would be desirable behavior.
3 Assisting with cleaning up after an activity would be positive behavior.
4 Sleeping instead of actively participating in an activity should be investigated if the behavior is a change from the routine level of participation.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  1

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 5. Describe how nurses in various care settings meet the needs of older adults.

Chapter page reference: 217

Heading: Adult Day Services

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Health Care System

Difficulty: Moderate

  Feedback
1 Because the participant asks for leftover food to take home this might mean that the person has limited resources for food. Meals on Wheels would be appropriate.
2 Asking for food indicates limited resources. Menus of restaurants that deliver would cost money.
3 If the person is asking for food, then there are limited resources to purchase food from a grocery store.
4 Attendance at adult day services necessitates a certain level of independence. The person most likely is able to cook but does not have the financial resources to purchase food.

 

 

PTS:   1                    CON:  Health Care System

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 6. Discuss relocation stress and ways in which a nurse can help an older person adjust to a new environment.

Chapter page reference: 215

Heading: Relocation Trauma

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Stress

Difficulty: Moderate

  Feedback
1 Residents who are having trouble adjusting to a new environment more often withdraw and do not become active in facility activities.
2 Residents who are having trouble adjusting to a new environment more often withdraw and do not become active in facility activities.
3 Increased confusion and wandering are classic symptoms of relocation trauma.
4 The refusal to take a tub bath could be interpreted as a personal choice issue.

 

 

PTS:   1                    CON:  Stress

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 6. Discuss relocation stress and ways in which a nurse can help an older person adjust to a new environment.

Chapter page reference: 215

Heading: Relocation Trauma

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Stress

Difficulty: Moderate

  Feedback
1 Eating meals in the dining room may or may not impact relocation stress.
2 Introducing residents to caregivers may not influence the level of relocation stress.
3 Reviewing policies and procedures may increase the level of relocation stress.
4 Having familiar belongings in the resident’s room, along with providing the resident access to personal items, often lessens the trauma of relocation.

 

 

PTS:   1                    CON:  Stress

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 6. Discuss relocation stress and ways in which a nurse can help an older person adjust to a new environment.

Chapter page reference: 214

Heading: Stimulation and Personalization

Integrated Processes: Nursing Process: Planning

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Stress

Difficulty: Easy

  Feedback
1 If every room appears the same, it may add to the resident’s confusion.
2 Barren and stark surroundings might relate to sensory deprivation.
3 The use of colors and stimulating wall coverings has been shown to increase agitation.
4 Personalization of the environment for the resident’s comfort and to reflect the resident’s identity is the most important environmental consideration.

 

 

PTS:   1                    CON:  Stress

 

  1. ANS:  3

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 6. Discuss relocation stress and ways in which a nurse can help an older person adjust to a new environment.

Chapter page reference: 215

Heading: Relocation Trauma

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Stress

Difficulty: Moderate

  Feedback
1 This can be done after the resident becomes comfortable in the new environment.
2 This can occur after the resident’s environment is made comfortable.
3 To help minimize relocation trauma, staff members should help the resident make the new environment as comfortable and familiar as possible.
4 This can be done at any time after the resident moves in.

 

 

PTS:   1                    CON:  Stress

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 6. Discuss relocation stress and ways in which a nurse can help an older person adjust to a new environment.

Chapter page reference: 215

Heading: Relocation Trauma

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Stress

Difficulty: Moderate

  Feedback
1 Argumentative behavior may be the result of conflict.
2 Refusing to participate in a discussion or share a meal does not demonstrate rigidity.
3 The person may be viewed as being noncompliant to the other family members, however, this is not what the person is demonstrating.
4 The person is acting out, which is a characteristic of transitional stress, particularly because the person is relocating to a new living environment.

 

 

PTS:   1                    CON:  Stress

 

  1. ANS:  4

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 6. Discuss relocation stress and ways in which a nurse can help an older person adjust to a new environment.

Chapter page reference: 215

Heading: Relocation Trauma

Integrated Processes: Nursing Process: Implementation

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Application [Applying]

Concept: Stress

Difficulty: Moderate

  Feedback
1 Relocation stress might be heightened when overloading the person with new people and experiences too quickly.
2 Relocation trauma is temporary and the behavioral signs of decompensation should diminish as the older person becomes familiar with the new environment, however, the nurse should help the patient acclimate.
3 Introducing the person experiencing relocation stress to too many people may be overwhelming.
4 The more familiar the new environment is to the older person, the easier the transition is for the person. Bringing favorite objects to the new setting increases its familiarity to the older person.

 

 

PTS:   1                    CON:  Stress

 

MULTIPLE RESPONSE

 

  1. ANS:  2, 3, 4, 5
  Feedback
1. Delivery people are not identified as being in an environment of caring.
2. The climate of caring involves the people in the environment. The people in an older person’s living environment may include paid caregivers.
3. The climate of caring involves the people in the environment. The people in an older person’s living environment may include family members.
4. The climate of caring involves the people in the environment. The people in an older person’s living environment may include neighbors.
5. The climate of caring involves the people in the environment. The people in an older person’s living environment may include friends.

 

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 3. Discuss the aspects included in a climate of caring.

Chapter page reference: 213

Heading: Climate of Caring

Integrated Processes: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Nursing Roles; Promoting Health

Difficulty: Moderate

 

PTS:   1                    CON:  Nursing Roles | Promoting Health

 

  1. ANS:  1, 2, 4, 5
  Feedback
1. Agitation is a manifestation of relocation trauma.
2. Acting out is a manifestation of relocation trauma.
3. Poor appetite is not a manifestation of relocation trauma.
4. Hallucinations are a manifestation of relocation trauma.
5. Disorientation is a manifestation of relocation trauma.

 

Chapter number and title: Chapter 12: Environments of Care

Chapter/learning objective: 6. Discuss relocation stress and ways in which a nurse can help an older person adjust to a new environment.

Chapter page reference: 215

Heading: Relocation Trauma

Integrated Processes: Nursing Process: Assessment

Client Need: Physiological Integrity: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Stress

Difficulty: Easy

 

PTS:   1                    CON:  Stress