Transcript
Toward Healthy Aging
Gerontological Nursing and an Aging Society
MULTIPLE CHOICE
Serious and well controlled research studies on aging have been available:
Only in the past 50 years
Since the turn of the 20th century
Following the Great Depression
Since the year 2000
ANS: A
Only in the past 50 years have serious and carefully controlled research studies flourished. Before that, anecdotal evidence was used to illustrate issues assumed to be universal, making all the remaining options incorrect.
level: Knowledge TOP: Integrated Process: Teaching and Learning
MSC: Health Promotion and management
When asked by new parents what the life expectancy is for their African-American newborn, the nurse replies that, “2010 statistics indicate that your son:
“will benefit from a life expectancy of at least 78.4 years.”
“can realistically expect to live into his 80s.”
“has a good chance of celebrating his 70th birthday.”
“is likely to live into his late 70’s.”
ANS: C
In 2010, the life expectancy for African-American males in the United States was 70.2 years while African-American females statically had a life expectancy of 77.2. The other options are not supported by reliable research.
TOP: Integrated Process: Teaching and Learning
MSC: Health Promotion and Management
Which of the following culturally diverse male clients will most benefit from educational material related to “Staying Healthy into your 80s”
Japanese
Swedish
Chinese
Irish
ANS: A
Japan has the longest life expectancy at 82.6 years. Sweden has the second longest life expectancy at 81.7 years. The average life expectancy in China and Ireland is lower than in either Japan or Sweden.
A geriatric nurse shows an understanding of one of the major barriers to acquiring research-based geriatric nursing care when:
recognizing the need to assess the need for sleep differently
assuming the likelihood that the subjects will have hearing and vision problems
planning for issues related to the cognitive abilities of the research participants
planning specific enticements to encourage the geriatric subjects to participate
ANS: A
One of the major problems in aging research are that the older people, although statistically ranging from 65 to 115 years old, are often grouped into a single category. Recognizing the need to tailor assessment to specific groups is insightful. While aging affects vision, hearing, and, in some incidences, cognition, such deficiencies should not be assumed. The older adult population is not likely to need more incentives to participate than any other age group.
level: Application
MSC: Health Promotion and Management
Based on current demographic data, which statement identifies a predictive trend regarding the health care needs of society?
There will be an increasing need for health programs for older males.
More nursing services will be required to serve the needs of the population 85 years of age and older.
Fewer nurses will be needed to care for the older, especially in long-term care facilities.
North Dakota is likely to experience the greatest need for gerontological nurses.
ANS: B
The old-old, individuals older than age 85, are the fastest growing segment of the population. Therefore, more nursing services will be needed to care for these individuals. There are more older females than there are older males; women live longer than men. Because the number of older adults is growing, there will be a need for more nurses to deliver care to this population, not less. Florida, Pennsylvania, and West Virginia have the highest percentage of older adults.
MSC: Health Promotion and Management
To best assure the existence of competent entry level geriatric nurses among its graduates, a school of nursing:
requires students take at least one geriatric-focused course.
integrates geriatric content throughout its curriculum.
stresses the importance of providing effective geriatric care.
supports its faculty in acquiring efficiency in geriatric care topics.
ANS: D
Often geriatric content is difficult to present effectively since faculty with expertise in gerontological nursing are scarce; schools must support their faculty in acquiring and mastering the expertise to teach geriatric-focused care topics. Until facility is able to address these needs, requiring geriatric courses or even integrating geriatric care into existing courses will not be possible. Stressing the importance of effective geriatric care as a nursing responsibility will not assure competent entry-level geriatric nurses.
level: Application
MSC: Health Promotion and Management
The Scope and Standards of Gerontological Nursing Practice:
identifies minimum nurse staffing levels for both acute and long-term care facilities.
describes minimum gerontological nursing education required for nursing staff in long-term care facilities.
mandates the presence of a full-time advanced practice nurse (APN), either a gerontological clinical nurse specialist or a geriatric nurse practitioner, for all patient care areas with greater than 50% of the population older than age 65.
identifies levels of clinical gerontological care and gerontological nursing performance.
ANS: D
The Scope and Standards of Gerontological Nursing Practice identifies the levels of gerontological nursing practice, identifies levels of clinical gerontological nursing care, and gerontological nursing performance. This document does not address minimum staffing levels in any setting. The document does not address minimum educational requirements for any setting, nor does it mandate the presence of an APN in geriatric settings.
level: Knowledge Process: Assessment
MSC: Health Promotion and Management
The nurse is completing discharge instructions for an 88-year-old patient who is being discharged from the hospital following a myocardial infarction. He is provided with written literature on heart healthy diets, exercise, and smoking cessation. His daughter states, “I don’t know why you are bothering. What difference is it going to make? He has been smoking and eating poorly for years; he isn’t going to change now.” This statement reflects the concept of:
reality orientation
character assessment
negative stereotyping
senescence
ANS: C
People often characterize older adults in a negative manner, believing that things cannot change after a certain age. Reality orientation is a strategy that is used with individuals with dementia or delirium. Character assessment is a process of identifying parts of an individual’s personality. Senescence is the process of aging.
Process: Assessment
MSC: Health Promotion and Management
A group of nursing students conducts a small research project examining the most effective means to deliver medication education to older adults. Their sample consists of 100 adults from ages 55 to 101 who live in the same community. The students conclude that individuals from ages 55 to 64 prefer computerized instructions, and individuals from ages 65 to 100+ prefer typewritten instructions. What is a potential problem with this study?
The sample size of 100 is too small to draw any conclusions.
The older adults ranging in age from 65 to 100+ were grouped into one category.
It has been proven that older adults are not computer literate.
The study design is not a randomized, controlled trial.
ANS: B
Combining all older adults into one category is not accurate, because the age range is large and the “group” may not share many similarities. One would not consider combining 13-year-olds and 3-year-olds in the same group; this is a similar situation. A sample size of 100 may be adequate, but it is not possible to draw the conclusion that it is not based on the very limited information. The study did not concern computer literacy. A randomized, controlled trial is not possible or necessary for every study.
level: Application Process: Evaluation
MSC: Health Promotion and Management
MULTIPLE RESPONSE
Research has shown that long-term care (LTC) facility nursing: Select all that apply.
is comparable to the complexity and demand of intensive care nursing
requires similar skills and knowledge as does critical care nursing
is a nursing intensive environment
demands both biomedical skills and knowledge
crosses the continuum of care
ANS: A, C, E
ICU/critical care and LTC require different nursing skills, judgment, and knowledge, but research suggests that the work of nurses in LTC is as complex and demanding as ICU/critical care nursing work and there are many similarities in terms of uncertainty and nursing judgment, patient variability, and instability. LTC nursing crosses the continuum of care (rehabilitation, subacute, custodial, and palliative). While the ICU/critical care work environment is a biomedically intensive environment, the LTC nursing environment is a nursing intensive environment that is highly autonomous and centered on nursing care.
level: Application Process: Assessment
MSC: Health Promotion and Management
