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Chapter 2: Gerontological
Nursing History,
Education, and
Roles(FREE)

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Chapter 2: Gerontological Nursing History, Education, and

Roles
Test Bank
MULTIPLE CHOICE
1. Identify the best statement about gerontological
nursing.
a.

Nurses have only recently become involved in

the care of the older adult.

b.

Gerontological care was the second specialty

in which the American Nurses Association
(ANA) offered a certification program.

Promoted

c.

Purposes of gerontological nursing include the

promotion of health and support for maximal
independence.

d.

ANA certification is available only for

gerontological nurses in research positions.

ANS: C
Promoting health and fostering independence are
purposes of the practice, as reflected, for example, in the

ANA Scope and Standards. Nurses have always cared for

older patients. The ANAs gerontological nursing
certification program was the organizations first and
includes a variety of positions, such as nurse
practitioners, clinical specialists, researchers, and
administrators.
PTS:1DIF:RememberREF:8-9
TOP: Nursing Process: Assessment MSC: Health
Promotion and Maintenance
2. Which gerontological nursing organization welcomes
nurses from all educational backgrounds?
a.

The National Gerontological Nursing

Association (NGNA)

b.

The National Conference of Gerontological

Nurse Practitioners (NCGNP)

c.

The National Association of Directors of

Nursing Administration in Long-Term Care
(NADONA/LTC)

d.

The American Society on Aging (ASA)

ANS: A
The NGNA was formed specifically for all levels of nursing
personnel: registered nurses (RNs), licensed practical
nurses (LPNs), licensed vocational nurses (LVNs), and
certified nursing assistants (CNAs). The NCGNP is, as its
name implies, limited to nurse practitioners. The
NADONA/LTC is, as its name implies, limited to directors
and assistant directors of nursing. The ASA is an
interdisciplinary organization not limited to nurses.
PTS:1DIF:RememberREF:15-16
TOP: Nursing Process: Assessment MSC: Health
Promotion and Maintenance
3. Which is an accurate statement regarding
gerontological nursing education?
a.

Gerontological nursing content has long been

integrated into the curriculum of the typical
school of nursing.

b.

Undergraduate nursing programs extensively

cover gerontological nursing in dedicated
courses, comparable with the coverage of
psychiatric nursing.

c.

When content is integrated throughout a

curriculum, less than 25% is devoted to
geriatric care.

d.

Accreditation of a nursing program guarantees

that appropriate amounts of gerontological
nursing content are included in the curriculum.

ANS: C
When content is integrated throughout the curriculum,

less than 25% of the content is devoted to geriatric care.

Only recently has gerontological nursing content begun
to appear in nursing school curricula. Most nursing
schools still do not have such courses. At present, no
minimum requirements exist for the coverage of care of
older adults.
PTS: 1 DIF: Remember REF: 6-7 TOP: Teaching/Learning
MSC:Health Promotion and Maintenance
4. Based on current demographic data, which of the
following statements identifies a predictive trend
regarding the health care needs of society?
a.

Most nurses will not need to care for older

persons.

b.

More nursing services will be required to serve

the needs of the population older than 85
years of age.

c.

Fewer nurses will be needed to care for older

adults.

d.

Older adults expect their quality of life to be

less than that of earlier generations at their
ages.

ANS: B
Projections are that 20% of the American population will
be older than 65 years of age by 2050, with those older
than 85 years showing the greatest increase in numbers.
Most nurses can expect to care for older people during
the course of their careers. By 2050, the United Nations
predicts that more Americans will be over the age of 60
years than those under the age of 15 years. Older people
are better educated and more affluent and expect a higher

quality of life than their elders had at their age.

PTS:1DIF:RememberREF:2
TOP: Nursing Process: Assessment MSC: Health
Promotion and Maintenance
5. A case manager is likely to have how many years of
nursing education?
a.

1 to 1.5

c.

4 to 6

b.

d.

8 or more

ANS: C
A case manager typically has a bachelors or masters
degree. This amount of training is typical for an LPN, who
typically practices at a nursing home or on a home nursing
staff. This amount of training, resulting in an Associates
Degree in Nursing (ADN), is typical for an associate RN,
who is typically found on hospital, home, and nursing
home staffs. A nurse with 8 or more years of education,
as well as a doctorate, is typically involved in research and
teaching.
PTS: 1 DIF: Remember REF: 8-14 TOP: Teaching/Learning
MSC: Safe, Effective Care Environment
6. Which was the first formal action the ANA took in
relation to gerontological nursing?
a.

Established a national geriatric nursing group

b.

Defined educational standards for

gerontology

c.

Created the ANA Division of Geriatric Nursing

d.

Formed the Council of Long Term Care Nurses

ANS: A
The first formal act of the ANA to promote gerontological
nursing was to form a national geriatric nursing group in
1962. In 1973, the ANA defined educational standards
for geriatric nursing. The ANA Division of Geriatric
Nursing was begun in 1966. In 1979, the ANA formed the
Council of Long Term Care Nurses.
PTS:1DIF:UnderstandREF:4
TOP:Communication and Documentation
MSC:Health Promotion and Maintenance
7. A older man is transferred to a hospice facility with
end-stage disease. Which is a suitable nursing
intervention for this older adult and his family according
to the goals of long-term care?
a.

Decrease the analgesic dose to prevent

sedation.

b.

Provide a basin and towels for morning selfcare.

c.

Inform family members about strict visiting

hours.

d.

Facilitate family rituals related to death and

dying.

ANS: D
To promote comfort and dignity, the nurse facilitates the
enactment of family wishes, rituals, or religious practices
related to death and dying. To promote comfort, the

gerontological nurse administers medications as

prescribed and avoids restricting analgesic agents to
patients, regardless of the setting or the nurses personal
views. Although fostering independence is within the
scope of the gerontological nursing practice, the nurse
should assess the older adult and family before assuming
that he will want or be able to perform self-care.
Although hospice can have regular visiting hours, the
older adult may need his family at the bedside for comfort,
strength, or companionship. Thus to provide comfort and
promote dignity, the gerontological nurse adapts visiting
hours to suit the older adults needs.
PTS:1DIF:ApplyREF:30 Box 2-6
TOP: Nursing Process: Implementation MSC: Safe,
Effective Care Environment
8. A nursing home executive interviews RNs to fill a fulltime position for direct patient care to maintain the
standards of elder care. Which nurse should the nursing
home hire?
a.

Nurse from a

c.

certified college

Nurse with 15
years of
experience

b.

Certified
gerontological

d.

Gerontological
nurse practitioner

nurse
ANS: B
A certified gerontological nurse receives education and
training to care for older adults, assuring the nursing
home and the public that the nurse has mastered the
specialized skills and knowledge to care for older adults
according to gerontological nursing standards. A nurse
educated in a certified college does not necessarily have

specialty education and training in gerontology. A nurse

with 15-years experience might have no experience with
gerontology and offers no proof of specialized
knowledge or skills. Although a gerontological nurse
practitioner receives specialized education and training in
gerontology, these nurses provide primary care in a
nursing home.
PTS:1DIF:ApplyREF:9
TOP: Nursing Process: Implementation MSC: Safe,
Effective Care Environment
9. Mezey and Fulmer (2002) justify gerontological nursing
research and the work of gerontological advanced
practice nurses by concluding the following:
a.

Other scientists devalue gerontological

nursing research.

b.

The research influences outcomes from

nursing care in a positive way.

c.

Gerontological care is expensive but required

in long-term care.

d.

Gerontological nursing research is well known

to practicing nurses.

ANS: B
The practices of advanced practice nurses, who base their
practice on nursing research, have resulted in positive
older adult outcomes and cost effectiveness. The
scientific community widely accepts the research.
Advanced practice nurses generate positive outcomes
and are cost effective in many settings. Mezey and Fulmer
believe the goal of gerontological nursing is to
disseminate the knowledge from gerontological nursing

research to all nurses and to have the knowledge applied

to their practices.
PTS: 1 DIF: Understand REF: 16 TOP: Nursing Process:
Diagnosis
MSC:Health Promotion and Maintenance
10. The gerontological nurse collaborates with the wound
care team about an older patient who has an ulcer. How is
this nurse demonstrating leadership in the care of older
people?
a.

Assessing older adults effectively

b.

Facilitating access to elder care programs

c.

Coordinating members of the health care team

d.

Empowering older adults to manage chronic

illness

ANS: C
The nurse demonstrates leadership in the care of older
adults by initiating and coordinating collaboration with
the wound care team to improve the health of an older
adult. Screening and assessing are only indirectly related
to collaboration. In this case, the nurses collaborative
efforts are unrelated to facilitating access to a program.
Thus far, the nurse has not educated or trained this
patient in wound care.
PTS: 1 DIF: Apply REF: 8-9 TOP: Nursing Process:
Evaluation
MSC:Health Promotion and Maintenance
11. Several organizations collaborated in 2001 to publish

Scope and Standards of Gerontological Nursing Practice

by the ANA. What is the significance of the collaborative

effort to gerontological nurses?
a.

Changes the health care delivery to increasing

numbers of older adults

b.

Mandates gerontological certification for

nurses who care for older adults

c.

Standardizes gerontological nursing practice

among various organizations

d.

Ensures minimum gerontological competencies

for all graduating students

ANS: C
Various gerontological nursing organizations
collaborated to define the criteria for gerontological
nursing practice, demonstrating an agreement among the
various organizations on these standards. The
collaboration among multiple organizations potentially
improves the quality of gerontological nursing care as the
number of older adults grows. This document establishes
the criteria for gerontological nursing practice.
To improve the health care to older adults, all graduating
students should master minimum competencies in
gerontological nursing; however, many students continue
to receive little specialty training and education in the care
of older adults.
PTS: 1 DIF: Analyze REF: 5 TOP: Nursing Process:
Evaluation
MSC: Safe, Effective Care Environment
12. Which had a major influence in shifting the care of
older adults away from almshouses and public institutions

and stimulated the growth of commercial nursing homes?

a.

Medicare

b.

Social Security Act

c.

Hartford Institute for Geriatric Nursing

d.

Health maintenance organizations (HMOs)

ANS: B
With the passage of the Social Security Act of 1935,
federal monies were provided for old-age insurance and
public assistance for needy older people not covered by
insurance. To combat the fear of almshouse placement,
Congress stipulated that the Social Security funds could
not be used to pay for care in almshouses or other public
institutions. This move is thought to have been the
genesis of commercial nursing homes. During the next 10
years, many almshouses closed, and the number of
private boarding homes providing care to older adults
increased. Because retired and widowed nurses often
converted their homes into such living quarters and gave
care when their boarders became ill, they can be
considered the first geriatric nurses and their homes to
be the first nursing homes. The Hartford Institute has
sponsored significant improvements in gerontological
nursing practice, research, and education. HMOs have had
a significant impact on the management of care but were
virtually nonexistent in the 1930s and 1940s.
PTS:1DIF:UnderstandREF:4
TOP: Nursing Process: Assessment MSC: Health
Promotion and Maintenance
13. Which gerontological organization had a significant
influence on the care of older adults?

a.

American Association of Retired Persons

(AARP)

b.

John Hartford Foundation

c.

Medicare

d.

Mutual of Omaha Insurance

ANS: B
The most significant influence in enhancing gerontological
nursing has been the work of the Hartford Institute for
Geriatric Nursing, funded by the John A. Hartford
Foundation. The foundation seeks to shape the quality of
the nations health care for older Americans by promoting
geriatric nursing excellence to both the nursing
profession and the larger health care community.
Initiatives in nursing education, nursing practice, nursing
research, and nursing policy include enhancing geriatrics
in nursing education programs through curricular reform
and faculty development and the development of nine
Centers of Geriatric Nursing Excellence. AARP is a
foundation that helps struggling seniors by being a force
for change on the most serious issues they face today.
Medicare is a national social insurance program,
administered by the U.S. federal government since 1965,
that guarantees access to health insurance for Americans
ages 65 years and older and younger people with
disabilities. Mutual of Omaha is a Fortune 500 mutual
insurance and financial services company based in
Omaha, Nebraska.
PTS:1DIF:RememberREF:5
TOP: Nursing Process: Assessment MSC: Safe, Effective
Care Environment

MULTIPLE RESPONSE
1. In which areas have advanced practice nurses
demonstrated their skill in improving? (Select all that

apply.)
a.

Health outcomes

b.

Length of stay

c.

Cost effectiveness

d.

Reimbursement measures

e.

Interprofessional communication

ANS: A, C
Advanced practice nurses have demonstrated their skill in
improving health outcomes and cost effectiveness. Many
of these advanced practice nurses have nursing facility
practices managing complex care of frail older adults in
collaboration with interprofessional teams. This role is
well established, and positive outcomes include increased
patient and family satisfaction, decreased costs, less
frequent hospitalizations and emergency department
visits, and improved quality of care. Reimbursement
measures and interprofessional communication have not
been identified as areas that advanced practice nurses
have demonstrated their skill in improving.
PTS: 1 DIF: Remember REF: 10 TOP: Nursing Process:
Evaluation
MSC: Safe, Effective Care Environment
2. Identify future directions for gerontological nursing
research as suggested by Wykle and Tappen. (Select all

that apply.)

a.

Interdisciplinary practice models

b.

Intergenerational caregiving

c.

Health disparities

d.

Influence of culture on aging

e.

Long-term care initiatives

ANS: A, B, C, D
The following have been identified for future directions
for gerontological nursing research according to Wykle
and Tappen: interdisciplinary practice models,
intergenerational caregiving, health disparities, and the
influence of culture on aging. Long-term care initiatives
have not been identified as a future direction for nursing
research.
PTS: 1 DIF: Remember REF: 27 Box 2-3 TOP: Nursing
Process: Planning
MSC: Safe, Effective Care Environment

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