Chapter 1: Holistic Caring

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

____	1.	According to the 2010 U.S. Census, approximately how many Americans are older than age 65?
1)	2%	
2)	5%	
3)	13%	
4)	20%	

____	2.	What is the average life expectancy today?
1)	70.2 years	
2)	75 years	
3)	81.1 years for women and 76.3 years for men	
4)	Longer for men than for women	

____	3.	Which statement is NOT true about holistic nursing?
1)	Holistic nursing focuses on the specific disease or disorder a person has in order to treat it effectively.	
2)	Holistic nursing aims to treat the whole person, not just a specific disease or disorder the person may have.	
3)	Holistic nursing focuses on the individual patient and uses many techniques, such as empathetic listening, music, and imagery, as well as specific clinical skills.	
4)	Holistic nursing weaves the technical skills of nursing with the social science skills that enhance communication and rapport between the nurse and the person receiving care.	

____	4.	The Science of Human Caring theory was developed by
1)	Florence Nightingale	
2)	Clara Barton	
3)	Jean Watson	
4)	Savage and Money	

____	5.	Which is NOT emphasized in The Science of Human Caring?
1)	Providing transpersonal caring	
2)	Focusing on the person while you are with him or her	
3)	Ensuring that all nonessential tasks, such as bathing, are given according to a strict schedule	
4)	Reaching out to the patient, making eye contact, touching if appropriate, speaking softly	

____	6.	Which of the following is included as a basic concept of holistic nursing?
1)	Using your developed clinical expertise	
2)	Developing a close relationship with the patient’s family members and significant others	
3)	Remembering the personal intuition and creativity of patients in your nursing plan	
4)	All of the above	

____	7.	Most elderly people having a heart attack have
1)	Pain diffused over the entire chest area	
2)	No pain	
3)	Crushing sternal pain	
4)	Pain on the left side of the chest and pain that radiates down the left arm	

____	8.	Compared with the doses of medication given to a young adult, the doses given to an old-old person are usually
1)	Smaller	
2)	Larger, because the old-old person is probably sicker	
3)	The same	
4)	Minimal, because the person is very old and probably near death	

____	9.	What communication technique has been developed specifically for dealing with demented elderly persons?
1)	Cognitive therapy	
2)	Validation therapy	
3)	Geriatric Depression Scale	
4)	Mini-Mental Status Examination (MMSE)	

____	10.	An 82-year-old patient is diagnosed with liver cancer and has long-standing cardiovascular problems. The patient begins screaming and pushes his meal tray away. What would be an appropriate response?
1)	Take the meal tray and leave the room without saying anything.	
2)	Tell him to stop screaming in a loud voice.	
3)	Calmly ask him what he is upset about and listen carefully to him.	
4)	Call your supervisor.	

____	11.	The nurse is overhead addressing an 87-year-old patient as “honey.” What is this an example of?
1)	Beneficence	
2)	Paternalism	
3)	Caring	
4)	Malfeasance	

____	12.	The term “elite-old” is used for people
1)	65 to 74 years old	
2)	75 to 84 years old	
3)	85 to 100 years old	
4)	Older than 100 years	

____	13.	Which is a key concept in holistic nursing?
1)	Following physician instructions and follow-up with the physician	
2)	Developing a relationship with family members of the patient	
3)	Using what you have learned—your clinical experience	
4)	All of the above	

____	14.	How should the nursing instructor explain the term “gerontology” to a new class of students?
1)	It means the use of older medications to treat illnesses.	
2)	It comes from a Greek word that means “related to old age.”	
3)	It focuses on the housing needs of people who are underserved.	
4)	It is a way of explaining health problems of people over age 50.	

____	15.	Which term should the nurse use when explaining medical care that an older patient requires?
1)	Genetics	
2)	Geriatrics	
3)	Gerontology	
4)	Gentrification	

____	16.	During lunch a nursing colleague states that she never wants to be assigned to care for an older patient. What behavior is this nurse demonstrating?
1)	Ageism	
2)	Stereotyping	
3)	Ethnocentricity	
4)	Personal preference	

____	17.	How should a nursing instructor explain the term “baby boomers” to new students?
1)	People who have large families	
2)	People who advocate for the care of infants	
3)	People who have decided not to have large families	
4)	People born between 1946 and 1965 after World War II	

____	18.	What explains the decline in the elderly black population since 1980?
1)	Diabetes	
2)	Homicides	
3)	Hypertension	
4)	Heart disease	

____	19.	Why are older people more likely to participate in exercise programs?
1)	They have more time to exercise.	
2)	They are trying to avoid boredom.	
3)	They initiated the fitness movement.	
4)	They want to spend time with their grandchildren.	

____	20.	What information would be helpful when explaining Social Security to a group of new nursing students?
1)	It is a federal and state supported process that provides health care to financially disadvantaged people.	
2)	It is federal regulation providing health care for individuals older than age 65 or individuals who are permanently disabled.	
3)	It is a federal benefit check paid to persons older than age 65 or persons with disabilities who  are unable to work.	
4)	It is a federal benefit check paid to retired workers of a specific age, disabled workers of any age, and spouses and minor children of deceased workers.	

____	21.	What should be used to describe a nursing philosophy to a new nursing student?
1)	It is a personal concept.	
2)	It defines goals and aspirations.	
3)	It outlines steps to a successful career.	
4)	It recognizes the importance of education.	

____	22.	Which behavior demonstrates that a nurse is developing a healing relationship with a patient?
1)	Answering a call light using the intercom system	
2)	Telling a patient that there is no time to try something new	
3)	Sitting down in the patient’s room to discuss the plan of care	
4)	Reminding a patient that other patients are waiting for the nurse	

____	23.	Which skill is essential to promote holistic nursing?
1)	Critical thinking	
2)	Active listening	
3)	Time management	
4)	Care coordination	

____	24.	Who should the nurse identify as being members of the holistic health-care team for an older patient?
1)	The nurse, doctor, and pharmacist	
2)	The nurse, dietician, and discharge planner	
3)	Those who will help meet the patient’s needs	
4)	The social worker, physical therapist, and nurse	

____	25.	Which action demonstrates a safe environment?
1)	Telephoning a patient prior to arriving for a home visit	
2)	Mounting grab bars near the commode and in the shower	
3)	Ensuring that a patient receives a requested daily newspaper	
4)	Making sure that the television in the room has adequate volume	

____	26.	What action should a nurse take who desires to become a more caring nurse?
1)	Become a caring person.	
2)	Ensure adequate daily rest.	
3)	Set aside time for personal activities.	
4)	Consume nutritious meals and exercise.	

____	27.	An older patient with heart failure refuses any diagnostic tests and does not want to take any medication because of having limited health insurance. Which action should the nurse take that demonstrates caring?
1)	Recommend that the patient be discharged home as soon as possible.	
2)	Ask family members if they are willing to help pay for the patient’s care.	
3)	Contact a social worker to talk with the patient about health insurance coverage.	
4)	Find out if the patient has any resources that can be liquidated to pay for the care.	

____	28.	During a home visit, an older patient is planning to have dinner with a close friend and then see a movie. What does this behavior indicate to the nurse?
1)	Industry	
2)	Self-absorption	
3)	Identity diffusion	
4)	Gerotranscendence	

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

____	29.	The home health nurse is completing an admission assessment of an older patient. Which health problems should the nurse identify as being leading chronic diseases of older adults? Select all that apply.
1)	Cancer	
2)	Diabetes	
3)	Heart disease	
4)	Hypertension	
5)	Multiple sclerosis	

____	30.	What should be identified as reasons for the increased number of older adults in today’s society? Select all that apply.
1)	Better nutrition	
2)	Earlier retirement	
3)	Increased exercise	
4)	Improved health care	
5)	Consistent sanitation	

____	31.	What should the instructor emphasize as being essential elements of a nursing philosophy with beginning students? Select all that apply.
1)	Simple	
2)	Popular	
3)	Specific	
4)	Meaningful	
5)	Inexpensive	

Chapter 1: Holistic Caring
Answer Section

MULTIPLE CHOICE

	1.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference:  7
Heading: Demographics of Aging
Integrated Processes: Nursing Process: Assessment
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Knowledge [Remembering]
Concept: Economics
Difficulty: Easy
	Feedback	
1	Individuals 65 years of age or older make up more than 2% of the population.	
2	Individuals 65 years of age or older make up more than 5% of the population.	
3	Based on the most recent U.S. census completed in 2010, individuals 65 years of age and older make up 13% of the population. There were 23 million women and 17 million men older than age 65. 	
4	Individuals 65 years of age or older do not make up 20% of the population. 	

PTS:	1	CON:	Economics

	2.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference:  7
Heading: Point of Interest
Integrated Processes: Nursing Process: Assessment
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Knowledge [Remembering]
Concept: Economics
Difficulty: Easy
	Feedback	
1	The average life expectancy is greater than 70.2 years.	
2	The average life expectancy is greater than 75 years.	
3	The average life expectancy has increased dramatically in the last 75 years—from 59.7 years in 1930 to 81.1 years for women and 76.3 years for men, according to the latest census information.	
4	Women live longer than men. 	

PTS:	1	CON:	Economics

	3.	ANS:	1
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference:  9
Heading: Holistic Nursing
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Comprehension [Understanding]
Concept: Nursing Roles
Difficulty: Moderate
	Feedback	
1	The word “holism” is derived from the Anglo-Saxon root “hal,” which means “whole” or “to heal.” Holistic nursing focuses on the whole person, not the person’s specific disease or disorder.	
2	Holistic nursing treats the whole person and not just a disease or disorder. 	
3	Holistic nursing uses techniques such as empathetic listening, music, and imagery, as well as specific clinical skills.	
4	Holistic nursing uses technical skills in combination with those that enhance communication and rapport. 	

PTS:	1	CON:	Nursing Roles		

	4.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 5. Discuss the theory “The Science of Human Caring” by Dr. Jean Watson as it relates to clinical practice.
Chapter page reference:  11
Heading: Human Caring
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level:  Knowledge [Remembering]
Concept: Nursing Roles
Difficulty: Easy
	Feedback	
1	Florence Nightingale, known as the Mother of Modern Nursing, practiced holistic nursing long before the term was even used.	
2	Clara Barton served as an exemplary nurse during the Civil War.	
3	The Science of Human Caring is a nursing philosophy developed by Dr. Jean Watson of the University of Colorado. This philosophy is taught worldwide and serves as the basis for teaching and caregiving.	
4	Savage and Money have written on the concepts of holistic nursing.	

PTS:	1	CON:	Nursing Roles		

	5.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 5. Discuss the theory “The Science of Human Caring” by Dr. Jean Watson as it relates to clinical practice.
Chapter page reference:  12
Heading: Human Caring
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level:  Comprehension [Understanding]
Concept: Nursing Roles
Difficulty: Moderate
	Feedback	
1	Transpersonal caring is the human-to-human relationship, which is a part of The Science of Human Caring. 	
2	The person is the focus in The Science of Human Caring.	
3	It is important that essential tasks, such as giving medications, be done according to schedule, but if a patient is in distress, needs to talk, or needs answers, there should be some flexibility for nonessential tasks. The nurse needs to treat the whole person, not just give out drugs and see to it that certain grooming tasks are performed routinely.	
4	Personal contact, eye contact, and speaking softly are parts of The Science of Human Caring. 	

PTS:	1	CON:	Nursing Roles		

	6.	ANS:	4
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference: 12
Heading: Basic Concepts of Holistic Care
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level:  Knowledge [Remembering]
Concept: Nursing Roles
Difficulty: Easy
	Feedback	
1	The practice of holistic nursing uses clinical expertise.	
2	A close relationship is developed with family members and significant others in holistic nursing. 	
3	Holistic nursing uses personal intuition and creativity when planning patient care.	
4	The practice of holistic nursing includes following physicians’ orders, using your clinical expertise, respecting and drawing on a person’s knowledge of and intuition of his or her own body, and integrating significant others in the patient’s life into his or her care.	

PTS:	1	CON:	Nursing Roles		

	7.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference:  6
Heading: Gerontological Nursing
Integrated Processes: Nursing Process: Assessment
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level:  Knowledge [Remembering]
Concept: Comfort; Perfusion; Nursing
Difficulty: Easy
	Feedback	
1	Pain over the chest area is a symptom often found in younger people.	
2	Most elderly people who have a heart attack are less likely to have chest pain.	
3	Crushing sternal pain is a symptom often found in younger people.	
4	Pain over the left side of the chest radiating down the left arm is a symptom often found in younger people.	

PTS:	1	CON:	Comfort | Perfusion | Nursing

	8.	ANS:	1
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference:  7
Heading: Gerontological Nursing
Integrated Processes: Nursing Process: Planning
Client Need: Physiological Integrity: Pharmacological Therapies
Cognitive level: Comprehension [Understanding]
Concept: Medication; Nursing
Difficulty: Easy
	Feedback	
1	Medication doses for a young or middle-aged person may overwhelm the systems of an elderly person with devastating results. As people age, their metabolism often slows, and there are many changes in body systems that can affect a drug’s absorption and excretion. Older people often require smaller drug dosages. 	
2	Medication doses are not larger because the patient is sicker.	
3	Medication doses are not the same. 	
4	Medication doses are not being withheld because the patient is old and possibly near death, which is an uncaring belief.	

PTS:	1	CON:	Medication | Nursing	

	9.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 1. Define gerontological nursing.
Chapter page reference: 6
Heading: Gerontological Nursing
Integrated Processes: Communication and Documentation
Client Need: Psychosocial Integrity
Cognitive level: Comprehension [Understanding]
Concept: Cognition
Difficulty: Easy
	Feedback	
1	Cognitive therapy, also known as cognitive behavioral therapy, is a method of treating many emotional and psychological problems, including anxiety, depression, and phobias.	
2	Validation therapy is a communication technique that has been developed specifically for dealing with demented elderly persons (including persons with Alzheimer’s disease). It focuses on accepting the person’s view of reality and age-appropriate behavior and can be used to calm a pacing, agitated older person.	
3	The Geriatric Depression Scale is a tool used in neurological and psychological assessment.	
4	The MMSE is a tool used in neurological and psychological assessment.	

PTS:	1	CON:	Cognition

	10.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 6. Describe five examples of how you, as a novice nurse, can use Watson’s theory as you give nursing care to older adults.
Chapter page reference: 15
Heading: Expanding the Concept of the Science of Human Caring
Integrated Processes: Communication and Documentation
Client Need: Psychosocial Integrity
Cognitive level: Application [Applying]
Concept: Caring
Difficulty: Moderate

	Feedback	
1	Removing the meal try and leaving the room is uncaring and insulting to the patient.	
2	Telling the patient to stop screaming in a loud voice is responding with anger and does not determine the cause of the outburst.	
3	The nurse should try to find out what is bothering him and ask specific questions. Remember that the patient has been given a very serious and probably terminal diagnosis, and anger is understandable. There is a reason for every behavior, and the nurse has the responsibility to learn the reason before reacting. 	
4	If the patient becomes unruly assistance should be obtained, but first try to determine the reason for the outburst and provide comfort if possible.	

PTS:	1	CON:	Caring

	11.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 6. Describe five examples of how you, as a novice nurse, can use Watson’s theory as you give nursing care to older adults.
Chapter page reference: 14
Heading: Point of Interest
Integrated Processes: Communication and Documentation
Client Need: Psychosocial Integrity
Cognitive level: Comprehension [Understanding]
Concept: Nursing; Communication
Difficulty: Easy
	Feedback	
1	Beneficence is an ethical principle in nursing. Beneficence is to be aimed for.	
2	Speaking to patients as if they are children is a form of paternalism. Elderly people should be addressed with respect, usually by Mr. or Mrs., unless they specifically ask you to use their first name. 	
3	Caring includes respect, and paternalism is not respectful to an older adult.	
4	Malfeasance is not an ethical principle in nursing. Malfeasance is to be avoided.	

PTS:	1	CON:	Nursing | Communication

	12.	ANS:	4
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 7
Heading: Point of Interest
Integrated Processes: Nursing Process: Assessment
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Knowledge [Remembering]
Concept: Nursing: Economics
Difficulty: Easy
	Feedback	
1	The term “young-old” is used for people 65 to 74 years old.	
2	The term “middle-old” is used for people 75 to 84 years old.	
3	The term “old-old” is used for people 85 to 100 years old.	
4	The increased numbers of elderly people in the United States has resulted in new definitions. The term “elite-old” is used for people older than 100 years.	

PTS:	1	CON:	Economics

	13.	ANS:	4
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference: 10
Heading: Basic Concepts of Holistic Care
Integrated Processes: Nursing Process: Assessment
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Comprehension [Understanding]
Concept: Nursing Roles
Difficulty: Moderate
	Feedback	
1	A key concept in holistic nursing is following the physician’s instructions and following up with the physician.	
2	A key concept in holistic nursing is developing a relationship with family members of the patient. 	
3	A key concept in holistic nursing is using clinical experience. 	
4	Key concepts in holistic nursing include following the physician’s instructions and communicating with the physician; using clinical experience; respecting the ideas the elderly patient has about his or her own body and how to make it well and incorporating those ideas into the nursing plan, if possible; and involving family members in the care of the elderly patient.	

PTS:	1	CON:	Nursing Roles		

	14.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 1. Define gerontological nursing.
Chapter page reference: 4
Heading: Gerontological Nursing
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Application [Applying]
Concept: Nursing Roles
Difficulty: Moderate
	Feedback	
1	Gerontology is not the use of older medications to treat illnesses.	
2	Gerontology comes from a Greek word that means “related to old age.”	
3	Gerontology does not focus on the housing needs of people who are underserved.	
4	Gerontology is not a way of explaining health problems of people over age 50. 	

PTS:	1	CON:	Nursing Roles		

	15.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 1. Define gerontological nursing.
Chapter page reference: 5
Heading: Gerontological Nursing
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Application [Applying]
Concept: Nursing 
Difficulty: Moderate
	Feedback	
1	Genetics is the study of heredity. 	
2	Geriatrics refers to the medical specialty that deals with the diagnosis and treatment of elderly adults. 	
3	Gerontology refers to the study of human aging.	
4	Gentrification is the purchase of properties in communities for the purpose of renovation. 	

PTS:	1	CON:	Nursing

	16.	ANS:	1
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 6
Heading: Gerontological Nursing
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive level: Comprehension [Understanding]
Concept: Diversity; Nursing 
Difficulty: Moderate
	Feedback	
1	Ageism is being prejudiced against older adults. 	
2	Stereotyping is saying that all members of a group have the same behaviors and characteristics. 	
3	Ethnocentricity believes that one cultural group is superior to another.	
4	Personal preference is selecting one thing over another.	

PTS:	1	CON:	Diversity | Nursing	

	17.	ANS:	4
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 7
Heading: Demographics of Aging
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Application [Applying]
Concept: Nursing Roles
Difficulty: Moderate
	Feedback	
1	Baby boomers are not individuals who have large families.	
2	Baby boomers are not individuals who advocate for the care of infants.	
3	Baby boomers are not individuals who have decided not to have large families.	
4	Baby boomers are people born between 1946 and 1965 after World War II. 	

PTS:	1	CON:	Nursing Roles		

	18.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 8
Heading: Demographics of Aging
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive level: Knowledge [Remembering]
Concept: Diversity; Nursing Roles
Difficulty: Easy
	Feedback	
1	Diabetes is a leading chronic disease affecting people older than age 65 years.	
2	Since the 1980s to the present, the gap in life expectancy between white and black elders has widened because the elderly black population has declined. This decline is attributed to death by homicide.	
3	Hypertension is a leading chronic disease affecting people older than age 65 years.	
4	Heart disease is a leading chronic disease affecting people older than age 65 years.	

PTS:	1	CON:	Diversity | Nursing Roles

	19.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 8
Heading: Demographics of Aging
Integrated Processes: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive level: Knowledge [Remembering]
Concept: Nursing Roles
Difficulty: Easy
	Feedback	
1	Older people are not more likely to participate in exercise programs because they have more time to exercise. 	
2	Older people are not more likely to participate in exercise programs because they are trying to avoid boredom. 	
3	Older people are more likely to participate in exercise programs because they initiated the fitness movement. 	
4	Older people are not more likely to participate in exercise programs because they want to spend more time with their grandchildren. 	

PTS:	1	CON:	Nursing Roles		

	20.	ANS:	4
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 8
Heading: Point of Interest
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Application [Applying]
Concept: Economics
Difficulty: Easy
	Feedback	
1	Medicaid is a federal and state supported process that provides health care to financially disadvantaged people.	
2	Medicare is a federal regulation providing health care for individuals older than age 65 or individuals who are permanently disabled.	
3	Supplemental Social Security is a federal benefit check paid to persons older than age 65 or persons with disabilities who are unable to work.	
4	Social Security is a federal benefit check paid to retired workers of a specific age, disabled workers of any age, and spouses and minor children of deceased workers.	

PTS:	1	CON:	Economics

	21.	ANS:	1
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 3. Write a one-sentence nursing philosophy.
Chapter page reference: 8
Heading: Nursing Philosophy
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Application [Applying]
Concept: Nursing Roles
Difficulty: Easy
	Feedback	
1	A nursing philosophy is a personal concept that has to come from within. 	
2	A nursing philosophy does not define goals and aspirations. 	
3	A nursing philosophy does not outline steps to a successful career.	
4	A nursing philosophy is not used to recognize the importance of education. 	

PTS:	1	CON:	Nursing Roles		

	22.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference: 10
Heading: Basic Concepts of Holistic Care
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive level: Comprehension [Understanding]
Concept: Nursing Roles
Difficulty: Moderate
	Feedback	
1	Answering a call light using the intercom system does not demonstrate a nurse who is unrushed and truly wants to develop a relationship with the patient. 	
2	Telling a patient that there is no time to try something new does not demonstrate a healing relationship with the patient. 	
3	Sitting with a patient to discuss the plan of care indicates an interest in developing a healing relationship with the patient. 	
4	Reminding a patient that others are waiting for the nurse does not indicate an interest in developing a healing relationship with the patient. 	

PTS:	1	CON:	Nursing Roles		

	23.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference: 10
Heading: Basic Concepts of Holistic Care
Integrated Processes: Nursing Process: Planning
Client Need: Psychosocial Integrity
Cognitive level: Knowledge [Understanding]
Concept: Nursing Roles
Difficulty: Easy
	Feedback	
1	Critical thinking is not critical to promote holistic care. 	
2	Listening is critical to promote holistic care.	
3	Time management is not critical to promote holistic care.	
4	Care coordination is not critical to promote holistic care. 	

PTS:	1	CON:	Nursing Roles		

	24.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 4. Define the word holism as it relates to gerontological nursing.
Chapter page reference: 10
Heading: Holistic Care Is Based on Teamwork
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Application [Applying]
Concept: Nursing; Nursing Roles
Difficulty: Moderate
	Feedback	
1	Members of the holistic health-care team may or may not include the doctor and pharmacist. 	
2	Members of the holistic health-care team may or may not include the dietician and discharge planner. 	
3	Members of the holistic health-care team include those who will help meet the patient’s needs.	
4	Members of the holistic health-care team may or may not include the social worker and physical therapist. 	

PTS:	1	CON:	Nursing | Nursing Roles

	25.	ANS:	2
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 5. Discuss the theory “The Science of Human Caring” by Dr. Jean Watson as it relates to clinical practice.
Chapter page reference: 13
Heading: Human Caring
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive level: Comprehension [Understanding]
Concept: Nursing; Safety
Difficulty: Moderate
	Feedback	
1	Telephoning prior to making a home visit respects the patient’s privacy.	
2	Mounting grab bars near the commode and in the shower demonstrates environmental safety. 	
3	Ensuring the delivery of a daily newspaper provides for stimulation. 	
4	Ensuring adequate volume on the television provides for stimulation. 	

PTS:	1	CON:	Nursing | Safety	

	26.	ANS:	1
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 5. Discuss the theory “The Science of Human Caring” by Dr. Jean Watson as it relates to clinical practice.
Chapter page reference: 14
Heading: Expanding the Concept of the Science of Human Caring
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive level: Application [Applying]
Concept: Nursing Roles
Difficulty: Easy
	Feedback	
1	To become a more caring nurse, the nurse should become a caring person. 	
2	Adequate rest is not identified as an action to become a more caring nurse. 	
3	Setting aside time for personal activities is not identified as an action to become a more caring nurse. 	
4	Consuming nutritious meals and exercising are not identified as actions to become a more caring nurse. 	

PTS:	1	CON:	Nursing Roles		

	27.	ANS:	3
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 6. Describe five examples of how you, as a novice nurse, can use Watson’s theory as you give nursing care to older adults.
Chapter page reference: 11
Heading: Expanding the Concept of the Science of Human Caring
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive level: Application [Applying]
Concept: Nursing Roles
Difficulty: Moderate 
	Feedback	
1	Recommending that the patient be discharged home as soon as possible does not demonstrate caring or meet the patient’s health needs. 	
2	Asking family members if they are willing to help pay for the patient’s care violates the patient’s privacy. 	
3	Contacting a social worker to talk with the patient about health insurance coverage demonstrates caring and addresses the patient’s concerns. 	
4	Finding out if the patient has any resources that can be liquidated to pay for the care violates the patient’s privacy and does not demonstrate caring or meet the patient’s health needs. 	

PTS:	1	CON:	Nursing Roles		

	28.	ANS:	4
Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 7. Define the concept of “gerotranscendence.”
Chapter page reference: 14
Heading: Gerotranscendence
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive level: Analysis [Analyzing]
Concept: Nursing Roles
Difficulty: Moderate 
	Feedback	
1	Industry is a developmental task of middle childhood. 	
2	Self-absorption is a part of the adult middle age developmental task. 	
3	Identity diffusion is a part of the adolescent developmental task. 	
4	Gerotranscendence means that the older person is satisfied with life and looks forward to living a full life for the rest of his or her days.	

PTS:	1	CON:	Nursing Roles		

MULTIPLE RESPONSE

	29.	ANS:	2, 3, 4
	Feedback	
1. 	Cancer is not identified as being a leading chronic disease of older adults.	
2. 	Diabetes is identified as being a leading chronic disease of older adults. 	
3. 	Heart disease is identified as being a leading chronic disease of older adults.	
4. 	Hypertension is identified as being a leading chronic disease of older adults.	
5. 	Multiple sclerosis is not identified as being a leading chronic disease of older adults. 	

Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 7
Heading: Point of Interest 
Integrated Processes: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive level: Application [Applying]
Concept: Assessment; Nursing
Difficulty: Moderate

PTS:	1	CON:	Assessment | Nursing	

	30.	ANS:	1, 4, 5
	Feedback	
1. 	Reasons for the increased number of older persons in our society include better nutrition. 	
2. 	Reasons for the increased number of older persons in our society do not include early retirement. 	
3. 	Reasons for the increased number of older persons in our society do not include increased exercise. 	
4. 	Reasons for the increased number of older persons in our society include improved health care. 	
5. 	Reasons for the increased number of older persons in our society include consistent sanitation. 	

Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 2. Discuss the current demographics of people older than age 65 years.
Chapter page reference: 7
Heading: Demographics of Aging 
Integrated Processes: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive level: Comprehension [Understanding]
Concept: Assessment; Nursing
Difficulty: Easy

PTS:	1	CON:	Assessment | Nursing	

	31.	ANS:	1, 3, 4
	Feedback	
1. 	A characteristic of a valuable nursing philosophy is that it is simple. 	
2. 	Popularity is not a characteristic of a valuable nursing philosophy. 	
3. 	A characteristic of a valuable nursing philosophy is that it is specific. 	
4. 	A characteristic of a valuable nursing philosophy is that it is meaningful. 	
5. 	Cost is not a characteristic of a meaningful nursing philosophy. 	

Chapter number and title: Chapter 1 Holistic Care
Chapter/learning objective: 3. Write a one-sentence nursing philosophy.
Chapter page reference: 8
Heading: Nursing Philosophy
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive level: Comprehension [Understanding]
Concept: Nursing; Nursing Roles
Difficulty: Easy

PTS:	1	CON:	Nursing | Nursing Roles