Gerontological Nursing Exam 1 2025/2026 Latest

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Explain the different ways in which older adults have been viewed
throughout history. (ch 1) - Answer Confucius: correlation of age and
respect
Chinese: attaining old age was an accomplishment
Egyptians: dreaded growing old
Greeks: struggles between the old and the young
Ancient Romans: limited respect for elders
The Bible: well-being of family; desire to respect elders
Medieval times: rise of superiority of youth
Industrial revolution: persons of advanced age left unprotected
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Describe characteristics of today's older population in regard to: life
expectancy, marital status, living arrangements, income and employment,
and health status (ch 1) - Answer - life expectancy :
increased, 77.8 years old
Negative attitudes from society
Fear of losing sexual abilities
Concerns about body image
Relationship issues
Misconceptions by older adults
-marital status
Half of women over 65 are widowed
Majority of men are married
-living arrangements
Most older adults life w/ spouse or other family
Twice the number of women than men live alone later in life
Potential for living alone increases w/ age for men & women
-income and employment
% of older adults living below poverty level has declined
Most depend on social security for more than half of income
High prevalence of home ownership by older adults "asset rich, cash poor"
Women & minority groups have less income than white men
-health status
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Chronic illnesses is the major issue with older adults, not acute illness.
However, older people who do develop acute illnesses usually require
longer periods of recovery and have more complications from these
conditions.
Most older adults have at least one chronic illness.
Chronic conditions limit ADLs and IADLs: major source of disability.
Instrumental Activities of Daily Living are activities related to independent
living.
Leading chronic conditions: arthritis, hypertension, hearing issues, heart
conditions, visual impairments, orthopedic issues, diabetes, sinusitis,
allergies, and varicose veins.

Discuss projected changes in future generations of older people and the

implications for health care. (ch 1)
Approximately one in four older adults will spend some time in a nursing
home.
Increasing need for gerontological nurses.
Health and social agencies must anticipate future needs.
Government payment of services in jeopardy in an age of budget cuts.
Baby boomers are the next wave of older adults.
Higher rates of hospitalization, surgery, and physician visits: Paid by
federal dollars, most o

Discuss the change in focus regarding learning about factors influencing

aging. - Answer

List the major biological theories of aging. - Answer -Stochastic

theory: View aging as random assaults form both internal and external
-Examples: Cross Linking Theory, Free Radicals and Lipofuscin Theory,
Wear and Tear, Evolutionary, Biogerontology
-Nonstochastic theory: view aging from resulting a complex,
predetermined process
-Apoptosis, Genetic Theory, Autoimmune Reaction, Radiaton,
Neuroendocine and neurochemical , nutrition, environmental

Describe the major psychosocial theories of aging. - Answer

Identify factors that promote a healthy aging process. - Answer Diet,

Activity, play and laughter, faith, empowerment, stress management

Describe the way in which gerontological nurses can apply theories of

aging to nursing practice. - Answer -identifying elements known to
influence aging and using them as a foundation to promote positive
practices
-nurses who view aging as a process of continued development may
appreciate late life as an opportunity to gain new satisfaction and
understanding, thereby promoting joy and a sense of purpose in patients.
•No one theory can adequately explain the cause of aging
•Biological, psychological, and social processes of aging are interrelated
and interdependent
•The journey of aging can be unique for each individual and impacted by
many factors
•Nurses need to have a holistic focus in assessing, planning, and providing
care.
•View aging as a process of continued development
Describe projected changes in the diversity of the older population in the
United States. (ch 3) - Answer By 2020, ¼ of America's older
population will be minority racial or ethnic
Growing number of lesbian, gay, bisexual, transgender seniors

Describe unique views of health and healing among major ethnic groups.
(ch 3) - Answer Hispanic Americans: Health & illness as actions of
God. Illness = violation of good practices of livings or being punished by
God. Illness may be viewed as family affair.
Curanderos: women who have special knowledge and charismatic qualities
Sobadoras: persons who give massages and manipulate bones and
muscles
Espiritualistas: persons who analyze dreams, cards, and premonitions
Brujos: women who practice witchcraft
Senoras: older women who have learned special healing measures
Black Americans: Less access to healthcare. Lower life expectancy.
Asian Americans , Chinese, Japanese Americans: Chinese medicine:
Traditional Chinese medicine is based on the belief that the female negative
energy (yin) and the male positive energy (yang) must be in balance.
5 elements. Qi (Life force), acupuncture, acupressure. Herbs, message, t'ai
chi.
Native Americans: good or evil forces, or punishment for acts
Jewish Americans
Jewish faith: strong sense of identity, shared beliefs
Immigration from various nations: different customs and cultures
Scholarship important: 60% attend college
Religious traditions: sundown Friday to sundown Saturday is Sabbath
Kosher diet: exclusion of pork and shellfish, prohibit milk and meat at
same meal or from same dishes
Strong, positive feelings for older adults
Specific death rituals

Identify ways in which nursing care may need to be modified to

accommodate persons of diverse ethnic backgrounds. (ch 3) - Answer
Ensure cultural, religious, and sexual differences of older adults are
understood, appreciated, and respected.
Cultural sensitivity honors older adults' history and preserves the familiar
and what is important to them.
Do not allow loss of ethnic or cultural importance.

Discuss ageism and its consequences. - Answer concept introduced

decades ago and defined as "the prejudices and stereotypes that are
applied to older people sheerly on the basis of their age (38)
Although older adults constitute the most diverse and individualized age
group in the population, they continue to be stereotyped by the following
misconceptions:
Old people are sick and disabled.
Most old people are in nursing homes.
Dementia comes with old age.
People are either very tranquil or very cranky as they age.
Old people have lower intelligence and are resistant to change.
Old people are not able to have sexual intercourse and are not interested
in sex.
There are few satisfactions in old age.
For most older adults, the above statements are not true
Consequences of Ageism: (38)
younger people are less likely to see the similarities between themselves
and older adults.
also reduces the opportunities for the young to gain realistic insights into
aging
makes it easier for younger individuals to minimize the socioeconomic
challenges of the older population.
systematically stereotyping and discriminating against older persons will
not prevent individuals from growing old themselves and experiencing the
challenges of old age.
Ageism, unfortunately, can predispose aging persons to disappointment
because they may believe stereotypical views that old age is a time of
purposelessness and decline.

Discuss changes that occur in aging families.(ch 4) - Answer Loss of a

spouse
Children become their own nuclear family, parents may feel
disconnected/less purpose
As parents age they may need care from children or care that is overseen
by children

Describe challenges faced by widows. - Answer •Adjustments:

•Task of living alone
•Developing alternative roles
•Income issues
•Loss of an intimate partner
•Choosing a new lifestyle

Outline the phases and challenges of retirement. (ch 4) - Answer Loss

off the work role
Reduced income
Preretirement phase: Fantasy regarding retirement role
Retirement phase: "Honeymoon period" attempt to do everything they
never had time for
Disenchantment phase: Life begins to stabilize, letdown sometimes
depression is experienced. More unrealistic the preretirement fantasy,
greater the disenchantment
Reorientation phase: Realistic choices and alternative sources of
satisfaction
Retirement routine phase: Understanding of role. Framework for concern,
involvement, action in older persons life
Termination of retirement: Retirement role is lost due to illness of disability

Discuss the impact of age-related changes in health and functioning on

roles. (44) - Answer Difficult for the aging person to accept new body
image, self concept, and the body's declining efficiency.
Examples: poor memory, slow response, easy fatigue, declining function
Societal expectations frequently determine the adjustment individuals
make to declining function.
Common results of declining function are illness and disability.
older people have one or more chronic diseases, and more than one third
have a serious disability that limits major activities such as work and
housekeeping.
Describe cumulative effects of life transitions. (ch 4) - Answer
Shrinking social world - loss of social connections and increased risk of
loneliness
Awareness of Mortality - due to death of friends, widowhood

List nursing measures to assist individuals in adjusting to the challenges

and changes of aging. (ch 4) - Answer Life Review & Life Story. Self-
reflection. Journaling, Writing letters & e-mails, reflection through art

Describe the importance of evidence-based practice in gerontological

nursing. - Answer •A systematic approach that uses existing research
for clinical decision making
•Meta-analysis
•A process of analyzing and compiling the results of published research
studies on a specific topic
•Cost-analysis
•Cost-related data are gathered on outcomes to make comparisons
•Benchmarking
•Performance is compared with best practices or industry averages

Identify standards used in gerontological nursing practice. - Answer

•Reflect the level and expectations of care that are desired and serve as a
model against which practice can be judged
•State and federal regulations outline minimum standards of practice for
various health care workers and agencies
•ANA Scope and Standards of Practice for Gerontological Nursing
List principles guiding gerontological nursing practice. - Answer
•Nursing principles are those proven facts or widely accepted theories that
guide nursing actions
Examples: Nursing process, health education, pathophysiology, sociology,
ethincs, psychology, medical-surgical nursing

Discuss major roles for gerontological nurses. - Answer •Healer-

Nurses need to identify their own weaknesses, vulnerabilities, and need for
continued self-healing
•Caregiver-Ensure that the care of older adults is based on sound
knowledge that reflects the unique characteristics, needs, and responses
of older persons by disseminating gerontological principles and practices
Educator- •May need to educate about topics including normal aging,
pathophysiology, geriatric pharmacology, health promotion, and available
resources
Advocator- •Can include advocacy for community efforts that affect older
adults
Innovator-"thinking outside the box

Discuss future challenges for gerontological nursing. - Answer •Utilize

evidence-based practices
•Advance research
•Promote integrative care
•Educate caregivers
•Develop new roles
•Balance quality care and health care cost
Describe activities that contribute to self-care for gerontological nurses. -
Answer •Nurses need to maintain, nurture, and strengthen connections
in their personal lives

Explain holistic gerontological nursing care. (ppt ch 7, slide 2) - Answer

Holism: "the integration of the biologic, psychological, social, and spiritual
dimensions of an individual in which the synergy creates a sum that is
greater than its parts"
•Incorporates knowledge and skills from a variety of disciplines to address
the physical, mental, social, and spiritual health of individuals
•Goal is to serve the needs of the whole person

Describe the needs of older adults pertaining to the promotion of health

and the management of health challenges.(ppt ch 7, slides 3 & 4) -
Answer Health promotion: (Health: "a state of wholeness ... an
integration of body, mind, and spirit to achieve the highest possible quality
of life each day")
Management of health Challenges:
•Education •Counseling •Coaching •Monitoring •Coordination •Therapies
•Advocacy

List the requisites that influence older persons' abilities to meet self-care
needs. (ppt ch 7, slide 5) - Answer •Physical, Mental, and
Socioeconomic Abilities
•Knowledge, Experience, and Skills
•Desire and Decision to Take Action
Describe the general types of nursing interventions that are employed
when older adults present self-care deficits. (ppt ch 7, slide 6) - Answer
Strengthen self care capacity
Eliminate or minimize self care limitations
Act for, do for, or partially assist

Describe four characteristics of nurses who function as healers. (ppt ch 7,

slide 7) - Answer •Presence
Time belongs fully to patient
•Availability
Provide the time and space for patients to express, explore, and
experience
•Willingness to Form Connections
Learn what makes each patient unique
•Models of Holism
Self-care practices

Discuss laws governing gerontological nursing practice. (ppt ch 8, slide 2)

- Answer Strengthen self care capacity
Eliminate or minimize self care limitations
Act for, do for, or partially assist

Describe four characteristics of nurses who function as healers. (ppt ch 7,

slide 7) - Answer •Presence
Time belongs fully to patient
•Availability
Provide the time and space for patients to express, explore, and
experience
•Willingness to Form Connections
Learn what makes each patient unique
•Models of Holism
Self-care practices

Discuss laws governing gerontological nursing practice. (ppt ch 8, slide 2)

- Answer Public laws: governs relationships between private parties
and the government
Scope of nursing practice: nurses standards of conduct
Requirements for licensure: facility licensure or individual medical
personnel licensure
Private laws: governs relationships among individuals or between
individuals and organizations
These laws protect individual rights and also set standards of conduct,
which, if violated, can result in liability of the wrongdoer. (106)

Describe legal issues in gerontological nursing practice and ways to

minimize risks.(ch 8)
(ppt ch 8 slides) - Answer Malpractice
• When performance deviates from the standard of care
• Duty, negligence, and injury must be present for malpractice to exist
• As the responsibilities assumed by nurses increase, so will the risk of
malpractice.
Confidentiality
• HIPPA
Patient consent
• Consent must be obtained before performing any medical or surgical
procedure
• Needed for anything that exceeds basic, routine care measures
• Must be informed
• Consider mental status
• Do not add to the consent after the patient has signed it
• Some consents cannot be witnessed by a nurse
Staff supervision
• Nurses responsible for supervision of other staff
• A nurse needs to ensure that those caregivers to whom tasks are
delegated are competent to perform the tasks and carry out their
assignments properly
• The nurse assumes certain risks in the role of supervision and delegation
Medications
• Nurses are responsible for safe administration of prescribed medications.
• Scope of practice does not include preparing, compounding, dispensing,
or retailing medications.
Restraints
• Often exacerbate the problem for which they are used
• Can cause serious injury and death
• Associated with negative effects
• Source of physical and psychological distress for the older adult
Telephone Orders
• Always read the order back to the provider
• Write it down
• Do not involve third parties
• Communicate relevant information
DNR orders
• Unless specified DNR, patients are all Full Code
• DNR is a medical order
Advanced directive, and Living will
• Refer patient to a lawyer/legal consultant
Elder Abuse
• Elder abuse can be physical, emotional, sexual, exploitation, neglect, or
abandonment
• Caregiver stress can lead to abuse
• Elder Assessment Instrument helps identify those being abused
• Nurses have a legal responsibility to report all cases of known or
suspected abuse
•S

List legal safeguards for nurses.(ppt ch 8, slide 20) - Answer Common

sense best ally
Sound nursing practice
Know the rules and laws
Know agency policies
Determine employee competency and check their work

Discuss various philosophies regarding right and wrong.(ppt ch 9, slide 2) -

Answer •Utilitarianism
Good acts are those from which the greatest number of people will benefit
•Egoism
An act is morally acceptable if it is of the greatest benefit to oneself
•Relativism
Right and wrong are relative to the situation
•Absolutism
There are specific truths to guide actions, truths vary based on personal
beliefs

Describe ethical standards, principles, and cultural considerations guiding

nursing practice.(ppt ch 9, slides 3,4,5) - Answer **External and
Internal ethical Standards**
Guided by:
•Code of Ethics
•Federal, state, and local standards
•Joint Commission
•American Heart Association
•Know your own values, beliefs, morals, and ethics
**Principles**
•Beneficence: to do good for patients
•Nonmaleficence: to prevent harm to patients
•Justice: to be fair, treat people equally, and give patients the service they
need
•Fidelity: to respect our words and duty to patients
•Veracity: truthfulness
•Autonomy: to respect patients' freedoms, preferences, and rights
•Confidentiality: to respect the privacy of patients
**Cultural Considerations**
•What may be considered an ethical practice for some individuals may not
be viewed as such by others due to their cultural backgrounds
•Nurses need to appreciate that ethical issues are influenced by culture

List factors that have increased ethical dilemmas for nurses.(ppt ch 9, slide
6) - Answer •Expanded Role of Nurses
•Medical Technology
•New Fiscal Constraints
•Conflict of Interest
•Greater Numbers of Older Adults
•Assisted Suicide

Identify measures to help nurses make ethical decisions. ( ppt ch 9, slide 7)

- Answer Supportive & Preventive Services
For individuals w/ the capacity for independent self-care
Financial services: Social security, Veterans Affairs, free checking
accounts, senior discounts. Assistance for burial and funeral expenses
Employment, Nutrition (Food stamps, lunch programs), housing
Preventative health care, social support & activities (religious groups,
nursing homes, chore assistance)
Volunteer work, education (free tuition) counseling, consumer affairs, legal
and tax services, transportation, personal emergency response systems.
Shopping at home
Partial & intermittent care services
For individuals with partial limitations in self-care capacity, therapeutic
demands that require occasional assistance, or both
Assistance w/ chores, home-delivered meals, home monitoring, telephone
reassurance, home health care. Foster care & group homes, Adult day
services. Day treatment & Day hospital programs. Assisted living. Respite
care. Health ministry & parish nurse programs. Care & Case management.
Programs of all-inclusive care for the elderly. Hospice.
Complete & Continuous care services
For individuals with partial or total limitations in self-care capacity and
therapeutic demands that require regular or occasional assistance
Hospital Care, nursing homes
Complementary and Alternative services
Wellness and renewal centers
Education, counseling, and case management from alternative
practitioners
Acupuncture and acupressure
Tai chi, yoga, and meditation classes
Therapeutic touch and healing touch
Medicinal herbal prescriptions
Herbal and homeopathic remedies
Guided imagery sessions
Sound, light, and aromatherapy

Discuss factors that influence service selection for older adults. (ch 10) -
Answer Services must address physical, emotional, social, and spiritual
factors.
Services must consider unique and changing needs.
Care and services must be flexible.
Services must be tailored to needs.
PRICE??

Describe various practice settings for gerontological nurses.(ch 10) -

Answer Long-term care facilities
Home health agencies
Senior housing complexes
Adult day care centers

List major functions of gerontological nurses.( ch 10) - Answer Guide

persons of all ages toward a healthy aging process.
Eliminate ageism.
Respect the rights of older adults and ensure others do the same.
Oversee and promote the quality of service delivery.
Notice and reduce risks to health and well-being.
Teach and support caregivers.
Open channels for continued growth.
Listen and support.
Offer optimism, encouragement, and hope.
Generate, support, use, disseminate, and participate in research.
Implement restorative and rehabilitative measures.
Coordinate and manage care.
Assess, plan, implement, and evaluate care in an individualized, holistic
manner.
Link services with needs.
Nurture future gerontological nurses for advancement of the specialty.
Understand the unique physical, emotional, social, and spiritual aspects of
each older adult.
Recognize and encourage the appropriate management of ethical
concerns.
Support and comfort through the dying process.
Educate to promote self-care and optimal independence.

Describe basic spiritual needs. (ch 15) - Answer Love: most important,
people need to feel cared for
Meaning and purpose: need to know that life experiences had a meaning
and served a purpose--nothing is in vein
Hope: anticipation for new adventures, pleasures, and relationships or
belief that suffering will have an end
Dignity: Western society, self-worth is often judged by appearance,
function, & productivity; when those attributes lack older adults find worth
through their connection with God or other higher power
Forgiveness: burden of the wrongs committed by or to oneself is
significantly stressful and can detrimentally affect health; Forgiving and
accepting forgiveness is healing
Gratitude: It is easy to fall into the trap of focusing on the negatives; an
attitude of thankfulness nourishes the spirit and strengthens the ability to
cope with any situation
Transcendence: affords people life beyond material existence and equips
them to make sense of the difficult circumstances
Expression of faith: is encompassed and expressed through
religious/spiritual practices. Spiritual distress: Disruption in the ability to
express one's faith because of illness or disability
List questions that could be used for spiritual assessment.( ch 15) -
Answer What is your faith or religion?
Are you involved with a church, temple, or faith community? What is it?
Would you like to have them involved with your care?
Are there religious practices that are important to you? Are you able to
practice them now? If not, is there a way I can assist you in practicing
them?
Do you believe in God or a higher power? Could you please describe what
that belief means to you?
Do you read the Bible or other religious text? Are you able to do this
reading now?
What do you think God's role is in your illness and healing?
Is there anything about your faith or spiritual beliefs that is causing you
distress, discomfort, or conflict?
What is most meaningful to you?
What gives your life purpose?
What is your source of strength or support?
From whom do you receive love?
Who are the most significant recipients of your love?
Do you feel like you have unfinished business? Things you need to say to
someone? Forgiveness you wish to seek or offer?
What are your fears?
How can I (we) best support your spiritual beliefs and practices at this
time?

Discuss measures to support spiritual needs. (ppt ch 15, slide 12) -

Answer Being available
Honoring beliefs and practices
Providing opportunities for solitude
Promoting hope
Assisting in discovering meaning in challenging situations
Facilitating religious practices
Praying with and for
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