Question 1

Mrs. Bilyea is an 80-year-old widow who lives in a very expensive neighbourhood with her 55-year-old son. She requires minor assistance with her activities of daily living. She has recently been admitted to hospital with chest pain. The nurse examines the older adult and discovers that she has bruises on both of her upper arms. The son states that she was in the shower and fell, and while he was lifting her up, he grabbed both of her arms very tightly because she was wet and he did not want her to fall again. The nurse discusses her observations with other members of the health care team. Which statement by a member of the health care team indicates that more education is required?

Accepted Answer

A)   "This could not possibly be older adult abuse. Mrs. Bilyea is white and wealthy; abuse does not happen to ladies like her."
B)   "Abuse increases proportionately to the increased time needed to provide care."
C)   "We are not sure what has happened so we should report our suspicions."
D)   "Most abusers are either adult children or spouses." A

Question 2

Social security retirement income programs are designed to minimize the chances of retirees and older people living in poverty in Canada. Which of the following individuals over the age of 65 years would encounter the most challenges in accessing the social security retirement income programs, which include Old Age Security (OAS), Guaranteed Income Supplement (GIS), Allowance for the Survivor, and the Canada Pension Plan (CPP)?

Accepted Answer

A)   Mrs. Perez, who has been living in Canada for eight years as a sponsored immigrant
B)   Ms. Soznicki, who has been a common-law partner for ten years
C)   Mrs. Haas, who is the widow of an old age security pensioner
D)   Mr. Naipal, who has been a same-sex partner for 15 years A

Question 3

The National Advisory Committee on Aging (NACA) has raised an important issue of "under-subscription," that is, people who are eligible for the GIS, the Allowance, Old Age Security (OAS), or the Allowance for the Survivor, but who do not receive it because they have not applied or reapplied for the benefits. Which of the following groups constitutes the majority of those who do not subscribe or apply for OAS benefits?

Accepted Answer

A)   Canadians who do not speak English or French, or who have low literacy
B)   Canadians who live in remote regions
C)   Canadians who are homeless
D)   Canadians who are older women D

Question 4

In 2001, the Canadian Health Services Research Foundation (CHSRF) reported that if the pattern of typical health care service use by older Canadians changes, there could be an impact on overall health care costs for the population. What would cause health care expenditures in Canada to increase?

Accepted Answer

A)   As the baby boomer generation ages, older Canadians will be in poor health and require more health care services.
B)   Healthy older adults will be using more health care services, mainly more physician visits and tests for preventative measures.
C)   The biggest cost increase in the health care expenditure will be for prescription medication.
D)   As the population ages, more hospital services will be required, thereby increasing the overall cost of health care.

Question 5

Under the Canada Health Act, "medically necessary" services are publicly insured, including primary health care, care in hospitals, and surgical-dental services. How is the term "medically necessary" interpreted by the provinces and the territories?

Accepted Answer

A)   There is provincial and territorial variability in terms of how some "medically necessary" services are interpreted.
B)   All provinces and territories follow the same interpretation, and provide all "medically necessary" services to Canadians.
C)   Home care, medications outside of hospital, physiotherapy, and optometry services are provided to all Canadians.
D)   The level of funding provided for all "medically necessary" services is the same throughout Canada.

Question 6

An older male adult is being abused by his daughter, a single, working mother of four children, with whom he lives. The nurse investigates and learns that the abuse is due to situational stress. Which should the nurse implement to address the short-term crisis?

Accepted Answer

A)   Remove him from his daughter's home immediately.
B)   Encourage the daughter to work with social services.
C)   Arrange respite care or day care for the patient.
D)   Place the patient in a long-term care facility.

Question 7

The nurse distrusts the male caregiver, the son of an older female adult, and collaborates with social services about potential resources for abused older adults. Which characteristics of the caregiver does the nurse report to social services as indicators of potential elder abuse?

Accepted Answer

A)   The caregiver collects unemployment benefits.
B)   The caregiver finds fault with any nursing care.
C)   The caregiver takes frequent breaks for smoking.
D)   The caregiver sits at the patient's bedside for hours daily.

Question 8

Preparation for a time when patients are no longer competent and want to have their wishes communicated, or for patients who want a substitute decision-maker recognized to ensure that their wishes are carried out, requires a signed document. Which document ensures that patients' wishes are communicated if they can no longer speak for themselves?

Accepted Answer

A)   Power of attorney
B)   Advance directive
C)   Will
D)   Do-not-resuscitate (DNR)  order

Question 9

A health care provider asks the nurse about an older male adult's power of attorney because consent is needed for a medically necessary invasive procedure; the patient has end-stage disease, is intubated, and is on mechanical ventilation. Which one of the following steps should the nurse implement?

Accepted Answer

A)   Refer to the patient's advance directive for a name.
B)   Assist with obtaining informed consent from the patient.
C)   Use an oral test to measure the patient's cognitive function.
D)   Apply the Confusion Assessment Method for critical care.

Exam 22: Economic and Legal Issues

In 2001, the Canadian Health Services Research Foundation (CHSRF) reported that if the pattern of typical health care service use by older Canadians changes, there could be an impact on overall health care costs for the population. What would cause health care expenditures in Canada to increase?

Under the Canada Health Act, "medically necessary" services are publicly insured, including primary health care, care in hospitals, and surgical-dental services. How is the term "medically necessary" interpreted by the provinces and the territories?

An older male adult is being abused by his daughter, a single, working mother of four children, with whom he lives. The nurse investigates and learns that the abuse is due to situational stress. Which should the nurse implement to address the short-term crisis?

The nurse distrusts the male caregiver, the son of an older female adult, and collaborates with social services about potential resources for abused older adults. Which characteristics of the caregiver does the nurse report to social services as indicators of potential elder abuse?

A health care provider asks the nurse about an older male adult's power of attorney because consent is needed for a medically necessary invasive procedure; the patient has end-stage disease, is intubated, and is on mechanical ventilation. Which one of the following steps should the nurse implement?