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MULTIPLE CHOICE
1. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this
man’s wellness?
a. Wellness can only be achieved with aggressive medical interventions.
b. Wellness is not a real option for this client because he is terminally ill.
c. Wellness is defined as the absence of disease.
d. Nursing interventions can help empower a client to achieve a higher level of
wellness.
ANS: D
Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse
can foster wellness in his or her clients. Wellness is defined by the individual and is
multidimensional. It is not just the absence of disease. A wellness perspective is based on the
belief that every person has an optimal level of health independent of his or her situation or
functional level. Even in the presence of chronic illness or while dying, a movement toward
wellness is possible if emphasis of care is placed on the promotion of well-being in a
supportive environment.
2. In differentiating between health and wellness in health care, which of the following
statements is true?
a. Health is a broad term encompassing attitudes and behaviors.
b. The concept of illness prevention was never considered by previous generations.
c. Wellness and self-actualization develop through learning and growth.
d. Wellness is impossible when one’s health is compromised.
ANS: A
Health is a broad term that encompasses attitudes and behaviors; holistically, health includes
wellness, which involves one’s whole being. The concept of illness prevention was never
considered by previous generations; throughout history, basic self-care requirements have
been recognized. Wellness and self-actualization develop through learning and growth—as
basic needs are met, higher level needs can be satisfied in turn, with ever-deepening richness
to life. Wellness is possible when one’s health is compromised—even with chronic illness,
with multiple disabilities, or in dying, movement toward a higher level of wellness is possible.
3. Which racial or ethnic group has the highest life expectancy in the United States?
a. Native Americans
b. African Americans
c. Hispanic Americans
d. Asian and Pacific Island Americans
4. Historical influences that have shaped the lives of the majority of the in-between cohort in the
United States today include which of the following?
a. Influenza epidemic of 1918
b. World War I
c. Child rearing in the Depression
d. World War II
ANS: D
Those who are in the in-between cohort in 2016 were born between 1915 and 1945. The men
were likely to have fought in World War II. The last of the Holocaust survivors are in this
group. A person who survived the influenza epidemic would be at least 98 years old in 2016
and therefore would be considered old-old or a centenarian. Most of those who are of the
in-between cohort had not reached childbearing age by the end of the Depression. Individuals
in the in-between cohort would not have been old enough to fight in World War II.
7. An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL.
Which nursing intervention is most likely to assist this man in achieving his highest level of
wellness?
a. Instruct him about increasing dietary fiber.
b. Ask the health care provider for a low-fat diet.
c. Schedule a consultation for him with the dietitian.
d. Review a menu with him to choose suitable foods.
ANS: D
The nurse collaborates with the older adult to choose suitable foods, which is likely to be an
effective nursing intervention to help an older adult with hyperlipidemia achieve optimal
health and well-being; it gives him some control over the regimen and thus engages him in the
process of lowering serum cholesterol. Informing the older man about dietary fiber offers no
control to him because he is not part of the decision. Nursing interventions developed with the
older adult’s collaboration are most likely to help the older adult achieve health and wellness.
Collaborating with the health care provider for a low-fat diet is a reasonable approach to help
this man with hyperlipidemia to achieve health and wellness. However, he is more likely to
have motivation and enthusiasm for a therapeutic regimen over which he has had some
control. Scheduling a consultation with a dietitian is a reasonable approach to an older adult
with hyperlipidemia and is a part of a multifaceted approach to optimizing his health.
However, the older adult is more likely to engage in a regimen over which he has input.
8. Which approach requires the nurse to integrate and balance all aspects of an individual’s life
into the plan of care?
a. Holistic nursing
b. Healthy People 2020
c. Maslow’s hierarchy of human needs
d. Orem’s self-care requirements
ANS: A
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eighteen from the South, and but eleven from the North; although
nearly four-fifths of the judicial business has arisen in the Free
States, yet a majority of the Court has always been from the South.
This we have required so as to guard against any interpretation of the
Constitution unfavorable to us. In like manner we have been equally
watchful to guard our interests in the Legislative branch of
Government. In choosing the presiding Presidents (pro tem.) of the
Senate, we have had twenty-four to their eleven. Speakers of the
House we have had twenty-three, and they twelve. While the
majority of the Representatives, from their greater population, have
always been from the North, yet we have so generally secured the
Speaker, because he, to a great extent, shapes and controls the
legislation of the country. Nor have we had less control in every other
department of the General Government. Attorney-Generals we have
had fourteen, while the North have had but five. Foreign ministers
we have had eighty-six, and they but fifty-four. While three-fourths
of the business which demands diplomatic agents abroad is clearly
from the Free States, from their greater commercial interest, yet we
have had the principal embassies so as to secure the world-markets
for our cotton, tobacco, and sugar on the best possible terms. We
have had a vast majority of the higher offices of both army and navy,
while a larger proportion of the soldiers and sailors were drawn from
the North. Equally so of Clerks, Auditors, and Comptrollers filling
the executive department, the records show for the last fifty years
that of the three thousand thus employed, we have had more than
two-thirds of the same, while we have but one-third of the white
population of the Republic.
Again, look at another item, and one, be assured, in which we have
a great and vital interest; it is that of revenue, or means of supporting
Government. From official documents, we learn that a fraction over
three-fourths of the revenue collected for the support of the
Government has uniformly been raised from the North.
Pause now while you can, gentlemen, and contemplate carefully
and candidly these important items. Look at another necessary
branch of Government, and learn from stern statistical facts how
matters stand in that department. I mean the mail and Post-Office
privileges that we now enjoy under the General Government as it has
been for years past. The expense for the transportation of the mail in
the Free States was, by the report of the Postmaster-General for the
year 1860 a little over $13,000,000, while the income was
$19,000,000. But in the Slave States the transportation of the mail
was $14,716,000, while the revenue from the same was $8,001,026,
leaving a deficit of $6,704,974, to be supplied by the North for our
accommodation, and without it we must have been entirely cut off
from this most essential branch of Government.
Leaving out of view, for the present, the countless millions of
dollars you must expend in a war with the North; with tens of
thousands of your sons and brothers slain in battle, and offered up as
sacrifices upon the altar of your ambition—and for what, we ask
again? Is it for the overthrow of the American Government,
established by our common ancestry, cemented and built up by their
sweat and blood, and founded on the broad principles of Right,
Justice and Humanity? And as such, I must declare here, as I have
often done before, and which has been repeated by the greatest and
wisest of statesmen and patriots in this and other lands, that it is the
best and freest Government—the most equal in its rights, the most
just in its decisions, the most lenient in its measures, and the most
aspiring in its principles to elevate the race of men, that the sun of
heaven ever shone upon. Now, for you to attempt to overthrow such
a government as this, under which we have lived for more than
three-quarters of a century—in which we have gained our wealth, our
standing as a nation, our domestic safety while the elements of peril
are around us, with peace and tranquillity accompanied with
unbounded prosperity and rights unassailed—is the height of
madness, folly, and wickedness, to which I can neither lend my
sanction nor my vote.
The seven seceding States (South Carolina, Mississippi, Georgia,
Florida, Alabama, Louisiana and Texas,) as shown by data previously
given, organized their Provisional Government, with Jefferson Davis,
the most radical secession leader, as President; and Alex. H.
Stephens, the most conservative leader, as Vice-President. The
reasons for these selections were obvious; the first met the views of
the cotton States, the other example was needed in securing the
secession of other States. The Convention adopted a constitution, the
substance of which is given elsewhere in this work. Stephens
delivered a speech at Savannah, March 21st, 1861, in explanation and
vindication of this instrument, which says all that need be said about
it:
“The new Constitution has put at rest forever all the agitating
questions relating to our peculiar institutions—African slavery as it
exists among us—the proper status of the negro in our form of
civilization. This was the immediate cause of the late rupture and
present revolution. Jefferson, in his forecast, had anticipated this as
the ‘rock upon which the old Union would split.’ He was right. What
was conjecture with him, is now a realized fact. But whether he fully
comprehended the great truth upon which that rock stood and
stands, may be doubted. The prevailing ideas entertained by him and
most of the leading statesmen at the time of the formation of the old
Constitution, were that the enslavement of the African was in
violation of the laws of nature: that it was wrong in principle,
socially, morally, and politically. It was an evil they knew not well
how to deal with, but the general opinion of the men of that day was,
that somehow or other, in the order of Providence, the institution
would be evanescent and pass away. This idea, though not
incorporated in the Constitution, was the prevailing idea at the time.
The Constitution, it is true, secured every essential guarantee to the
institution while it should last, and hence no argument can be justly
used against the constitutional guarantees thus secured, because of
the common sentiment of the day. Those ideas, however, were
fundamentally wrong. They rested upon the assumption of the
equality of races. This was an error. It was a sandy foundation, and
the idea of a government built upon it; when the ‘storm came and the
wind blew, it fell.’
“Our new Government is founded upon exactly the opposite idea;
its foundations are laid, its corner-stone rests upon the great truth
that the negro is not equal to the white man. That slavery—
subordination to the superior race, is his natural and normal
condition. This, our new Government, is the first, in the history of
the world, based upon this great physical and moral truth. This truth
has been slow in the process of its development, like all other truths
in the various departments of science. It has been so even amongst
us. Many who hear me, perhaps, can recollect well, that this truth
was not generally admitted, even within their day. The errors of the
past generation still clung to many as late as twenty years ago. Those
at the North who still cling to these errors, with a zeal above
knowledged, we justly denominate fanatics.***
“In the conflict thus far, success has been, on our side, complete
throughout the length and breadth of the Confederate States. It is
upon this, as I have stated, our actual fabric is firmly planted; and I
cannot permit myself to doubt the ultimate success of a full
recognition of this principle throughout the civilized and enlightened
world.
“As I have stated, the truth of this principle may be slow in
development, as all truths are, and ever have been, in the various
branches of science. It was so with the principles announced by
Galileo—it was so with Adam Smith and his principles of political
economy—it was so with Harvey and his theory of the circulation of
the blood. It is stated that not a single one of the medical profession,
living at the time of the announcement of the truths made by him,
admitted them. Now they are universally acknowledged. May we not,
therefore, look with confidence to the ultimate universal
acknowledgment of the truths upon which our system rests. It is the
first government ever instituted upon principles of strict conformity
to nature, and the ordination of Providence, in furnishing the
materials of human society. Many governments have been founded
upon the principle of certain classes; but the classes thus enslaved,
were of the same race, and in violation of the laws of nature. Our
system commits no such violation of nature’s laws. The negro, by
nature, or by the curse against Canaan, is fitted for that condition
which he occupies in our system. The architect, in the construction of
buildings, lays the foundation with the proper materials, the granite;
then comes the brick or the marble. The substratum of our society is
made of the material fitted by nature for it, and by experience we
know that it is best, not only for the superior, but for the inferior race
that it should be so. It is, indeed, in conformity with the ordinance of
the Creator. It is not for us to inquire into the wisdom of His
ordinances, or to question them. For His own purposes He has made
one race to differ from another, as He has made ‘one star to differ
from another star in glory.’
“The great objects of humanity are best attained when conformed
to His laws and decrees, in the formation of governments, as well as
in all things else. Our Confederacy is founded upon principles in
strict conformity with these laws. This stone which was first rejected
by the first builders ‘is become the chief stone of the corner’ in our
new edifice.
“The progress of disintegration in the old Union may be expected
to go on with almost absolute certainty. We are now the nucleus of a
growing power, which, if we are true to ourselves, our destiny, and
high mission, will become the controlling power on this continent.
To what extent accessions will go on in the process of time, or where
it will end, the future will determine.”
It was determined by the secession of eleven States in all, the
Border States except Missouri, remaining in the Union, and West
Virginia dividing from old Virginia for the purpose of keeping her
place in the Union.
The leaders of the Confederacy relied to a great extent upon the
fact that President Buchanan, in his several messages and replies to
commissioners, and in the explanation of the law by his Attorney-
General, had tied his own hands against any attempt to reinforce the
garrisons in the Southern forts, and they acted upon this faith and
made preparations for their capture. The refusal of the
administration to reinforce Fort Moultrie caused the resignation of
General Cass, and by this time the Cabinet was far from harmonious.
As early as the 10th of December, Howell Cobb resigned as Secretary
of the Treasury, because of his “duty to Georgia;” January 26th, John
B. Floyd resigned because Buchanan would not withdraw the troops
from Southern forts; and before that, Attorney-General Black,
without publicly expressing his views, also resigned. Mr. Buchanan
saw the wreck around him, and his administration closed in
profound regret on the part of many of his northern friends, and,
doubtless, on his own part. His early policy, and indeed up to the
close of 1860, must have been unsatisfactory even to himself, for he
supplied the vacancies in his cabinet by devoted Unionists—by Philip
F. Thomas of Maryland, Gen’l Dix of New York, Joseph Holt of
Kentucky, and Edwin M. Stanton of Pennsylvania—men who held in
their hands the key to nearly every situation, and who did much to
protect and restore the Union of the States. In the eyes of the North,
the very last acts of Buchanan were the best.
With the close of Buchanan’s administration all eyes turned to
Lincoln, and fears were entertained that the date fixed by law for the
counting of the electoral vote—February 15th, 1861—would
inaugurate violence and bloodshed at the seat of government. It
passed, however, peaceably. Both Houses met at 12 high noon in the
hall of the House, Vice-President Breckinridge and Speaker
Pennington, both democrats, sitting side by side, and the count was
made without serious challenge or question.
On the 11th of February Mr. Lincoln left his home for Washington,
intending to perform the journey in easy stages. On parting with his
friends at Springfield, he said:
“My Friends: No one, in my position, can realize the sadness I feel
at this parting. To this people I owe all that I am. Here I have lived
more than a quarter of a century. Here my children were born, and
here one of them lies buried. I know not how soon I shall see you
again. I go to assume a task more difficult than that which has
devolved upon any other man since the days of Washington. He
never would have succeeded except for the aid of Divine Providence,
upon which he at all times relied. I feel that I cannot succeed without
the same Divine blessing which sustained him; and on the same
Almighty Being I place my reliance for support. And I hope you, my
friends, will all pray that I might receive that Divine assistance,
without which I cannot succeed, but with which success is certain.
Again, I bid you all an affectionate farewell.”
Lincoln passed through Indiana, Ohio, New York, New Jersey and
Pennsylvania on his way to the Capitol. Because of threats made that
he should not reach the Capitol alive, some friends in Illinois
employed a detective to visit Washington and Baltimore in advance
of his arrival, and he it was who discovered a conspiracy in Baltimore
to mob and assassinate him. He therefore passed through Baltimore
in the night, two days earlier than was anticipated, and reached
Washington in safety. On the 22d of February he spoke at
Independence Hall and said:
“All the political sentiments I entertain have been drawn, so far as
I have been able to draw them, from the sentiments which originated
in, and were given to the world from, this hall. I never had a feeling,
politically, that did not spring from the sentiments embodied in the
Declaration of Independence.
“It was not the mere matter of the separation of the Colonies from
the motherland, but that sentiment in the Declaration of
Independence, which gave liberty, not alone to the people of this
country, but, I hope, to the world for all future time. It was that
which gave promise that, in due time, the weight would be lifted
from the shoulders of men. This is the sentiment embodied in the
Declaration of Independence. Now, my friends, can this country be
saved upon that basis? If it can, I will consider myself one of the
happiest men in the world, if I can help to save it. If it cannot be
saved upon that principle, it will be truly awful! But if this country
cannot be saved without giving up the principle, I was about to say, ‘I
would rather be assassinated on the spot than surrender it.’ *** I
have said nothing but what I am willing to live by, and if it be the
pleasure of Almighty God, to die by!”
Lincoln’s First Administration.
Such was the feeling of insecurity that the President elect was
followed to Washington by many watchful friends, while Gen’l Scott,
Col. Sumner, Major Hunter and the members of Buchanan’s Cabinet
quickly made such arrangements as secured his safety. Prior to his
inauguration he took every opportunity to quell the still rising
political excitement by assuring the Southern people of his kindly
feelings, and on the 27th of February,[17] “when waited upon by the
Mayor and Common Council of Washington, he assured them, and
through them the South, that he had no disposition to treat them in
any other way than as neighbors, and that he had no disposition to
withhold from them any constitutional right. He assured the people
that they would have all of their rights under the Constitution—‘not
grudgingly, but freely and fairly.’”
He was peacefully inaugurated on the 4th of March, and yet
Washington was crowded as never before by excited multitudes. The
writer himself witnessed the military arrangements of Gen’l Scott for
preserving the peace, and with armed cavalry lining every curb stone
on the line of march, it would have been difficult indeed to start or
continue a riot, though it was apparent that many in the throng were
ready to do it if occasion offered.
The inaugural ceremonies were more than usually impressive. On
the eastern front of the capitol, surrounded by such of the members
of the Senate and House who had not resigned their seats and
entered the Confederacy, the Diplomatic Corps, the Judges of the
Supreme Court, headed by Chief Justice Taney, the author of the
Dred Scott decision; the higher officers of Army and Navy, while
close by the side of the new President stood the retiring one—James
Buchanan—tall, dignified, reserved, and to the eye of the close
observer apparently deeply grieved at the part his party and position
had compelled him to play in a National drama which was now
reaching still another crisis. Near by, too, stood Douglas (holding
Lincoln’s hat) more gloomy than was his wont, but determined as he
had ever been. Next to the two Presidents he was most observed.
Sec. 8. That all persons in the naval service of the United States,
who have entered said service during the present rebellion, who have
not been credited to the quota of any town, district, ward, or State, by
reason of their being in said service and not enrolled prior to
February twenty-four, eighteen hundred and sixty-four, shall be
enrolled and credited to the quotas of the town, ward, district, or
State, in which they respectively reside, upon satisfactory proof of
their residence made to the Secretary of War.
GUERRILLAS.