Question 1

An 89-year-old Chinese patient had a cerebrovascular accident that left him totally dependent in activities of daily living.He subsequently had a percutaneous enteral gastrostomy (PEG)tube placed for feeding.He is ready to be discharged from the acute care setting,and the family is expressing that they want to take him home and care for him.The following are important for the nurse to assess when evaluating the family support system except:

A) number of family members who are accessible.
B) economic status of each of the family members.
C) recent stresses of each of the family members.
D) ethnic background of each of the family members.

Accepted Answer

The ethnic background of each of the family members is not a part of a family support system assessment.Options A,B,and C are part of a family support system assessment,which includes an assessment of size of family,ability of family members,willingness of family members,functions of each of the family members,deterrents,and recent stresses of all the family members.

Question 2

A 68-year-old accountant is planning for retirement.He talks about volunteering in an animal shelter after he retires because he loves animals.What action would be most helpful in assisting him in adjusting to this new role?

A) Begin volunteering for an hour or two per week while he is still working.
B) Volunteer for 40 hours per week immediately upon retiring.
C) Choose a volunteer position in the animal shelter's financial office.
D) Seek a volunteer opportunity that offers a small stipend to supplement his pension.

Accepted Answer

Individuals should be encouraged to begin minimal participation in volunteer programs before discontinuing the work role to serve as a bridge to the new role.The number of hours worked in the volunteer role will not necessarily help him adjust to the role.Retirement is often seen as a time to develop secondary interests and challenges.It is not necessary for the volunteer role to be in the same line of work as the paid employment was.A stipend offered for the volunteer work will not assist with adjustment.

Question 3

Your client is cared for at home by his son and daughter-in-law,who are also responsible for the care of their four preschool-aged children.What is true of this &#34;sandwich&#34; generation?&#10;A) The pressure and conflicts that arise from caring for both older adults and children can be very stressful.&#10;B) The majority of middle-aged adults are faced with balancing the care of parents and children at the same time.&#10;C) The average age of an adult caring for parents is in the 30s.&#10;D) The majority of caregivers affected by this &#34;sandwich&#34; generation are males.

Accepted Answer

Caregivers of older adults are often faced with conflicts between active lives,demanding careers,and multiple needs of parents and children.Although there are many middle-age adults caring for parents and children at the same time,it is not a majority.The average age of caregivers who care for parents is 46.The majority of caregivers (61%)are female and usually daughters.

Question 4

An 88-year-old resident of a long-term care facility relates that she used to be the family member who arranged family reunions.Although she was never married and had no children,her room is full of pictures of nieces and nephews and grandnieces and grandnephews,and she can tell you about all of the individuals in the pictures.You could describe the resident as:

A) preoccupied with the family.
B) matriarch of the family.
C) kin-keeper.
D) living in the past.

Accepted Answer

The resident can be described as a kin-keeper,a family member who arranges get-togethers,develops the family history and rituals,and promotes solidarity and unity among family members.The resident's involvement with the affairs of her family does not represent a preoccupation.There is no evidence that she is the matriarch of the family.She is not living in the past.

Question 5

A married couple lives in a retirement community.The husband is 76 and the wife is 73.When she attends her Tai Chi class,she shares the following with the nurse: "I expected to enjoy retirement with my husband.These were supposed to be our golden years.I am so stressed out.All I do is spend my time taking care of him; he has so many things wrong with him." The nurse bases her response on the understanding that:

A) The woman's comments are atypical of older married adults and reflect severe depression.
B) The woman's comments are typical and reflect the many stressors faced by older married couples.
C) The woman's comments are typical and reflect the financial strain faced by older married couples.
D) The woman's comments are atypical and reflect a conflict situation between her and her children.

Accepted Answer

Physical changes in late life can pose a challenge to relationships.Deteriorating health of one partner often puts a strain on the marriage in older adults.The comments are typical of many older married couples and are not reflective of severe depression.There is no indication of financial hardship or a conflict situation with children.

Question 6

A 78-year-old woman is a resident of a nursing home.Her daughter visits daily and records everything that the staff does for her mother in a notebook that she carries with her.She visits the director of nursing weekly to discuss omissions in care.She states that her role is to "protect her mother from harm." Her mother's recent laboratory values demonstrate that she is dehydrated.The nurse meets with the resident's daughter and explains dehydration and asks that the daughter assist the resident to drink 8 ounces of fluid every 2 hours and to document it on an intake and output form.This is an example of:

A) collaborating with the family.
B) rescuing.
C) surveillance.
D) psychosocial support.

Accepted Answer

The nurse is collaborating with the family and fostering a partnership to provide care to the resident.Rescuing involves providing a safety net for the caregiver by stepping in to provide direct care and make clinical decisions.The nurse is not providing surveillance or ongoing monitoring; she is collaborating with the family member.The nurse is not attending to the psychosocial well-being of the caregiver.

Question 7

Lesbian,gay,bisexual,and transgender older adult couples face additional challenges as they age.All are challenges frequently encountered except:&#10;A) ability to access social security and health care benefits of partner.&#10;B) health care systems geared to special needs of lesbian,gay,bisexual,and transgender older adults.&#10;C) same-gender marriages not recognized in all states in the United States.&#10;D) family members not recognized as relatives in the traditional sense.

Accepted Answer

Option B is incorrect; this statement is not true.Health care systems are most often not responsive to the special needs of this population.Options A,C,and D are all challenges frequently encountered by this population.

Question 8

Select the true statement regarding grandparenthood.&#10;A) Grandparenthood is an outdated role in today's society.&#10;B) Grandparents tend to be less involved with their grandchildren than are great-grandparents with great-grandchildren.&#10;C) Most older adults are grandparents.&#10;D) The role of parent is subordinate to that of grandparent.

Accepted Answer

Eighty percent of adults older than age 65 are grandparents.Grandparenthood is an important role in today's society.Grandparents are usually more involved than great-grandparents.The parent role is primary; the role of grandparent is a step beyond parent and has a different level of responsibility.

Question 9

An 82-year-old widow with Alzheimer's disease is being cared for at home by her daughter.Twice a week,the widow goes to an adult day care program.This is an example of:&#10;A) long-term care.&#10;B) a PACE program.&#10;C) transitional care.&#10;D) respite care.

Accepted Answer

Respite care provides temporary relief to the caregiver.When the widow goes to the adult day care program,her daughter has some relief from the duties of caregiving.Long-term care is care in a nursing home.PACE (Program for All-inclusive Care for the Elderly)is a program in which an individual who has many physical care and skilled care needs is cared for in the community.Part of a PACE program includes an adult day care program.Transitional care addresses the individual's needs as they transition between and among different care settings.

Question 10

A 99-year-old resident of a long-term care facility came to the facility 12 years ago after the death of her husband of 56 years.She has no children or other relatives.She has a very close relationship with one of the nurse aides and refers to the aide as her daughter.The nurse aide is an example of:

A) delusional kin.
B) fictive kin.
C) kin-keeper.
D) primary kin.

Accepted Answer

Fictive kin are nonrelatives who become surrogate family members.These individuals take on instrumental and affectional attributes of family.These individuals are real; they are not delusions.A kin-keeper is a family member who arranges get-togethers and promotes solidarity among family members.The aide is not related to the resident in the traditional sense.

Deck 20: Relationships,Roles,and Transitions