Deck 19: The Aging Adult

Question 1

A middle adult client requests visits by the hospital chaplain and reads the Bible each day while hospitalized for treatment of heart problems. What is the individual illustrating?

A) Midlife transition
B) Support of the rights of others
C) Fear for the future
D) Trust in spiritual strength

Answer 1

Trust in spiritual strength

Question 2

While caring for an older adult male, the nurse observes that his skin is dry and wrinkled, his hair is gray, and he needs glasses to read. Based on these observations, what would the nurse conclude?

A) These are normal physiologic changes of aging.
B) The observations are not typically found in older adults.
C) These are abnormal observations and must be reported.
D) Extra education will be necessary to prevent complications.

Answer 2

These are normal physiologic changes of aging.

Question 3

Which of the following statements is true for nursing care of older adults?

A) Most older adults are unable to care for themselves independently.
B) Most older adults are functional, benefiting from health-oriented interventions.
C) Fewer older adults will require nursing care during the 21st century.
D) Interventions for older adults are no different from those for young adults.

Answer 3

Most older adults are functional, benefiting from health-oriented interventions.

Question 4

The daughter of an older adult calls the nurse practitioner to report that her mother is becoming very confused after dark. What is this type of confusion named?

A) Night-time confusion
B) Sundowning syndrome
C) Alzheimer's disease
D) Cognitive dysfunction

Question 5

According to Erikson, the middle adult is in a period of generativity versus stagnation. What happens if developmental tasks are not achieved?

A) Physical changes are denied
B) Health needs become a major concern
C) Motivation to learn is decreased
D) Awareness of own mortality increases

Question 6

According to the free radical theory of aging, what substance is affected by aging and causes damage?

A) Carbohydrates
B) Proteins
C) Water
D) Lipids

Question 7

A nurse educates adults in preventive measures to avoid problems of middle adult years. Which of the following are the major health problems during the middle adult years?

A) Cardiovascular disease, cancer
B) Upper respiratory infections, fractures
C) Communicable diseases, dementia
D) Sexually transmitted diseases, drug abuse

Question 8

A nurse says to an older adult who is being cared for at home, "Tell me what your life was like when you were first married." What does this statement encourage the client to do?

A) Explain why he or she has certain emotions
B) Become more introspective and self-focused
C) Practice life review or reminiscence
D) Look backward with regret for undone tasks

Question 9

During a health assessment, a woman age 49 years tells the nurse that she is "just so tired and has been having mood swings and hot flashes." Based on this information, the nurse would conduct a more thorough history and assessment of what body system?

A) Reproductive
B) Cardiovascular
C) Respiratory
D) Cranial nerves

Question 10

While conducting a health assessment with an older adult, the nurse notices it takes the person longer to answer questions than is usual with younger clients. What should the nurse do?

A) Stop asking questions so as not to confuse the client.
B) Slow the pace and allow extra time for answers.
C) Realize that the client has some dementia.
D) Ask a family member to answer the questions.

Question 11

Which aging theory describes a chemical reaction that produces damage to the DNA and cell death?

A) Genetic theory
B) Immunity theory
C) Cross-linkage theory
D) Free radical theory

Question 12

Which of the following assessment findings of a male client age 77 years should signal the nurse to a potentially pathologic finding, rather than a normal age-related change?

A) The client is oriented to person and place but is unsure of the month.
B) The client states that his urine stream is less strong than in the past.
C) The client claims to hear high-pitched sounds less clearly than earlier in life.
D) The client's gait is slow and his posture appears stooped.

Question 13

A client age 71 years has recently integrated large amounts of blueberry and pomegranate juice into her diet, touting their antioxidant properties that mitigate the effects of separated high-energy electrons. The client's actions reflect which of the following theories of aging?

A) Free radical theory
B) Genetic theory
C) Cross-linkage theory
D) Immunity theory

Question 14

A teenager states, "Old people are different. They don't need the same things that young people do." What is this statement an example of?

A) Racism
B) Ageism
C) Indifference
D) Knowledge

Question 15

A woman aged 88 years who lives alone has deficits in vision and hearing, although these deficits are corrected by glasses and hearing aids. Her blood pressure medicine is making her dizzy. What response to these health problems would the home health nurse identify?

A) Risk for decreased social interaction
B) Altered consciousness
C) Risk for accidental injury
D) Risk for impaired judgment

Question 16

The staff at a long-term care facility have made minimal effort to secure a shared room for a couple in their late 80s, who have been married for several decades. The manager states, "I'm sure that bedroom activity is the last thing on their mind these days." How should the nurse best respond to the manager's characterization of sexuality in older adults?

A) "They might not be as active as in years past, but sexuality is still important for older people."
B) "It's actually a myth that older adults have sex less often than younger adults."
C) "There's no reason that we should assume they're less interested than when they first got married."
D) "Their sexual activity has probably stopped by now, but they still need companionship."

Question 17

A nurse is developing a plan of care for an older adult with chronic heart disease. Which of the following factors must be considered?

A) Family members do not need to be as involved in the care of the older adult.
B) Almost 100% of all older adults have limitations from multiple chronic illnesses.
C) Older adults do not want to maintain their health and independence.
D) Medications, hospitalizations, and medical supplies increase economic difficulties.

Question 18

An older adult, newly widowed, has been unable to adjust to her change in roles or form new relationships. What is this experience called?

A) Social isolation
B) Social ineptness
C) Ineffective coping
D) Negativism of aging

Question 19

What is one reason for the "middle-aged spread" often seen in middle adults?

A) Changes in hormones
B) Loss of satisfactory roles
C) Decreased physical activity
D) Satisfaction with one's life

Question 20

A home health care nurse has observed that a client 80 years of age, who has multiple chronic health problems, takes a total of 19 medications on either a scheduled or PRN (as needed) basis. How should the nurse address this client's risk of harm from polypharmacy?

A) Ensure that the client's care is coordinated and encourage the primary care provider to review her medication regimen.
B) Recommend holistic and herbal remedies to replace some of the medications.
C) Contact the client's local pharmacy to discuss possible changes to her medication regimen.
D) Encourage the client to reduce her medication load by withholding some medications when she is asymptomatic.

Question 21

Eighty percent of older adults have one chronic illness, and 60% have at least two. The older adult's ability to adapt determines:

A) whether they are ill or healthy.
B) degree of loss of the physiologic reserve of the various organ systems
C) that not wanting to change makes them more determined.
D) how quickly they become overwhelmed with the stress of it all.

Question 22

A nurse is providing care to an older adult at home after major abdominal surgery. Which of the following nursing diagnoses would most likely be appropriate?

A) Adult Failure to Thrive
B) Anticipatory Grieving
C) Impaired Memory
D) Risk for Infection

Question 23

According to Havighurst, which of the following are developmental tasks of middle adulthood? Select all that apply.

A) Accept and adjust to physical changes.
B) Maintain a satisfactory occupation.
C) Assist children to become responsible adults.
D) Maintain social contacts and relationships.
E) Relate to one's spouse or partner as a person.

Question 24

In general, what is the focus of care for nurses who work with older adults?

A) Providing all necessary physical care
B) Referring clients for needed emotional support
C) Establishing goals and expected outcomes for the client
D) Assisting clients to function as independently as possible

Question 25

Which of the following are physical changes that occur in middle adulthood? Select all that apply.

A) Body fat is redistributed.
B) The skin is more elastic.
C) Cardiac output begins to increase.
D) Muscle mass gradually decreases.
E) There is a loss of calcium from bones.

Question 26

A nurse is educating a group of middle adults about health promotion. What statement by one of the participants indicates the need for additional education?

A) "I will make exercise a part of my daily activities."
B) "I should eat a diet high in fats but low in fiber."
C) "I will begin a smoking cessation program this week."
D) "I only have one glass of wine a day with dinner."

Question 27

An older adult lives in a facility that provides, housing, group meals, personal care and support, social activities, and minimal health care services. What type of facility does this describe?

A) Nursing home
B) Assisted living
C) Accessory apartment
D) Home modification

Question 28

A nurse who provides care in a long-term care facility recognizes the need to promote health rather than solely treating illness. Which of the following measures should the nurse encourage among the older adult resident population of the facility? Select all that apply.

A) Encourage frequent naps in order to ensure adequate sleep and rest.
B) Encourage residents to take dietary supplements when safe.
C) Conduct activities at a slower pace and allow residents time to respond.
D) Encourage residents to engage in the present rather than perform reminiscence.
E) Promote self-care and only assist residents when it is necessary.

Question 29

While providing hygiene care to a confused older adult client diagnosed with Alzheimer's disease, the nures is called to the nursing station. To ensure patient safety the nurse must do what?

A) Ask a family member to stay with him.
B) Cover him with a blanket for warmth.
C) Reattach the restraints.
D) Put side rails up before leaving the client.

Question 30

The home health nurse is making an initial home visit to a male widow age 76 years. During the assessment the nurse finds that the client is taking multiple medications. The client states that he has also been taking some herbal remedies. What should the nurse be sure to include in the client education?

A) Herbal remedies are holistic.
B) Herbal remedies are often cheaper than prescribed medicine.
C) The importance of avoiding herbal remedies
D) The need to inform his physician and pharmacist about the herbal remedies

Question 31

The nurse is assigned to a 52-year-old male patient. He is talkative and usually friendly when the nurse enters his room. Today, however, he is standing at the mirror and says: I lost my job because the company downsized, there isn't anything I can do. As his caregiver, the nurse recognizes this expression of concern is related to which of the following?

A) He assumes the termination is his fault.
B) Dissatisfaction with changes in his appearance and energy levels.
C) His career goals and retirement plans are compromised.
D) He is in an androgenic crisis.

Question 32

Dementia is a disorder that progresses over several years, with increasing confusion, forgetting family, and disorientation in familiar surroundings. A common problem with dementia patients is sundowning syndrome, which is described as ...

A) a behavior change at sunset as the client becomes more fatigued, listless, and disoriented.
B) occasional onset of marked confusion, wandering and feeling lost during the afternoon, before sunset.
C) habitual agitation, restlessness, and confusion that occurs after dark.
D) increasing sleeplessness at night because the patient cat-naps during the day.

Question 33

Which of the following statements is true of the older adult population?

A) Old age begins at 65 years of age.
B) Most older adults live in nursing homes.
C) Older adults are not interested in sex.
D) Incontinence is not a part of aging.

Question 34

A nurse documents the following assessment on an older adult client's chart: "dry, thin skin." Which of the following nursing diagnoses would be appropriate for this client?

A) Risk for falls
B) Risk for imbalanced body temperature
C) Risk for infection
D) Risk for sedentary lifestyle

Question 35

One of the adverse events that Medicare will no longer reimburse the hospital for is an in-hospital fall. Fall prevention is a major part of nursing and risk management. In order to reduce the risk of falling, the nurse must:

A) ensure that the patient wears his prescription glasses when up.
B) post signs to alert staff to the patient at high risk for falls.
C) always assist every patient with ambulation.
D) assess the patient's fatigue level.
E) monitor gait and balance.