Deck 13: Young to Middle Adult

Question 1

The nurse is preparing to discuss postpartum depression as a part of discharge teaching with the parents of a newborn.Which of the following nursing actions would be most therapeutic regarding early detection of this postpartum condition?
1) Helping the couple understand the importance of social interaction with other adults
2) Providing the couple with a video that tells the story of a new mother's experience with depression
3) Encouraging the couple to attend parenting classes designed to minimize the stressors of parenting an infant
4) Having a discussion with the father in which he identifies the signs and symptoms of postpartum depression

Answer 1

4
Educating both new mothers and their families regarding the signs and symptoms of postpartum stress and depression will facilitate early detection and treatment of the condition.While preventing social isolation is important to the prevention of generalized depression,it has little impact on detecting the signs and symptoms of the condition.While the video may be informative it is not the most therapeutic option because it lacks interaction between the nurse and the clients.While Option 3 is appropriate in regard to minimizing the risk of developing depression stemming from postpartum stressors,it does not directly impact the identification of the signs and symptoms of the condition.

Question 2

The most serious risk for death for a young adult living in rural poverty is:
1) Suicide
2) Homicide
3) Poor health maintenance practices
4) Family history of chronic illnesses

Answer 2

1
A young adult is more likely to die of self-inflicted injury when living at or below the poverty level when no other risk factors (i.e. ,a violent environment,drug abuse,etc. )are present.In 2002 the death rate (per 100,000 population)for 25- to 34-year-olds in the United States caused by homicide was 11.2;the death rate caused by accidents was 31.5;and the death rate caused by suicide was 12.6 (U.S.Department of Health and Human Services [USDHHS]).

Question 3

A 49-year-old client is experiencing problems with depression.She has come to the clinic showing signs of malnutrition and fatigue.Which of the following is the best initial statement for the nurse to make in the assessment phase?
1) "How much weight have you lost over the past month?"
2) "Have you recently been experiencing menopausal symptoms?"
3) "Depression is something to expect at your age,and with assistance you will get better."
4) "Your depression is somewhat uncommon.Can you tell me what has happened recently to cause it?"

Answer 3

2
Mood changes and depression are common phenomena during menopause,and this client is in the expected age range to be experiencing menopause.Asking the client about weight loss may be an indication to verify depression;however,it is not the best initial response.Depression is not something to expect,although it can occur.Depression is not uncommon during menopause.

Question 4

The nurse is alert to stressors that may have an influence on the young adult client.One example of a common stressor for this age-group is:
1) Occupational pursuits
2) Health-related matters
3) Coping with cognitive changes
4) Caring for the older adult parent

Question 5

A nurse is preparing an education program on safety for a young adult group.Based on the major cause of mortality and morbidity for this age-group,the nurse should focus on:
1) Birth control
2) Automobile safety
3) Occupational hazards
4) Prevention of heart disease

Question 6

The nurse,trying to promote positive health habits regarding stress management is aware of the external influences on young and middle adult clients.With this knowledge,the nurse recognizes that an effective strategy for this age-group is:
1) Teaching clients to abstain from all alcohol consumption
2) Demonstrating how to take an accurate blood pressure measurement
3) Determining an effective daily exercise schedule for stress reduction
4) Describing the types of medications commonly used for treating depression

Question 7

A nurse is working in the health office at a local college where most of the students are young adults.Being aware of the major concerns for this age-group,the nurse includes assessment of these clients':
1) Current marital history status
2) Lifestyle and leisure activities
3) Experience with chronic disease
4) History of childhood accidents

Question 8

Which of the following young adults is at greatest risk for experiencing death or injury?
1) An 18-year-old with a father who is an alcoholic
2) A 30-year-old who is a professional rodeo rider
3) A 20-year-old living in an urban housing project
4) A 26-year-old riding a motorcycle across the country

Question 9

Research has shown that certain postpartum factors negatively affect a woman's general health status after pregnancy.Which of the following women has the greatest risk factor for poor postpartum health?
1) A mother with complaints of fatigue,loss of appetite,and insomnia
2) A practicing attorney who has reluctantly taken a 3-month maternity leave
3) A stay-at-home mom who gave birth 2 months ago and whose husband recently lost his job
4) A mother of a 3-week-old and a 2-year-old whose military husband is currently deployed overseas

Question 10

A client thinks that she might be pregnant.Which first trimester physiological changes would most likely indicate this?
1) Amenorrhea and nausea
2) Braxton Hicks contractions
3) Increased urinary frequency
4) Edematous ankles and dyspnea

Question 11

During a routine physical assessment a 27-year-old client acknowledges the suspension of his driver's license because of an arrest for driving under the influence of alcohol.This admission should prompt the nurse to discuss which of the following in detail with the client?
1) Use of illegal drugs
2) History of depression
3) Unprotected sexual experiences
4) Tendency toward violent behavior

Question 12

Individuals at the young adult point in their life are generally expected to,according to developmental patterns:
1) Continue physical growth
2) Experience severe illnesses
3) Ignore physical symptoms
4) Seek frequent medical care

Question 13

As an individual enters middle adulthood health problems generally become more prevalent.The middle adult may be influenced by chronic illness that results in:
1) Decreased health care tasks
2) Reinforcement of family roles
3) Changed sexual behavior habits
4) Improvement of family relationships

Question 14

Because young adults are less likely to experience serious illness,which of the following nursing interventions is most effective in determining risk for illness in this age-group?
1) Health screenings
2) Personal lifestyle assessment
3) Full body systems assessment
4) Cardiopulmonary focal assessment

Question 15

To determine how the client,who is a single parent of three children,will be able to cope with the current pregnancy,the nurse should ask the client:
1) "Have you ever been married?"
2) "Where do you currently work?"
3) "Has anyone ever taught you about contraception?"
4) "Who do you have for support during this pregnancy?"

Question 16

The nurse is performing a physical examination on a 58-year-old adult client.The nurse will most likely find that the client of this age is experiencing which one of the following physiological changes related to normal aging?
1) Palpable thyroid lobes
2) Decreased skin turgor
3) Reduced pupillary reaction
4) Increased range of joint motion

Question 17

A client who works in a dry cleaning establishment comes to the clinic for a regular check-up.Based on this information,the nurse assesses the client for:
1) Asbestosis
2) Dermatitis
3) Tendonitis
4) Raynaud's phenomenon

Question 18

The nurse is completing a physical exam for a 45-year-old client who has come to the family practice office.In evaluating the observations made during the examination,the nurse recognizes that an expected finding for a client in this age-group is:
1) Hepatomegaly
2) Visual acuity below 20/50
3) An oral temperature of 39° C
4) Increased amount of skin turgor

Question 19

The nurse is performing a physical examination on a 40-year-old adult client.The nurse will most likely find that the client of this age is experiencing which one of the following physiological changes related to normal aging?
1) Decreased hearing acuity
2) Decreased sense of smell
3) Decreased strength of abdominal muscles
4) Decreased function of the various cranial nerves

Question 20

When discussing the stressors felt by a single mother in her 30s,the nurse recognizes that the greatest financial impact on this family is caused by:
1) The ever-rising cost of living in the United States
2) The realization that a female earns 25% less than her male co-worker
3) Court-ordered child support is often times inadequate.
4) Daycare expenses are a strain on a single wage earner family

Question 21

Which of the following nursing assessment questions is best directed toward determining the presence of a normal physiological change experienced by a middle-aged client?
1) "Any problems with your teeth or gums?"
2) "Any family history of thyroid problems?"
3) "Do you have a skin-moisturizing routine?"
4) "Are you having a problem with driving at night?"

Question 22

In preparing to discuss safe sex practices with a 20-year-old,it is most important that the nurse shares with the client that in addition to physical symptoms of genital pain and discharge,sexually transmitted diseases:
1) Can lead to chronic illness and infertility
2) Are particularly common in young adults
3) Respond well to treatment when detected early
4) May be effectively controlled through the use of condoms

Question 23

Which of the following client responses shows the best understanding regarding the management of risk factors for chronic illness among young adults?
1) "Unprotected sex is just plain dangerous."
2) "Everyone riding in my car wears a seat belt."
3) "I'm a vegetarian,but I eat non-animal protein."
4) "I've never smoked,and I drink only occasionally."

Question 24

Which of the following statements concerning health promotion habits made by a young adult best reflects an understanding regarding the primary cause of death and injury among that age group?
1) "Eating a healthy,low-fat diet is very important to me."
2) "AIDS is nothing to mess with,so I always practice safe sex."
3) "Regardless of what my friends say,I always wear a seat belt."
4) "I enjoy mountain biking,but I always wear the right protection gear."

Question 25

Which of the following nursing assessment questions is best directed toward determining the presence of an occupational hazard-related condition specific for a client working in a dry cleaning establishment?
1) "Do you have any problems with rashes or itching?"
2) "How long have you worked in the dry cleaning business?"
3) "Do you treat the minor burns you experience?"
4) "Do you drive the company van to make deliveries?"

Question 26

Which of the following questions asked by the nurse best assesses for the signs of pregnancy most likely observed in the second trimester?
1) "Have you had any problems climbing steps?"
2) "Have you noticed any cramping in your abdomen?"
3) "Have you experienced any nausea in the morning?"
4) "Have you had any problems with shoes that don't seem to fit?"

Question 27

Which of the following client statements,made by a young adult regarding health promotion habits,reflects a need for further client education by the nurse?
1) "I go to the gym and work out 3 times a week with friends."
2) "My dad has high cholesterol,so I have mine checked yearly."
3) "Diabetes runs in my family,so I watch my carbohydrate intake."
4) "I drink alcohol only on weekends,when it doesn't interfere with work."

Question 28

Which of the following client responses shows the best understanding regarding the management of risk factors for chronic illness among young adults?
1) "Unprotected sex is just plain dangerous."
2) "Everyone riding in my car wears a seatbelt."
3) "I'm a vegetarian,but I eat nonanimal protein."
4) "I've never smoked and I drink only occasionally."

Question 29

Which of the following statements made by the parents of a newborn best reflects an understanding regarding the diagnosis of postpartum depression?
1) "I helped my sister when she was depressed after the birth of her second child."
2) "I have a wonderfully supportive family who will be there if I start feeling depressed."
3) "We've read over the literature,and I'll be able to recognize any signs of depression in my wife."
4) "Most new moms get a little depressed,but we will be sure to pay attention to any real indications of a problem."

Question 30

Which of the following client statements would be the best evidence that this young adult has adopted a positive strategy to promote his own personal emotional health?
1) "I drink alcohol only on special occasions and then moderately."
2) "I run at least three times a week;it seems to help me stay relaxed."
3) "I watch for the signs of depression since my mother experienced it."
4) "I know stress can affect my blood pressure,so I have it taken regularly."

Question 31

Which of the following lifestyle choices poses the greatest risk for chronic illness to the young adult?
1) Alcohol and tobacco use
2) Ignoring seat belt and helmet laws
3) Unprotected sex with multiple partners
4) Poor nutrition and a lack of structured exercise

Question 32

Which of the following nursing assessment questions is best directed toward determining the presence of career stressors in a young adult?
1) "What do you do to relieve stress for yourself?"
2) "What is the most stressful part of your daily job?"
3) "Career-wise,where would you like to be in 2 years?"
4) "Do you miss much work as a result of injuries or illness?"

Question 33

Which of the following statements made by a 27-year-old client shows the greatest need for further nursing assessment regarding the potential use of illegal drugs?
1) "Whether you wear a helmet or not should be the choice of the motorcyclist."
2) "I fractured my hand 3 years ago when I got so mad I hit a wall in my dorm room."
3) "I like to drink a bit too much,and I lost my license once for drinking and driving."
4) "My father suffered from depression when he lost his job,and he still takes medication for it."

Question 34

Which of the following lifestyle choices poses the greatest risk for chronic illness to the young adult?
1) Alcohol and tobacco use
2) Ignoring seat belt and helmet laws
3) Unprotected sex with multiple partners
4) Poor nutrition and a lack of structured exercise

Question 35

Which of the following client responses shows the best understanding regarding the management of risk factors for acquiring a sexually transmitted disease (STD)among young adults?
1) "I may want to have children someday,so I need to be careful."
2) "Even though there are treatments for STDs,I don't take chances."
3) "There is certainly enough literature out there on the use of condoms."
4) "Having unprotected sex with someone my age is very risky business."