Question 1

A nurse working with a middle-aged adult is concerned that the adult is not meeting developmental tasks associated with Erikson's theory. What question by the nurse is most appropriate?

Accepted Answer

According to Erikson, this adult is in the Generativity v. Stagnation phase. Successful completion of the tasks associated with this stage includes reaching out to others beyond the nuclear family to community groups and society at large. Volunteering with an organization would be one way to meet the task. The other questions are related to individual-oriented behaviors.

Question 2

A nurse is assessing a middle-aged adult for cognitive skills. The patient has difficulty with seriation tests. What action by the nurse is most appropriate?

Accepted Answer

Middle-aged adults (especially younger ones) often have trouble with math processing (fluid intelligence) because of the prevalence of calculators and computers and dependence upon them to do work formerly done by the individual. The nurse should conduct other tests for fluid intelligence. The findings should be documented, but this is not the only action needed. Dementia screening is not indicated with one test result. Family medical history should be part of all screenings but is not directly related to this issue.

Question 3

The nurse working with older adults encourages them to stay healthy. What instruction by the nurse takes priority?

Accepted Answer

One normal age-related change seen in the older adult is decreased immune function. The older adult should place high priority on avoiding illness by staying away from people who are sick and avoiding large crowds during peak communicable illness periods. The other instructions are also relevant but do not address this age-related change.

Question 4

A young nursing student is assessing an older patient. The nurse questions whether or not to take a sexual history. What response by the faculty is best?

Accepted Answer

Sexuality is a basic human need. The faculty should tell the student to complete the assessment. Procreation is not an issue at this time; however, this does not eliminate the need to discuss sexual issues. Asking permission may be an important part of taking a sexual history, but that response is implying the student can "get out of" the assessment if the patient is agreeable. The student needs practice to improve his/her comfort with this assessment.

Question 5

A young adult tells the nurse he has quit smoking cigarettes and now "vapes" (uses electronic cigarettes [e-cigarettes]). What response by the nurse is best?

Accepted Answer

The health consequences of using e-cigarettes are not yet known because they are new products. The nurse educates the young adult to this fact.

Question 6

A community nurse is working with a family that consists of a middle-aged adult, an older parent with dementia, and two school-aged children. Which assessment by the nurse is most important for this family?

Accepted Answer

Burnout can occur when caring for an older adult with dementia because their needs are great without lessening over time. Caring for both an older adult and school-aged children (often called the sandwich phenomenon or generation) adds even more stress. The priority assessment for this family is methods used to reduce stress.

Question 7

A young adult asks the nurse why she should participate in health screening and educational events. What response by the nurse is best?

Accepted Answer

Health behaviors entrenched in the young adult stage impact future health and well-being. While these events are free and full of information and bad habits can be changed if the person has knowledge and motivation, those responses do not give the person useful information. Asking if the person wants to know about health problems sounds accusatory.

Question 8

A nurse in the family practice clinic is assessing an older adult who has dementia. The adult daughter/caregiver expresses concern that the parent should no longer be left alone while the daughter is at work. What response by the nurse is best?

Accepted Answer

Adult day care facilities offer care of the older person during the working hours. This might be a good option for the family. A social worker can help, but the nurse should be active in problem solving with the daughter. Medications are available for dementia, but dementia remains a progressive disorder, so this does not help solve the problem. A nursing home may not yet be needed.

Question 9

The nurse working in long-term care knows that there are multiple theories regarding aging. The one the nurse most identifies with proposes that the body's cells are leading to damaged organs and organ systems. This description is congruent with which theory?

Accepted Answer

The wear-and-tear theory states that body cells are damaged from years of hard use. The cross-linking theory relates changes of aging to cross-linked and connected cells and systems become hardened over time, decreasing function. Gould's theory is a psychosocial one looking at tasks the adult completes, not physical changes. "Senescence" means biologic aging; there is no senescence theory of aging.

Question 10

The nurse is performing wellness checks at a community center for older adults. Which person would the nurse evaluate as having the highest risk of stroke?

Accepted Answer

African-Americans have a higher rate of stroke than whites at any age. Hypertension is also a risk factor for stroke. Stroke risk also increases with age overall. Therefore, the person with the highest risk of stroke is the older hypertensive African-American.

Question 11

The nurse knows that which attributes are characteristics of the young adult age group? (Select all that apply.)

Accepted Answer

More than 88% of people aged 25 to 34 have completed high school. Adult roles, which are influenced by many factors, are diverse and are not normed for this age group. The number of high school graduates going to college is increasing. More females than males aged 20 to 24 are married. Only about 9% of those 25 to 34 have advanced degrees.

Question 12

A nurse notes an older adult puts excessive amounts of salt on her food. What intervention by the nurse is best?

Accepted Answer

Older adults tend to lose their sense of taste and smell. Food becomes less attractive to them and they may respond by adding salt. The nurse who understands this concept will help the older adult explore other flavor enhancers for food. Teaching about the relationship of sodium to hypertension is important but does not address the problem. Encouraging the adult to use less salt does not give her a strategy to do so. Asking "why" questions is a communication barrier that often causes people to become defensive.

Question 13

The nurse working with an adult population knows that many age-related declines in function begin occurring at what age?

Accepted Answer

Many age-related functions peak before age 30 and begin to decline after that.

Question 14

A nurse who uses Havighurst's theory of development is assessing a young adult. What question does the nurse ask to provide the most relevant information about this person's successful negotiation of this developmental stage?

Accepted Answer

According to Havighurst, one of the tasks of the young adult is to select an occupation. Changing the way one performs familiar tasks is seen in the middle adult stage. Seriation activities test fluid intelligence and are often used in middle adulthood. Although for Havighurst, achieving emotional independence from parents is important, that does not preclude having a good relationship with them.

Question 15

A nurse reads on a patient's chart that she has sarcopenia. What assessment does the nurse perform to confirm this?

Accepted Answer

"Sarcopenia" means loss of tissue. Muscle tissue and muscle mass both tend to decrease starting in the 30s. The nurse assesses muscle strength to get information about possible sarcopenia in this patient. Tests of cognition, gait and balance, and sensory perception are not related.

Question 16

The nurse plans to develop a comprehensive screening tool to use with young adults, assessing their lifestyles and healthy living habits. What barrier must the nurse plan to overcome in order to make this screening successful?

Accepted Answer

Since young adults are at the peak of their physical development and abilities, they may not see a health care provider on a regular basis. Screening tools can be used with any population. The more risky behaviors demonstrated, the more education is needed. Time constraints are generally not the main reason young adults do not have regular medical care.

Question 17

An adult child brings his father to the emergency department and describes the sudden onset of a panic attack and aggressiveness. After ruling out an infectious process, what action by the nurse is best?

Accepted Answer

Abuse of illicit drugs can cause many symptoms, including panic attacks and aggressive behavior. After assessing for an infectious process, the nurse should determine if the patient has used any recreational drugs. The other assessments are not as important and can be completed later.

Question 18

A nurse is planning a community event in which participants will be assessed for their risk of having a stroke. Which site does the nurse choose to access the highest-risk population?

Accepted Answer

African-Americans have a higher rate of stroke death that do white Americans, even at younger ages. The nurse chooses the African-American church for stroke screening. The other places will not have as large of a high-risk population.

Question 19

A nurse is obtaining a history from a 37-year-old patient. What statement by the patient indicates that he has met the age-appropriate developmental task according to Gould?

Accepted Answer

According to Gould, this patient is in the midlife decade, which occurs after the upheaval of entering the adult world and questioning one's decisions, but prior to reconciling one's life and becoming stabilized. The patient who has moved out of his parents' house is demonstrating activities seen in the early adulthood stage in which leaving the parents' world is paramount. Reminiscing about the past life occurs as part of the reconciliation stage, seen in an older person. Questioning and re-examining are typically seen in the stage for 28- to 34-year-olds.

Question 20

An adult caregiver for an older adult reports the adult is doing well other than sleeping more frequently and for longer periods. What response by the nurse is best?

Accepted Answer

Depression is common in the older adult population and is frequently overlooked or misdiagnosed. People may think withdrawal and excessive sleeping are normal age-related changes, but they are not. he nurse should assess the older adult for depression. Other assessments can follow because they are not the priority for this patient.

Quiz 18: Human Development Young Adult to Older Adult