Chapter 02: Theories of Aging(FREE) My Nursing Test Banks

Chapter 02: Theories of Aging

Meiner: Gerontologic Nursing, 5th Edition

MULTIPLE CHOICE

1. The practitioner who believes in the free radical theory of aging is likely to recommend that the older adult:

a.

avoid excessive intake of zinc or magnesium.

b.

supplement his or her diet with vitamins C and E.

c.

increase intake of complex carbohydrates.

d.

avoid the use of alcohol or tobacco.

ANS: B

Vitamins C and E are two naturally occurring antioxidants that appear to inhibit the functioning of the free radicals or possibly decrease their production in the body. The free radical theory of aging is not related to zinc, magnesium, carbohydrates, or alcohol and tobacco.

DIF: Applying (Application) REF: N/A OBJ: 2-2

TOP: Nursing Process: Planning MSC: Health Promotion

2. To provide effective care to the older adult, the nurse must understand that:

a.

older adults are not a homogeneous sociologic group.

b.

little variation exists in cohort groups of older adults.

c.

health problems are much the same for similar age groups of older adults.

d.

withdrawal by an older adult is a normal physiologic response to aging.

ANS: A

The key societal issue addressed by the age stratification theory is the concept of interdependence between the aging person and society at large. This theory views the aging person as an individual element of society and also as a member, with peers, interacting in a social process. The theory attempts to explain the interdependence between older adults and society and how they constantly influence each other in a variety of ways. Variation exists among the members of a cohort. Health problems are not the same for every individual of the same age. Withdrawal by an older adult is not a normal response to aging but may be a sign of depression.

DIF: Understanding (Comprehension) REF: Page 16 OBJ: 2-2

TOP: Nursing Process: Planning MSC: Health Promotion and Maintenance

3. The nurse is using the eight stages of life theory to help an older adult patient assess the developmental stage of personal ego differentiation. The nurse does this by assisting the patient to:

a.

determine feelings regarding the effects of aging on the physical being.

b.

describe feelings regarding what he or she expects the future to hold.

c.

identify aspects of work, recreation, and family life that provide a sense of self-worth and pleasure.

d.

elaborate on feelings about the prospect of his or her personal death.

ANS: C

During the stage of ego differentiation versus work role preoccupation, the task for older adults is to achieve identity and feelings of worth from sources other than the work role. The onset of retirement and termination of the work role may reduce feelings of self-worth. In contrast, a person with a well-differentiated ego, who is defined by many dimensions, can replace the work role as the major defining source for self-esteem. Determining feelings related to the effects of aging, future death, or what the future may hold is not part of this theory.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Nursing Process: Implementation MSC: Psychosocial Integrity

4. A patient is recovering from a mild cerebral vascular accident (stroke). The home care nurse notes that the patient is talking about updating a will and planning funeral arrangements. Which of the following responses is most appropriate for the nurse to make?

a.

You seem to be preoccupied with dying.

b.

Is there anything I can do to help you?

c.

Are you worried about dying before you get your affairs in order?

d.

Lets focus on how you are recovering rather than on your dying.

ANS: B

According to Pecks expansion of Eriksons theory, the older adult who has successfully achieved ego integrity and ego transcendence accepts death with a sense of satisfaction regarding the life led and without dwelling on its inevitability. The patients action reflects a healthy transition and should be supported.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Nursing Process: Implementation MSC: Psychosocial Integrity

5. Your patients spouse died recently from a sudden illness after 45 years of marriage. The patient was the primary caregiver for the spouse during this time. The patient is now depressed and withdrawn and has verbalized feelings of uselessness. Which action by the nurse is best?

a.

Encourage the patient take up a hobby that will occupy some time.

b.

Explain that volunteering would be an excellent way to stay useful.

c.

Assure the patient that these feelings of sadness will pass with time.

d.

Ask the patient to share some cherished memories of the spouse.

ANS: B

Volunteering will help the patient to interact with people and feel productive and valued for the ability to help others as stated in the activity theory. A hobby does not offer the chance to help others. Assuring the patient that feelings will pass is false reassurance and does nothing to help the patient to be proactive. Reminiscing is a valued activity, but it is not the best choice for regaining a sense of usefulness.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Nursing Process: Implementation MSC: Psychosocial Integrity

6. A patient has recently been diagnosed with end-stage renal disease. The patient has cried often throughout the day and finally confides in the nurse that I am going home to be with my Lord. The nurses best response is:

a.

There is no reason to believe the end is near.

b.

Do you want me to call your family?

c.

We have a wonderful chaplain if youd like me to call him.

d.

I think this is the time for us to pray together.

ANS: C

It is important for the nurse to acknowledge the spiritual dimension of a person and support spiritual expression and growth while addressing spirituality as a component in holistic care without imposing upon the patient. Because the patient has made reference to the Lord, the nurse can safely offer religion-oriented spiritual care. Telling the patient there is no reason to believe that death is near does not help the patient work through emotions. Asking about calling the family is a yes/no question and is not therapeutic. The nurse is assuming too much by saying it is time to pray.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Nursing Process: Implementation MSC: Psychosocial Integrity

7. A nurse is responsible for the care of 20 older adults in a unit of an assisted living facility. In order to best address the needs and wants of the entire units population, the nurse:

a.

strictly adheres to facility policies so that all patients will be treated equally.

b.

encourages specific age cohorts to gather in the dayroom because they share similar interests.

c.

has the unit vote on which television programs will be watched each evening.

d.

schedules the patients bathing times according to their individual preferences.

ANS: D

Older adults continue to feel valued and viewed as active members of society when allowed to maintain a sense of control over their living environment by attention to personal choices and rituals. Adhering strictly to policies does not allow for individualized care. Not all in the same age cohort will have similar interests. Voting on television programs does not ensure each individual feels a sense of worth.

DIF: Applying (Application) REF: N/A OBJ: 2-5

TOP: Nursing Process: Planning MSC: Psychosocial Integrity

8. An older patient who reports being healthy enough to cut my own fire wood is being assessed prior to outpatient surgery. The nurse recognizes which assessment observation as a possible result of the wear-and-tear theory?

a.

Swollen finger joints

b.

Red, watery eyes

c.

Grimacing when raising left arm

d.

Bilaterally bruising on the forearms

ANS: C

This theory proposes that cells wear out over time because of continued use. The pain caused by movement of the shoulder is the observation most likely a result of the patients practice of cutting his own firewood. The other choices do not demonstrate continued use that is part of the wear-and-tear theory of aging.

DIF: Applying (Application) REF: N/A OBJ: 2-2

TOP: Nursing Process: Assessment MSC: Physiologic Integrity

9. A nurse cares for many older patients. Which finding should the nurse identify as pathologic in a 72-year-old?

a.

Two hospitalizations in 6 months for respiratory infections

b.

Patient reports of sleeping only of 5 to 6 hours each night

c.

Thinning hair and brittle nails

d.

Dry, tissue paperlike skin

ANS: A

Although there is an age-related decrease in immune function, reoccurring infections serious enough to require hospitalization are not considered a normal age-related finding. Decreased sleeping, thinning hair, brittle nails, and dry skin are all normal signs of aging.

DIF: Application (Apply) REF: N/A OBJ: 2-1

TOP: Nursing Process: Assessment MSC: Physiologic Integrity

10. In planning the care for an older adult patient, the nurse will best promote health and wellness by:

a.

encouraging independent living and self-care.

b.

scheduling regular cardiac and respiratory health screenings.

c.

effectively delivering health-related educational information.

d.

promoting a nutritious diet and an age-appropriate exercise routine.

ANS: C

Providing well-prepared and effectively delivered health-related educational information will provide the best means of promoting a patients ability to impact his or her wellness and general health. Each of the other options is too narrow to be the most effective way to promote health and wellness.

DIF: Applying (Application) REF: N/A OBJ: 2-5

TOP: Nursing Process: Planning MSC: Health Promotion

11. The student learning about aging theories understands that the main difference between stochastic theories and nonstochastic theories is which of the following?

a.

Stochastic theories view aging as a random, cumulative process.

b.

Stochastic theories view aging as similar among all people.

c.

Nonstochastic theories view aging as a result of psychosocial factors.

d.

Nonstochastic theories are backed by research, whereas stochastic theories are not.

ANS: A

Stochastic theories view aging as a result of random events and their cumulative effects. Nonstochastic theories view aging as a result of predetermined, timed phenomena. Both are types of biologic theories.

DIF: Remembering (Knowledge) REF: Page 17 OBJ: 2-1

TOP: Teaching-Learning MSC: Physiologic Integrity: Physiologic Adaptation

12. Which theory of aging does the student learn is related to problems with DNA transcription?

a.

Radical theory

b.

Error theory

c.

Cross linkage theory

d.

Wear-and-tear theory

ANS: B

The error theory poses that errors in DNA transcription lead to aging. The radical theory views the effects of free radicals as critical to aging. The cross linkage theory states that normally separated molecular structures are bound together through chemical reactions and that this interferes with metabolic processes. The wear-and-tear theory postulates that normal activity causes wear and tear on the body, leading to aging.

DIF: Remembering (Knowledge) REF: Page 19 OBJ: 2-1

TOP: Teaching-Learning MSC: Physiologic Integrity: Physiologic Adaptation

13. According to which theory does cancer occur as a possible result of aging?

a.

Radical theory

b.

Error theory

c.

Immunity theory

d.

Pacemaker theory

ANS: C

Immunosenescence is the term used in immunity theory to describe an age-related decrease in immune functioning. According to this theory, as people age, they are more prone to getting cancer or autoimmune diseases because of this phenomenon. This is a nonstochastic theory. Radical and error theories are both stochastic. The pacemaker theory looks at the interrelated role of the neurologic and endocrine systems and aging.

DIF: Remembering (Knowledge) REF: Page 19 OBJ: 2-1

TOP: Teaching-Learning MSC: Physiologic Integrity: Physiologic Adaptation

14. A nurse assesses an older patient who has lost a great deal of weight in a short time. When asked, the patient states this behavior started after the patient read a magazine article on the benefits of extreme caloric restrictions. What response by the nurse is best?

a.

That research was done on rodents and not on humans.

b.

You shouldnt restrict your calories so severely.

c.

You have lost so much weight you need dietary supplements.

d.

You cant believe everything you read in those magazines.

ANS: A

The metabolic theory of aging postulates that organisms have a specific metabolic lifetime and that by lowering metabolic rate, life span can be increased. However, this has been demonstrated in rodents and the nurse should educate the patient on this information. The other options do not give information that will help the patient make an informed decision as to whether or not to follow this activity.

DIF: Applying (Application) REF: N/A OBJ: 2-1

TOP: Communication and Documentation

MSC: Physiologic Integrity: Reduction of Risk Potential

15. A nurse is caring for an older patient who is sedentary and does not want to participate in any activities. What action by the nurse is best?

a.

Inform the patient about the consequences of immobility.

b.

Promote activity by explaining the use it or lose it concept.

c.

Tell the patient he or she will feel better by being more active.

d.

Explain the relationship of being active and being independent.

ANS: D

Activity increases circulation, provides range of motion, and leads to clearer mental functioning. Activity helps a person remain independent and able to perform activities of daily living (ADLs) and instrumental ADLs. Presenting information in a positive light that encourages the patient to take control of ones own health is more likely to be successful than stressing the negative such as consequences of immobility or the concept of use it or lose it. Telling the patient that he or she will feel better does not give concrete information the patient can use to make decisions.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Teaching-Learning MSC: Health Promotion

16. The nurse working with older patients teaches the student that disengagement theory potentially causes which problem?

a.

Fear

b.

Isolation

c.

Anxiety

d.

Malnutrition

ANS: B

The no-longer supported disengagement theory posed that older people withdrew from society as they aged and that this was a mutually agreed upon behavior. The result would be isolation as the person became focused solely on him- or herself. Fear, anxiety, or malnutrition could be a further consequence, but isolation and withdrawal from society was expected according to this theory.

DIF: Understanding (Comprehension) REF: Page 22 OBJ: 2-5

TOP: Teaching-Learning MSC: Psychosocial Integrity

17. The nurse working in a long-term care facility used the developmental theory of aging in practice. In caring for a frail, nearly bed bound patient, how can the nurse use this theory?

a.

Engage the patient in intellectually stimulating activities.

b.

Encourage the patient to participate in chair exercises.

c.

Ensure that the patient participates in all the group activities.

d.

Give the patient small chores to do for the facility.

ANS: A

In this theory, being active can mean physical or intellectual activity. The nurse can engage the patient in intellectually stimulating activities that allows the person a sense of satisfaction. The other options all call for physical activity, which the patient may or may not be able to perform.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Nursing Process: Implementation MSC: Psychosocial Integrity

18. The nurse working at a long-term care facility notes that one patient who is usually outgoing refuses to participate in games that require keeping score. What action by the nurse is best?

a.

Ask the patient why he or she wont participate.

b.

Assess the patients level of frustration with these activities.

c.

Find other activities for the patient to participate in.

d.

Do nothing; the patient can choose activities to engage in.

ANS: B

Although it is true that patients should be able to choose activities in which to participate, the best option is to assess the patient for frustration or anxiety associated with these types of activities. Once that is determined, the nurse can find other activities the patient can engage in successfully and is willing to participate in if the games are not an option. Asking why questions often puts people on the defensive and is not a therapeutic communication technique.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Nursing Process: Assessment MSC: Psychosocial Integrity

19. The nurse planning community events for older people uses sociologic theories to guide practice. Which activity planned by the nurse best fits these theories?

a.

Group exercise programs

b.

Volunteering at a day care

c.

Healthy cooking classes

d.

Reminiscing therapy

ANS: B

Using the sociologic theories to guide care, the nurse would plan events that allowed the older adult to remain active in the community and a valued member of society. Volunteering would offer the adult a way to stay engaged and provide a service to successive generations. Exercise and cooking classes would more fit in the biologic theories. Reminiscing therapy is a technique using psychological theories. All are good ideas for activities, but the one that specifically uses sociologic theory is the volunteer work.

DIF: Applying (Application) REF: N/A OBJ: 2-2

TOP: Nursing Process: Analysis MSC: Psychosocial Integrity

20. What statement by a patient most indicates healthy aging according to Jung?

a.

I wish I had traveled more when I was younger because now I cant.

b.

I am proud of my past accomplishments at work and home raising my kids.

c.

My leg amputation makes things harder, but I still find a way to work.

d.

I still like to read the paper and novels and enjoy a little gardening.

ANS: C

This patient shows acceptance of past accomplishments and finds value in him- or herself despite current limitations, which is healthy aging according to Jung. The person who wants to travel more displays remorse. The focus on past accomplishments does not show current acceptance. Reading and gardening do not show acceptance of past accomplishments.

DIF: Analyzing (Analysis) REF: N/A OBJ: 2-2

TOP: Nursing Process: Evaluation MSC: Psychosocial Integrity

21. A nurse is trying to teach a hospitalized older patient how to self-inject insulin. The patient is restless and does not seem to be paying attention. What action by the nurse is best?

a.

Ask if the patient needs to use the bathroom.

b.

Tell the patient youll try again later in the day.

c.

Ask if the patient prefers that you teach the family.

d.

Refer the patient for home health care services.

ANS: A

According to Maslow, physical needs take priority over other activities. This patient may be hungry, cold, tired, or need to use the bathroom. Telling the patient youll try again later, asking if you should teach the family, and referring to home health care does not provide for any unmet physical needs.

DIF: Applying (Application) REF: N/A OBJ: 2-4

TOP: Nursing Process: Implementation MSC: Physiologic Integrity: Basic Care and Comfort

22. The new nurse at a long-term care center asks the director of nursing why he needs to learn so many theories of aging. What response by the director is best?

a.

No theories have been proven yet.

b.

A wide range of theories allows for holistic care.

c.

Its required knowledge for certification exams.

d.

All the theories are important, so we use them all.

ANS: B

Using a combination of different theories, each with its own focus, allows the nurse to plan individualized, holistic nursing care.

DIF: Applying (Application) REF: N/A OBJ: 2-5

TOP: Communication and Documentation MSC: Psychosocial Integrity

MULTIPLE RESPONSE

1. According to Maslow, a fully actualized person displays which traits? (Select all that apply.)

a.

Spontaneity

b.

Self-direction

c.

Creativity

d.

Ethical conduct

e.

Acceptance of self

ANS: A, B, C, E

A fully actualized person displays the following characteristics: perception of reality; acceptance of self, others, and nature; spontaneity; problem-solving ability; self-direction; detachment and the desire for privacy; freshness of peak experiences; identification with other human beings; satisfying and changing relationships with other people; a democratic character structure; creativity; and a sense of values. Maslow does not specify ethical conduct.

DIF: Remembering (Knowledge) REF: Page 24 OBJ: 2-5

TOP: Teaching-Learning MSC: Psychosocial Integrity

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