Chapter 1: Introduction to Healthy Aging(FREE) My Nursing Test Banks

Chapter 1: Introduction to Healthy Aging

Test Bank

MULTIPLE CHOICE

1. Which option refers to the highest level of human functioning according to Maslow?

a.

Biological and physical integrity

b.

Safety and security

c.

Self-esteem

d.

Self-actualization

ANS: D

According to Maslow, persons whose basic physical needs are met, who feel safe and secure, and who possess self-esteem and self-efficacy can achieve self-actualization, reaching out beyond themselves to make their lives meaningful.

Biological and physical integrity is the lowest level in Maslows hierarchy, below safety and security. Safety and security are the second-lowest level, below self-esteem. Self-esteem is the second-highest level, below self-actualization.

PTS:1DIF:RememberREF:5-6

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment

2. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this mans wellness?

a.

Wellness is possible in the management of his medical care.

b.

Wellness is unfortunately not a real option for this client.

c.

Wellness is the same thing as faith healing, and if the client would be more receptive, then he could be back at work in a few weeks.

d.

Nursing interventions can help empower a client to achieve a higher level of wellness.

ANS: D

Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse can foster wellness at all levels of the needs hierarchy.

Wellness is possible even if the client assists in the management of his medical care; an individual must work hard to achieve wellness, similar to a job. Wellness is unfortunately not a real option for this client; however, all persons, regardless of age or life-health situations, can be helped to achieve a higher level of wellness. Wellness is the same thing as faith healing, and if the client would be more receptive, then he could be back at work in a few weeks; biomedical approaches and other treatments and techniques are used to achieve realistic improvements in wellness.

PTS: 1 DIF: Apply REF: 4-5 TOP: Nursing Process: Diagnosis

MSC:Health Promotion and Maintenance

3. In differentiating between health and wellness in health care, which of the following statements is true?

a.

Health is a broad term encompassing attitudes and behaviors.

b.

The concept of illness prevention was never considered by previous generations.

c.

Wellness and self-actualization develop through learning and growth.

d.

Wellness is impossible when ones health is compromised.

ANS: A

Health is a broad term that encompasses attitudes and behaviors; holistically, health includes wellness, which involves ones whole being.

The concept of illness prevention was never considered by previous generations; throughout history, basic self-care requirements have been recognized. Wellness and self-actualization develop through learning and growthas basic needs are met, higher-level needs can be satisfied in turn, with ever-deepening richness to life. Wellness is impossible when ones health is compromisedeven with chronic illness, with multiple disabilities, or in dying, movement toward a higher level of wellness is possible.

PTS: 1 DIF: Understand REF: 4 TOP: Nursing Process: Evaluation

MSC:Health Promotion and Maintenance

4. Which cultural group is predicted to have the fastest growing older adult population in the United States between the years 2010 and 2050?

a.

Native Americans

b.

African Americans

c.

Hispanic Americans

d.

Asian/Pacific Island Americans

ANS: C

As shown in Figure 1-1, the Hispanic older adult population is projected to be the most rapidly increasing population segment between 2010 and 2050.

The older adult populations of all other races, combined, do not rise as rapidly as the Hispanic older adult population between the years 2010 and 2050. The African-American older adult population is expected to have the second-fastest rise between 2010 and 2050. The non-Hispanic white older adult population is projected to decrease between 2010 and 2050.

PTS:1DIF:UnderstandREF:Figure 1-1 on page 3.

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment

5. Historical influences that have shaped the lives of the majority of the middle-old population in the United States today include which of the following?

a.

Influenza epidemic of 1918

b.

Immigration from communist Europe

c.

Child rearing in the Depression

d.

World War II

ANS: D

Those who are middle-old in 2005 were in their teens and 20s during World War II; in particular, the men were likely to have fought in it.

A person who survived the influenza epidemic would be at least 87 years old in 2005 and therefore would be considered old-old or a centenarian. Those who are middle-old in 2005 were born between 1920 and 1930, before communism swept Europe. Most of those who are middle-old in 2005 had not reached childbearing age by the end of the Depression.

PTS:1DIF:UnderstandREF:2-3

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment

6. The nurse prepares for the arrival of older adults evacuated from a hurricane to a shelter for short-term care. Which of the following is the priority nursing intervention?

a.

Demonstrate that the staff is prepared to meet their needs.

b.

Use individual medical records to develop a medication plan.

c.

Help older adults display family photographs and memorabilia.

d.

Help older adults teach one another a new skill in the shelter.

ANS: B

The nurse prepares for short-term care by prioritizing the needs of the older adults, and this intervention helps maintain the therapeutic plan, thereby addressing the need for physiological integrity. Furthermore, the nurse maintains continuity of care by preparing a medication schedule to prevent missed doses of medication. Providing safety and security from the storm is Maslows second most basic need.

In emergency conditions, the nurse provides basic care relating to safety, security, and physical well-being. Maintaining a sense of belonging is important but not in emergency conditions. A state of emergency is not the time to develop self-esteem; meeting safety, security, and physical needs are more important.

PTS:1DIF:AnalyzeREF:5-6

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

7. According to researchers, which characteristic will most centenarians share in the future?

a.

Female

b.

Demented

c.

Malnourished

d.

Wheelchair bound

ANS: A

Researchers expect women to make up the majority of centenarians in the future.

Gerontologists expect dementia to be common among older adults, but they are not predicting most centenarians will have dementia. Malnutrition is common among older adults, but researchers have not predicted that most centenarians will be malnourished. Decreased mobility is common among older adults, but researchers have not predicted that most centenarians will be confined to a wheelchair.

PTS:1DIF:RememberREF:2

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment

8. Which statement describes aging in developing countries?

a.

Aged dependence is likely to improve from 1:4 to 1:2.

b.

The biggest problem for older adults will be the lack of food.

c.

Most older adults are likely to reside in these countries.

d.

Similar to fertility, life expectancy is increasing, although at a different rate.

ANS: C

Currently, developing countries already contain two thirds of the worlds older adult population.

Aged dependence is likely to deteriorate from 1:4 to 1:2. The biggest problem of the worlds oldest adults is most likely to be a lack of regular income. Life expectancy is increasing, but fertility is decreasing worldwide.

PTS:1DIF:UnderstandREF:2-5

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment

9. An older woman tells the nurse that she has experienced increasing fatigue and shortness of breath over the last 2 days. Which goal is the nurses priority?

a.

Promote safety to prevent injury.

b.

Complete nutritional assessment.

c.

Balance exercise and rest periods.

d.

Explore the womans complaints.

ANS: D

Investigating the complaint is the nurses priority; fatigue and shortness of breath can indicate cardiac disease, especially in women. Women with cardiac disease often exhibit atypical symptoms, and because it tends to be treated less aggressively in women, the nurse must be careful not to miss indicators of potential cardiac disease. In addition, in investigating the older womans chief complaint, the nurse investigates all possible causes.

Promoting safety and preventing injury are reasonable goals to include for this adult but are not as important as investigating the chief complaint; breathing and circulation are two of the three most important physical needs. Completing the nutritional assessment for this adult is reasonable because the symptoms can be related to nutritional deficiencies; however, this assessment should be a part of the examination of the chief complaint. Balancing rest and exercise is a reasonable approach to a complaint of fatigue and shortness of breath if the adult is deconditioned; however, the nurse must investigate the chief complaint to determine whether deconditioning is a factor.

PTS: 1 DIF: Analyze REF: 5-6 TOP: Nursing Process: Planning

MSC: Safe, Effective Care Environment

10. The nurse develops a community program to promote exercise for older adults. Which should the nurse include in the exercise program?

a.

Reinforce the ease of exercising every day.

b.

Use exercise to relax any dietary restrictions.

c.

Describe ways to resume exercise after lapses.

d.

Participate because exercise achieves wellness.

ANS: C

Because the path to wellness includes progression, as well as regression, the nurse shares information to help participants anticipate these events. The nurse encourages participants by telling them to expect periods of regression; he or she emphasizes that progress made up to a point is not lost and explains how to approach resumption in progress toward wellness with exercise.

The nurse tells the participants that achieving wellness takes work and regular effort. Rather than offering false hope, the nurse shares practical advice about how to incorporate exercise into everyday life. The nurse avoids suggesting that adults can look forward to relaxing dietary or medical restrictions by using a single method; it is unethical to offer false hope, the plan can be ineffective, and the plan can have adverse effects. The nurse avoids instructing adults to rely on one method of achieving wellness; wellness is achieved by balancing emotional, spiritual, social, cultural, and physical processes.

PTS: 1 DIF: Apply REF: 4-6 TOP: Nursing Process: Planning

MSC:Health Promotion and Maintenance

11. Which describes the older man who is likely to experience the best overall health and well-being?

a.

Resides in assisted-living facility, watches television alone, uses herbal remedies, is underweight

b.

Resides alone, was moved to a new city recently by his family members for their convenience, has osteoarthritis

c.

Has prostate cancer with metastasis to the lungs, is receiving radiation therapy, is wealthy, has a large family

d.

Uses a wheelchair, has peripheral arterial disease, attends weekly baseball games with three friends

ANS: D

Despite a serious chronic illness and mobility restrictions, this older man has a social network and planned activities with friends. Further, he overcomes mobility issues to pursue personal interests; thus this person is most likely to experience the best health and well-being because of an optimal functional status.

This older adult is not thriving in an assisted-living facility, despite having other people in the facility, as evidenced by television viewing habits and weight, both potential indicators of depression. Various aspects of this persons life are unbalanced, thus inhibiting progress on the path to optimal health and wellness. In addition, the use of herbal remedies can be aggravating or precipitating the problems. After a move to a new region, an older adult, especially one who lives alone and is moved to a new area for the familys convenience, is likely to experience loneliness and isolation until a new social network is established. Although this person has a less acute health problem, the social isolation is likely to create significant disruption on the path to health and wellness. Although this older adults financial resources are plentiful, the existence of a large family does not ensure any type of psychosocial support. Most likely, this person faces a grim prognosis because the prostate cancer has crossed the diaphragm, thus reducing the likelihood of a prolonged life.

PTS:1DIF:AnalyzeREF:4-6

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

12. Which nursing intervention is a holistic approach to an older adult?

a.

Performs glucose testing during the weekly worship service.

b.

Wheels ambulatory adults to exercise when running late.

c.

Assigns female nurses to older women who are Islamic.

d.

Allows older adults in a nursing home to eat meals alone.

ANS: C

The nurse uses a holistic approach to the care of an older female adult who is Islamic because the woman and her family are more likely to be willing participants in a therapeutic regimen that respects a tenet of their culture.

Interrupting an older adults worship with glucose testing can be interpreted as a lack of respect for spiritual needs. The nurse can provide for and respect the physical and spiritual aspects of the older adults life by testing for glucose before the service begins. In transporting ambulatory adults to the exercise program in a wheelchair to save time, the nurse disregards the need for self-esteem and exercise, both important aspects of physical well-being. Ambulatory adults can walk with assistance, if needed, to exercise programs and can benefit from the additional activity and independence. The nurse can be tempted to allow an older adult to eat meals alone in his or her room if this will motivate the person to eat or if the older adult has dysphasia and is embarrassed. However, while focusing on physical needs, the nurse ignores psychosocial and other aspects of health and well-being.

PTS: 1 DIF: Understand REF: 4 TOP: Nursing Process: Evaluation

MSC:Health Promotion and Maintenance

13. An older man who resides in a nursing home has total cholesterol of 245 mg/dl. Which nursing intervention is most likely to assist this man in achieving his highest level of wellness?

a.

Instruct him about increasing dietary fiber.

b.

Ask the health care provider for a low-fat diet.

c.

Schedule a consultation for him with the dietitian.

d.

Review a menu with him to choose suitable foods.

ANS: D

The nurse collaborates with the older adult to choose suitable foods, which is likely to be an effective nursing intervention to help an older adult with hyperlipidemia achieve optimal health and well-being; it gives him some control over the regimen and thus engages him in the process of lowering serum cholesterol.

Informing the older man about dietary fiber offers no control to him because he is not part of the decision. Nursing interventions developed with the older adults collaboration are most likely to help the older adult achieve health and wellness. Collaborating with the health care provider for a low-fat diet is a reasonable approach to help this man with hyperlipidemia achieve health and wellness. However, he is more likely to have motivation and enthusiasm for a therapeutic regimen over which he has had some control. Scheduling a consultation with a dietitian is a reasonable approach to an older adult with hyperlipidemia and is a part of a multifaceted approach to optimizing his health. However, the older adult is more likely to engage in a regimen over which he has input.

PTS: 1 DIF: Analyze REF: 4-6 TOP: Nursing Process: Planning

MSC:Health Promotion and Maintenance

14. Which approach requires the nurse to integrate and balance all aspects of an individuals life into the plan of care?

a.

Holistic nursing

b.

Healthy People 2020

c.

Maslows Hierarchy of Human Needs

d.

Orems Self-Care Requirements

ANS: A

Holistic nursing integrates all aspects of an individuals life into the plan of care by balancing an individuals internal and external environment with psychosocial, spiritual, cultural, and physical processes.

Healthy People 2020, an updated document from 2000 that outlines the goals for achieving health in this country, is a mandate for health care professionals to follow with 467 objectives in 28 focus areas. Maslows Hierarchy of Human Needs provides a basis for understanding individuals in context and for ranking nursing assessments, diagnoses, goals, and interventions in order of importance. Dorothea Orems Self-Care Requirements lists human needs, including the need for air, fluids, nutrition, hygiene, elimination, activity, comfort, relief from suffering, and skin integrity. The nurse helps individuals meet these needs to achieve optimal health and wellness.

PTS:1DIF:RememberREF:4

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment

15. An older man living in an adult community becomes a widower 1 month after retirement. Two months later, he has not resumed a weekly outing with his fishing club. Which should the nurse implement?

a.

Ask the older adult why he is not fishing.

b.

Have club members visit him at home.

c.

Meet with him to assess his interests.

d.

Enroll him in a weekly card game.

ANS: C

The nurse meets with the older adult to determine how and when to establish new relationships and social activities in light of his wifes death. Although the older man was engaged in fishing before, the nurse respects his wishes and needs as he transitions to a different life.

The nurse avoids confronting him, even if done so in a gentle manner. Why questions can be interpreted as confrontational, and the older adult may be unable or unwilling to articulate a reason. The nurse avoids asking club members to visit him because doing so would remove the older adult from the decision making process. Although this effort can be well-meaning, it can also be interpreted as an invasion of privacy. The older adult is more likely to participate in an activity in which he has input. In addition, the nurses action can be interpreted as disrespectful because an adult has the right to control his own life.

PTS:1DIF:ApplyREF:4-6

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

16. The nurse plans activities for older women born between 1920 and 1930 and who reside in an assisted-living facility. Which is the best intervention for the nurse to implement?

a.

Have them bake cookies twice a week.

b.

Conduct interviews for specific interests.

c.

Arrange dog and cat visits from volunteers.

d.

Take them to the library for guest speakers.

ANS: B

The nurse conducts individual interviews with the women to determine their interests and to avoid generalizing; as people live longer, they become more and more unique.

Because most of these women are in their 80s, were born between 1920 and 1930, and have generally spent their lives as homemakers, the nurse presumes to know what activities they will enjoy. The nurse avoids arranging group activities until individual interests are determined. In addition, the nurse must assess for allergies and individual fears of animals before exposing an older adult to a pet visit. Unless it is organized on a voluntary basis, the nurse avoids arranging visits by guest speakers. In addition, the nurse will assess each older woman before an outside visit to avoid embarrassing events including incontinence and hearing and vision problems.

PTS:1DIF:AnalyzeREF:2-3| 4-6

TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment

17. Which are the major factors influencing the experience of aging?

a.

Health, history, and sex

b.

Self-care needs and culture

c.

Self-fulfillment and self-esteem

d.

Society, culture, and marital status

ANS: A

Health, history, and sex are major factors influencing the aging experience and interact to make each cohort distinctive.

Culture is a major influence on the experience of aging and contributes to the uniqueness of a cohort; however, self-care needs are basic human needs and contribute to the similarities between cohorts. Self-fulfillment and self-esteem are higher-level human needs on Maslows hierarchy and denote similarities between cohorts. Society and culture are major influences on the aging experience, but marital status is not.

PTS:1DIF:RememberREF:2-3

TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment

MULTIPLE RESPONSE

1. The nurse plans the care for an older man who has Medicare, lives on Social Security and a small pension, and has type 2 diabetes mellitus. Which aspect(s) of this man should the nurse integrate into a positive approach to his health and well-being? (Select all that apply.)

a.

Pays for some diabetic supplies.

b.

Enjoys regular physical activity.

c.

Practices effective glucose control.

d.

Lives alone in a high-rise apartment.

e.

Lacks low-cost, reliable transportation.

f.

Attends weekly dinner club for diabetics.

ANS: B, C, F

The enjoyment of physical activity is a positive aspect of this man and thus can be included in the nurses plan because he already incorporates an important part of diabetic care into his life and, potentially, enjoys the health benefits of exercise. Practicing effective glucose control demonstrates this mans resilience and capacity to manage effectively the challenges associated with a chronic illness and thus is a strength the nurse can use in a positive approach toward his health and well-being. This man has a social network that helps him to live with diabetes and to prevent the long-term complications of diabetes. This is a definite strength the nurse uses to help him achieve his optimal health and well-being.

With limited financial resources, paying for some of his diabetic supplies is a burden to overcome and cannot be used in a positive approach toward health and well-being. Living alone is not ideal for an older adult, especially one with diabetes, because of the potential for loneliness and complications from diabetes such as hypoglycemia. Living alone is a negative aspect of this mans life and one which has to be resolved for his safety and well-being. The nurse cannot include this mans transportation issues into a positive plan; the lack of reliable transportation is a problem to overcome and not a strength on which to capitalize.

PTS: 1 DIF: Analyze REF: 4-6 TOP: Nursing Process: Planning

MSC:Health Promotion and Maintenance

2. According to Healthy People 2020, older adults have been identified as a priority, with a goal to improve their health, function, and quality of life. Identify the targeted chronic focus areas for improvement. (Select all that apply.)

a.

Diabetes

b.

Arthritis

c.

Congestive heart failure

d.

Dementia

e.

Cancer

f.

Pressure ulcers

ANS: A, B, C, D

In a push toward wellness, older adults were identified as a priority area for the first time. The targeted chronic areas of focus were identified as diabetes, arthritis, congestive heart failure, and dementia.

PTS: 1 DIF: Remember REF: 4 TOP: Nursing Process: Planning

MSC:Health Promotion and Maintenance

3. Identify the Healthy People 2020 emerging issues in the health of older adults. (Select all that apply.)

a.

Coordinating care for the older adult population

b.

Assisting older adults in the management of their own care

c.

Identifying levels of training for those caring for older adults

d.

Making community resources available for older adults

e.

Increase in health disparities for rural older adults

ANS: A, B, C

According to United States Department of Health and Human Services (USDHHS): Healthy People 2020, emerging issues in the health of older adults are the following: coordinating care; helping older adults manage their own care, establishing quality measures; identifying minimum levels of training for people who care for older adults; and researching and evaluating appropriate training to equip providers with the tools they need to meet the needs of older adults.

PTS:1DIF:Remember

REF: Health People Box 1-2: Healthy People Emerging Issues in the Health of Older Adults

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

OTHER

1. An older woman has left-sided paralysis from a thrombus formation in the cerebral vasculature. Rank the nursing goals of this womans plan of care in order of importance, starting with the most important goal. (Select all that apply.)

A. Instruct her to call for help before moving.

B. Maintain her blood pressure below 120/80 mm Hg.

C. Reinforce occupational therapy for feeding.

D. Use range-of-motion exercises to prevent contractures.

ANS:

B, A, D, C

Using Maslows Hierarchy of Human Needs, the most important goal for this older woman is to control her blood pressure; hypertension and other factors contributed to the development of the thrombus. Thus to prevent further intimal damage to cerebral and other vessels, the nurse maintains the blood pressure at or below the limit as determined by the health care provider. The second priority goal for the nurse is to maintain safety by instructing the older woman to call for help when moving, which will help prevent accidents and injuries. The next goal in importance is the prevention of contractures; joint flexibility is easier to maintain than it is to restore. In addition, joint flexibility is important for adapting to her physical limitations as she learns to perform activities of daily living. The last goal is using joint flexibility and muscle strength to learn self-feeding. The order of these goals is correct; each goal is dependent on the preceding goal for its success.

PTS: 1 DIF: Analyze REF: 4-6 TOP: Nursing Process: Evaluation

MSC: Safe, Effective Care Environment

2. A nurse is providing care for a variety of older adults on a transitional care unit. Using Maslows Hierarchy of Human Needs as a basis for prioritizing care, rank the following actions, starting with the most important. (Select all that apply.)

A. Encourage a family member to take part in a teaching session.

B. Administer 2 liters of oxygen via nasal cannula.

C. Place a call bell in reach after transferring the older adult to bed.

D. Ask clients their preferences before beginning care.

ANS:

B, C, A, D

Using Maslows Hierarchy of Human Needs, the first and most important action to complete is to administer 2 liters of oxygen via nasal cannula, which meets a basic physiological need. According to Maslow, airway, nutrition, and elimination are first-level needs. The second action to complete is placing a call bell in reach after transferring an older adult to bed. A call bell promotes feelings of safety and security, which is addressed in Maslows second level. The third action would be encouraging a family member to take part in a teaching session. This action promotes maintaining support systems and is categorized as love and belonging, the third level of Maslows Hierarchy of Human Needs. The last action would be to ask a client his or her preferences, which would promote self-control and support self-esteem needs, which is Maslows fourth level.

PTS: 1 DIF: Analyze REF: 5-6 TOP: Nursing Process: Evaluation

MSC: Safe, Effective Care Environment

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