Chapter 12: Adulthood and the Family My Nursing Test Banks

Chapter 12: Adulthood and the Family

Test Bank

MULTIPLE CHOICE

1. The nurse is aware that according to Schaies theory of development, the most significant event in the life of a 26-year-old single woman who is graduating from graduate school would be:

a.

marriage and starting a family.

b.

academic recognition for her high grades.

c.

employment in a prestigious business.

d.

a long-term relationship with a significant other.

ANS: C

According to Schaie, the Achievement stage is satisfied by young adults being able to apply what they have learned to increase their competence and increase their career choices.

DIF: Cognitive Level: Comprehension REF: p. 152 OBJ: Theory #2

TOP: Schaies Theory | Young Adulthood

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

2. The nurse assesses a 36-year-old clinic patient as having slightly elevated blood pressure and being overweight by approximately 20 pounds. The most motivating suggestion the nurse could make would be:

a.

If you could lose that extra weight in the next month, your blood pressure would probably be back to normal.

b.

The chances of your having a stroke or heart attack will increase if you dont lose some weight and bring your blood pressure down.

c.

Youll need to take lifelong medications if diet and exercise dont reduce your blood pressure.

d.

Exercise and diet modification started now, even in small amounts, can improve your overall health and delay the onset of aging.

ANS: D

Research has established that healthy exercise and eating patterns delay the onset of aging and help control blood pressure.

DIF: Cognitive Level: Application REF: p. 159 OBJ: Clinical Practice #1

TOP: Exercise for Weight Loss KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

3. A 48-year-old married father of two teens is involved with his childrens sports teams as a coach and referee. He manages a large fast food franchise, which employs a number of teenagers whom he trains. The nurse recognizes that this lifestyle is conducive to:

a.

generativity from contact with young persons.

b.

self-absorption because he focuses on his recreational and business activities.

c.

isolation because of limited contact with people close to his age.

d.

stagnation based on repetitiveness of his work and recreation.

ANS: A

Generativity is the positive psychosocial outcome in adulthood that comes from teaching and guiding the younger generation. Isolation occurs when people fail to develop intimate relationships; stagnation results from not being involved in the younger generations life.

DIF: Cognitive Level: Application REF: p. 161 OBJ: Theory #3

TOP: Psychosocial Development | Middle Adulthood

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: growth and development

4. When caring for a child from another culture, the nurse takes into consideration the childs family because families:

a.

are disruptive to the childs therapy.

b.

shape how the child reacts to other people.

c.

may create a break in confidentiality.

d.

bring inappropriate foods to the child.

ANS: B

Families from all cultures shape cultural values and how the child interacts with others.

DIF: Cognitive Level: Comprehension REF: p. 153 OBJ: Theory #4

TOP: Families KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: growth and development

5. A recently divorced young mother tells the nurse in the well child clinic that her 5-year-old has become very withdrawn since the divorce. The nurses best response to this concern would be:

a.

He probably misses his dad. Young children adjust quickly though.

b.

He may be acting out his resentment toward you for the breaking up of the family unit.

c.

Young children frequently feel they are to blame for the family breakup.

d.

You should explain to him why the marriage was no longer sustainable.

ANS: C

Young children frequently feel that they are to blame for the family breakup and experience guilt feelings. The other three items are subjective.

DIF: Cognitive Level: Application REF: p. 154 OBJ: Clinical Practice #5

TOP: Psychosocial Development | Young Adulthood

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

6. The nurse takes into consideration that divorce affects more than just the parents; adolescents who come from a divorced family may experience:

a.

lack of trust in their own heterosexual relationships.

b.

a distancing from the family unit.

c.

hostile feeling that are acted out in such activities as vandalism and drug use.

d.

being rushed into adulthood.

ANS: A

Divorce frequently leads adolescents to lack trust in their own heterosexual relationships.

DIF: Cognitive Level: Knowledge REF: p. 154 OBJ: Theory #5

TOP: Divorce and Families KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

7. During a routine health examination, to obtain effective information relating to common health problems, the question the nurse could ask a 24-year-old patient that can introduce further assessments is:

a.

Are you sexually active?

b.

Have you noticed a change in your vision or hearing?

c.

Do you experience chest pain when exercising?

d.

Have you ever had the flu or pneumonia immunizations?

ANS: A

A common health problem of young adults is risk for unhealthy behaviors, among which is irresponsible sexual behavior that can result in unwanted pregnancy, sexually transmitted diseases, and, in particular, HIV infection.

DIF: Cognitive Level: Application REF: p. 155 OBJ: Clinical Practice #2

TOP: Health Concerns | Young Adulthood

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

8. The nurse appropriately advises a 28-year-old woman that to detect breast cancer in early stages she should:

a.

schedule annual breast mammograms for early detection.

b.

perform monthly breast self-examinations and begin mammograms at age 40.

c.

arrange for annual examinations by her physician and mammograms as indicated from the physical examination.

d.

schedule a complete physical examination every 5 years until age 50, then annual examinations that include a mammogram.

ANS: B

Breast self-examination should be taught and emphasized as a monthly early detection technique to all women. Mammograms are usually begun after age 40 unless there is a family history of breast cancer.

DIF: Cognitive Level: Application REF: p. 155 OBJ: Clinical Practice #2

TOP: Health Concerns | Young Adulthood

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

9. A nurse cautions that stress-related illnesses such as headaches and hypertension in young adults most likely will:

a.

diminish as the person ages.

b.

require no long-term treatment.

c.

increase in intensity over the years.

d.

post no threat to health.

ANS: C

Headaches and hypertension are often stress related and should be treated because these disorders may intensify as the person ages and pose a threat to health.

DIF: Cognitive Level: Knowledge REF: p. 155 OBJ: Clinical Practice #2

TOP: Health Concerns | Young Adulthood

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

10. The school nurse speaking to a group of college sophomores reminds them that in the modern world of work, it is normal to have as many as _____ different jobs throughout their work life.

a.

four

b.

five

c.

six

d.

seven

ANS: D

The myth of the ideal job has given way to a persons being employed in as many as seven jobs in their work life.

DIF: Cognitive Level: Knowledge REF: p. 156 OBJ: Theory #6

TOP: Employment for Young Adults KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

11. The nurse suggests that one option for people in middle adulthood to reduce stress is to:

a.

begin planning for retirement by developing leisure-time activities or hobbies that they will be able to continue into their later years.

b.

focus their time and energy on succeeding in their work environment with the knowledge that hard work will guarantee a secure position until retirement.

c.

change employment frequently to increase their skills and employability in a rapidly changing job market.

d.

find employment that pays very well, even if the work is not enjoyable, because that is the way to accumulate enough funds for eventual retirement.

ANS: A

Leisure activities and early planning for retirement are excellent stress reducers for the middle adult.

DIF: Cognitive Level: Comprehension REF: p. 158 OBJ: Clinical Practice #3

TOP: Work Life | Middle Adulthood KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

12. The nurse is aware that when the children of middle adults have grown and left home, the middle adults may:

a.

enjoy being part of a sandwich generation that has no responsibilities to either children or older parents.

b.

suddenly show marked changes in their personalities and habits that have characterized them since young adulthood.

c.

experience the empty nest syndrome characterized by depression and a sense of loss or sadness.

d.

look forward to their children becoming boomerang children who visit briefly with their expanding families and quickly return to their own homes.

ANS: C

The empty nest syndrome, with its sense of depression and loss, occurs for some adults, especially those whose lives had revolved around their children, when their children leave home.

DIF: Cognitive Level: Comprehension REF: p. 160 OBJ: Theory #6

TOP: Empty Nest Syndrome KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: growth and development

13. A 48-year-old woman asks the clinic nurse about symptoms she has experienced, such as trouble sleeping, because she wakes up feeling hot and sweaty. She has also felt tired and depressed about aging. The most helpful nursing response would be:

a.

You may have an illness that the doctor should evaluate.

b.

It sounds to me as though you might have symptoms of menopause.

c.

Youre too young to be going through menopause. Are you worried about anything?

d.

Those symptoms are all related to aging, and theres not much to do about it.

ANS: B

Symptoms of menopause often occur before the cessation of menses and are treatable. They are not a disease or illness but part of normal development.

DIF: Cognitive Level: Application REF: p. 158 OBJ: Clinical Practice #3

TOP: Menopause KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

14. The nurse reviews the medications of a 52-year-old woman in the outpatient clinic to confirm that her calcium dose has been:

a.

increased to 1200 mg/day.

b.

reduced to 1000 mg/day.

c.

replaced by a daily dose of vitamin D.

d.

augmented with glucosamine.

ANS: A

Women over the age of 51 should increase their calcium to 1200 mg a day. Vitamin D is also important to help utilize the calcium.

DIF: Cognitive Level: Application REF: p. 158 OBJ: Clinical Practice #2

TOP: Calcium Replacement KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: pharmacological therapies

15. A nurse is instructing a patient about the prevention of automobile accidents and reminds the 65-year-old patient that he may be prone to an accident because of:

a.

increasing speed of traffic.

b.

his tendency to be distracted.

c.

a slower reaction time.

d.

reduced strength.

ANS: C

Among the changes associated with age is the slowed reaction time.

DIF: Cognitive Level: Comprehension REF: p. 158 OBJ: Theory #6

TOP: Changes Associated with Age KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: physiological adaptation

16. A physician has ordered a Mantoux test. The patient asks the purpose of this test. The nurse tells the patient this test is done to screen for:

a.

Lyme disease.

b.

lung cancer.

c.

valley fever.

d.

tuberculosis.

ANS: D

Periodic Mantoux tests are advised to screen for tuberculosis.

DIF: Cognitive Level: Knowledge REF: p. 155 OBJ: Clinical Practice #1

TOP: Screening Tests KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

17. When the nurse in a long-term facility observes a resident bringing his reading material very close to his face, the nurse assesses that the patient is experiencing:

a.

presbyopia.

b.

myopia.

c.

presbycusis.

d.

cataracts.

ANS: A

Presbyopia is caused by decreased flexibility of the eye lens. This makes near vision more difficult, and leads to the need for reading glasses.

DIF: Cognitive Level: Knowledge REF: p. 158 OBJ: Clinical Practice #3

TOP: Assessment KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity: physiological adaptation

18. A patient states that she uses the supplement black cohosh. The nurse recognizes black cohosh is used:

a.

for reduction of blood pressure and cholesterol.

b.

to lessen signs and symptoms of menopause.

c.

to help maintain cartilage and decrease arthritis.

d.

to improve blood flow to the brain and decrease forgetfulness.

ANS: B

Black cohosh is used to lessen signs and symptoms of menopause.

DIF: Cognitive Level: Comprehension REF: p. 158 OBJ: Clinical Practice #3

TOP: Middle Adults KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: pharmacological therapies

19. A nurse is teaching a female patient about bone health in middle adults. The nurse would recognize the need for further teaching if the patient states:

a.

Since I have a family history of osteoporosis, I will begin regular bone density screening at age 45.

b.

Since I have experienced a loss of 2 inches in height since I was 20, I will seek screening for osteoporosis.

c.

I will obtain sufficient vitamin D from sunlight or take a vitamin D supplement as recommended by my physician.

d.

I will take 1500 mg/day of calcium until menopause, and then decrease my calcium intake to 1200 mg/day after menopause.

ANS: D

Calcium intake should be 1000 mg/day prior to menopause and should be increased to 1200 mg/day after menopause. Obtaining sufficient vitamin D from sunlight or supplementation is also important.

DIF: Cognitive Level: Comprehension REF: p. 158 OBJ: Clinical Practice #3

TOP: Middle Adults KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

20. A nurse talking to a group of women about the signs and symptoms occurring with menopause would explain that expected symptom include all of the following except:

a.

frequent insomnia.

b.

increased vaginal lubrication.

c.

increased emotional lability.

d.

increased fatigue.

ANS: B

Signs and symptoms occurring with menopause include decreased vaginal lubrication, emotional lability, fatigue, flushing and hot flashes with heavy sweating, headache, heart palpitations, and insomnia.

DIF: Cognitive Level: Knowledge REF: p. 159, Box 12-5

OBJ: Clinical Practice #6 TOP: Menopause

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

21. A nurse is concerned about a 21-year-old who does not seem to have any intimate relationships. The nurse is aware that according to the Eriksonian theory, a lack of intimacy in this persons life can result in:

a.

mistrust.

b.

guilt.

c.

role confusion.

d.

isolation.

ANS: D

Erik Eriksons psychosocial development theory includes the stage of intimacy vs. isolation. This stage is where love relationships are developed, and fear of intimate relationships will lead to a sense of isolation.

DIF: Cognitive Level: Knowledge REF: p. 153 OBJ: Theory #3

TOP: Theorists KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: growth and development

22. The nurse caring for a 42-year-old patient is satisfied that Erik Eriksons psychosocial development phase of generativity has been satisfied by the fact that this patient is:

a.

reflecting on ones life and ones achievements.

b.

investigating and identifying alternatives regarding vocation.

c.

attaining new intellectual skills and developing his career.

d.

fulfilling parenting and civic responsibilities.

ANS: D

Erik Eriksons psychosocial development theory includes the stage of generativity vs. stagnation in which parenting, nurturing others, and fulfilling civic responsibilities are the tasks. The adult finds ways to be productive and of help to others in order to grow personally.

DIF: Cognitive Level: Knowledge REF: p. 153 OBJ: Theory #3

TOP: Theorists KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: growth and development

23. Marriages may improve after the children are grown and gone if the partners:

a.

are of the same age.

b.

have developed mutual interests.

c.

have adequate income.

d.

are busy with community activities.

ANS: B

The development of mutual interests and having more time for each other often improve marriages after the children are grown.

DIF: Cognitive Level: Comprehension REF: p. 160 OBJ: Theory #1

TOP: Theorists KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: growth and development

COMPLETION

24. A 35-year-old mother of three children, ages 8, 10, and 13, has decided to return to school to become a nurse. Her husband and parents have been very supportive of her decision and will help with child care while she is in school. According to Schaies theory for cognitive development, she is in the ________ stage, which occurs in the _______ stage of adulthood.

ANS:

achievement; young

Schaie identifies the young adult stage with the achievement stage of cognitive development. The achievement stage features the persons need to improve, demonstrate competence, and advance in a career. Young adulthood is generally considered to be between the ages of 19 and 45.

DIF: Cognitive Level: Application REF: p. 152 OBJ: Theory #2

TOP: Cognitive Theory | Young Adulthood KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

25. A 55-year-old is married with two children, ages 15 and 17. He is a supervisor for the local utility company, where he has been employed for 25 years. He is active in his community and serves on the town council. According to Schaies theory of cognitive development, he is in the _________ stage, which occurs in the __________ stage of adulthood.

ANS:

responsibility; middle

Schaie identifies the middle stage of adulthood with the responsibility stage of cognitive development. The responsibility stage features a time of great responsibility for self, family, job, and community. Middle adulthood is generally considered to be between the ages of 46 and 64.

DIF: Cognitive Level: Application REF: p. 152 OBJ: Theory #2

TOP: Cognitive Theory | Middle Adulthood KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

26. A 24-year-old mother of two has just become divorced from her husband of 4 years. She is living with her parents again until she is able to get her finances in order and find her own apartment. This is an example of _______ children.

ANS:

boomerang

Young adults who return to the parental home for a period of time are referred to as boomerang children.

DIF: Cognitive Level: Comprehension REF: p. 156 OBJ: Theory #6

TOP: Young Adult Psychosocial Development

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

MULTIPLE RESPONSE

27. When planning a community health fair, which of the following topics are most appropriate for the nurse to include to target the young adult? (Select all that apply.)

a.

Sexually transmitted diseases, including HIV

b.

Alcohol and drug abuse

c.

Development of proper diet and exercise regimen

d.

Foot care

e.

Screening for presbyopia

f.

Osteoporosis

ANS: A, B, C

Young adults typically are in good health but may develop unhealthy behaviors including chemical abuse; sedentary lifestyle; overeating; and sexual promiscuity, which can lead to sexually transmitted diseases, including HIV.

DIF: Cognitive Level: Application REF: p. 155 OBJ: Clinical Practice #2

TOP: Health Promotion | Young Adulthood

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

28. When planning a community health program that is directed at young adults, the nurse will prepare the material to: (Select all that apply.)

a.

build on previous knowledge.

b.

design clear goals for the program.

c.

indicate how the new knowledge can be of benefit.

d.

use straight lecture method to get points across quickly.

e.

relate material to common concerns of young people.

ANS: A, B, C, E

Building on previous knowledge, designing clear goals based on common concerns, and stressing how the material can be of benefit should be part of the plan. The straight lecture method is not the most effective way of communicating with young adults.

DIF: Cognitive Level: Application REF: p. 156 OBJ: Clinical Practice #3

TOP: Health Promotion | Young Adulthood

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

29. Susan, a 21-year-old, has just graduated from college and will begin teaching at the local elementary school in the fall. Her parents have been supportive and have assisted with her tuition throughout college and consoled her when she became overwhelmed at school. They are also helping Susan find an apartment close to the school where she will teach. At this point in her life, Susan will be faced with which of the following developmental tasks? (Select all that apply.)

a.

Marriage

b.

Parenting

c.

Planning for retirement

d.

Caring for parents

e.

Developing a social group

ANS: A, B, E

The decision to marry and become a parent, as well as developing a network of friends, are developmental tasks for the young adult.

DIF: Cognitive Level: Application REF: p. 157 OBJ: Theory #3

TOP: Developmental Tasks | Young Adulthood

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: growth and development

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