Chapter 14. Developmental Considerations in the Nursing Care of Adults My Nursing Test Banks

Chapter 14. Developmental Considerations in the Nursing Care of Adults

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The nurse is caring for a patient with a chronic illness. What would be a priority outcome for this patient?
a. Decreasing social isolation
b. Decreasing stress levels in the family
c. Achieving optimal personal level of health
d. Controlling personal health care decisions
____ 2. The nurse is contributing to a community health-promotion educational event for middle-aged adults. What information should the nurse include in this presentation?
a. Dementia
b. Pneumonia
c. Heart disease
d. Hypoglycemia
____ 3. While obtaining a personal history from a 72-year-old patient being admitted to a long-term care facility the nurse notices that the patient seems depressed. Which intervention should the nurse recommend be included in the patients plan of care?
a. Tell the patient to look forward and not back at the past.
b. Remind the patient to be accepting of help from family members.
c. Explain to the patient that some level of depression is normal with aging.
d. Guide the patient in reminiscing about the past with a focus on the positives.
____ 4. The nurse is caring for a patient who has a chronic illness and is depressed over being a burden to others. Which nursing action would increase the self-esteem of this patient?
a. Establishing long-term patient goals
b. Allowing the patient self-care opportunities
c. Performing activities of daily living for the patient
d. Encouraging the family to provide supportive patient care
____ 5. The nurse is caring for a patient who has a chronic illness. What should the nurse encourage the patient to use as a coping resource?
a. Empower caregivers.
b. Develop a power base.
c. Be hopeful for a disease cure.
d. Develop a realistic, hopeful attitude.
____ 6. The nurse is caring for a 52-year-old patient who is self-absorbed. What should the nurse identify as the likely cause of this self-absorption?
a. Depression
b. Loss of friends
c. Unresolved finances
d. Unresolved generativity
____ 7. The nurse is contributing to a staff education program about Eriksons developmental stages.
Which should the nurse present as the developmental stage for an older adult?
a. Integrity versus despair
b. Intimacy versus isolation
c. Identity versus role confusion
d. Generativity versus self-absorption
____ 8. The nurse is contributing to a staff education program about Eriksons developmental stages.
Which should the nurse present as the developmental stage for a middle-aged adult?
a. Integrity versus despair
b. Intimacy versus isolation
c. Identity versus role confusion
d. Generativity versus self-absorption
____ 9. The nurse is caring for a 21-year-old patient with a disfiguring injury. Which statement should the nurse expect related to the patients developmental stage?
a. I just dont know who I am now.
b. Im afraid my fianc wont want me anymore.
c. I havent accomplished what Id planned in life yet.
d. Soccer is my life; what if I cant play anymore with my friends?
____ 10. The nurse is contributing to the plan of care for a patient. What should the nurse do to promote health in this patient?
a. Discuss poor health habits
b. Perform a health risk assessment
c. Change the patients habits
d. Teach healthful lifestyle practices
____ 11. The nurse is contributing to a staff education program about health and illness. How should the nurse characterize the relationship of health and illness?
a. Non-dynamic
b. Constant states
c. Changing states
d. Exclusive concepts
____ 12. The nurse is caring for a patient who had a stroke that caused permanent physical changes. Which developmental task should the nurse recognize that the patient needs to accomplish for a positive outcome?
a. Adapting to the changes
b. Accepting that hope is gone
c. Letting go of favorite hobbies
d. Accepting that improvement is not possible
____ 13. The nurse identifies a patient who had satisfactorily fulfilled the developmental task for middle age. What term should the nurse use to describe this patients accomplishments?
a. Creative
b. Rebellious
c. Withdrawn
d. Self-centered
____ 14. A patient has not been able to fulfill the developmental task for middle age. Which term should the nurse use to describe this patient?
a. Creative
b. Outgoing
c. Productive
d. Self-focused
____ 15. An older patient has accomplished expected developmental tasks. What term should the nurse use to describe this patients accomplishments?
a. Accepting
b. Productive
c. Withdrawn
d. Self-centered
____ 16. A middle-aged person expresses fear of aging. Which intervention should the nurse use to help this patient?
a. Allow the patient to express fears.
b. Reassure the patient that this fear is normal.
c. Explain to the patient that there is nothing to fear.
d. Tell the patient that these are the best years of life.
____ 17. The nurse determines that a patient has satisfactorily fulfilled the developmental task of integrity. Which phrase should the nurse use to describe this patient?
a. Accepts life lived
b. States a fear of death
c. Grieves over life mistakes
d. Expresses dissatisfaction with life
____ 18. The nurse is planning care for an older male patient who is recovering from a failed suicide attempt. What nursing diagnosis should the nurse use to guide this patients care?
a. Anxiety
b. Hopelessness
c. Social isolation
d. Deficit in knowledge
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____ 19. The nurse is contributing to a staff education program about chronic illness. What should the nurse include as reasons for the increasing incidence of chronic illness? (Select all that apply.)
a. People are living longer.
b. The birth rate is increasing rapidly.
c. More people have an active lifestyle.
d. Fewer people are dying from acute illnesses.
e. There is an increase in the number of hospitals.
f. Medical advances reduced mortality from chronic illnesses.
____ 20. The nurse is contributing to a staff education program about adult health concerns. Which common health concerns of middle-aged adults should the nurse include? (Select all that apply.)
a. Stroke
b. Hypertension
c. Kidney failure
d. Visual changes
e. Alzheimers disease
f. Cardiovascular disease
____ 21. The nurse is contributing to a staff education program about chronic illness. Which illnesses should the nurse explain as being acquired (not congenital or genetic) chronic illnesses? (Select all that apply.)
a. Cancer
b. Cataracts
c. Multiple sclerosis
d. Muscular dystrophy
e. Huntingtons disease
f. Chronic obstructive pulmonary disease
____ 22. The nurse is contributing to a staff education program about chronic illness. What should the nurse include as being congenital diseases? (Select all that apply.)
a. Cancer
b. Spina bifida
c. Cystic fibrosis
d. Sickle cell anemia
e. Huntingtons disease
f. Malabsorption syndrome
____ 23. The nurse is reinforcing teaching to assist the patient adapt to a chronic illness. What should the nurse include in the teaching? (Select all that apply.)
a. Limit your social contacts and activities.
b. Plan ways to compensate for your limitations.
c. Try to ignore your symptoms as much as possible.
d. Understand your medical regimen, and follow it carefully.
e. Revise your daily schedule as needed to adjust to your illness.
____ 24. The nurse suspects that a patient is experiencing despair. Which characteristics did the nurse recognize in this patient? (Select all that apply.)
a. Exercising daily
b. Stating a fear of death
c. Finding meaning in life
d. Avoiding social activities
e. Expressing life satisfaction
f. Coping with aging changes
____ 25. The nurse is caring for a patient who has been working on issues related to the developmental stage of young adulthood. Which behaviors indicate to the nurse that the patient has resolved developmental task issues? (Select all that apply.)
a. Verbalizes acceptance of life decisions
b. Verbalizes sense of productivity at work
c. Expresses concern for future generations
d. Has large network of family and friends at bedside
e. Expresses concern illness will cause strain on spouse and children
f. Requests visit from chaplain to discuss multiple losses and sense of isolation
____ 26. The nurse is assisting in the care of a patient with small cell lung cancer who regrets a long-term history of smoking and verbalizes a desire to stop smoking. Which intervention should the nurse recommend be included in the patients plan of care? (Select all that apply.)
a. Refer the patient for electroshock therapy.
b. Provide information related to smoking cessation.
c. Encourage the patient to establish short-term goals.
d. Discuss the patients previous efforts to stop smoking.
e. Discuss the benefits of smoking cessation with the patient and family.
f. Inform the patient that smoking cessation at this point is not beneficial.
____ 27. The nurse is caring for a patient with a chronic illness and whose spouse is the caregiver. What should the nurse do to assist the caregiver with coping? (Select all that apply.)
a. Empower the caregiver.
b. Share community resources.
c. Convey that a cure is possible.
d. Encourage a realistic, hopeful attitude.
e. Assist the caregiver in identifying a support network.
____ 28. A patient with a chronic illness is receiving care at home by a caregiver. What should the nurse discuss with the patient and caregiver about respite care? (Select all that apply.)
a. Prevent patient neglect.
b. Evaluate the health of the patient.
c. Allow the caregiver to go shopping.
d. Allow the caregiver to reduce stress.
e. Provide the caregiver with a vacation.
____ 29. The nurse is working with a patient and family to achieve wellness goals. What actions should the nurse take when creating this plan? (Select all that apply.)
a. Mobilizing resources
b. Recognizing potential crises
c. Providing an adaptable environment
d. Minimizing the patient and familys concerns
e. Teaching the patient and family about the health problem
____ 30. The nurse is participating in the creation of a teaching seminar about healthy behaviors for the young adult. What topics should the nurse suggest be included in this seminar? (Select all that apply.)
a. Diet and exercise
b. Avoiding tobacco use
c. Avoiding sun exposure
d. Restricting hours of sleep
e. Performing self-examinations
____ 31. During a health history, the nurse learns that a young adult smokes cigarettes, drinks alcohol, and does not exercise routinely. What should this information suggest to the nurse? (Select all that apply.)
a. The patient is isolated.
b. The patient is having a crisis with intimacy.
c. The patient has poor coping mechanisms for stress.
d. The patient is participating in risky lifestyle choices.
e. The patient has adopted positive ways to cope with stress.
____ 32. A middle-aged patient is upset that her oldest daughter is moving out of state and her parents are getting older and need more assistance. What terms should the nurse use to describe the situations in which this patient is experiencing? (Select all that apply.)
a. Ageism
b. Empty nest
c. Baby boomer
d. Digital immigrant
e. Sandwich generation

Chapter 14. Developmental Considerations in the Nursing Care of Adults
Answer Section

MULTIPLE CHOICE

1. ANS: C
The goal of nursing care for any patient, including a patient with chronic illness, can best be defined as helping a patient achieve his or her highest possible level of wellness. A. B. D. These might be personal goals for a patient with a chronic illness however may not be a priority.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

2. ANS: C
Hypertension and heart disease are major health concerns for middle-aged adult Americans. A. B. D. These health problems are not a major concern for this population.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

3. ANS: D
The developmental goal for people age 65 or older is integrity versus despair. Reminiscence is one way for the nurse to assist the older adult in passing through this stage. Depression is not normal with aging. A. B. C. These actions do not support the developmental goal for this age group.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

4. ANS: B
Establishing short-term goals or self-care activities that allow patients to participate or have small successes are important nursing actions that can increase their self-esteem. A. Long-term goals would not be appropriate at this time. C. D. Performing actions for the patient or encouraging the family to do so would strengthen this patients feelings of being a burden.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

5. ANS: D
Before coping resources can be used, hope must be established by the patient. False hope is not beneficial and should be replaced with realistic hope. Providing patients with accurate knowledge regarding their fears helps do this. C. Hope should not be directed toward a cure that may not be possible, but rather at living a quality life with the functional capacity that the patient has. A. B. Empowering caregivers and developing a power base are not strategies to cope with a chronic illness.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

6. ANS: D
The psychological developmental task of this age group is developing generativity versus self-absorption. Unresolved conflict could be seen as preoccupation with personal needs or self-absorption. A. B. C. These would not be the likely cause of this patients self-absorption.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Analysis

7. ANS: A
The developmental goal for people age 65 or older is integrity versus despair. The older adult looks back and evaluates what has been done with his or her life. Integrity refers to accepting responsibility for ones life so far and reflecting on it in a positive way. B. C. D. These are developmental stages for other age groups.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

8. ANS: D
Between ages 45 to 65, the psychological developmental task of this age group is developing generativity versus self-absorption. Generativity includes a sense of productivity and creativity and is demonstrated by a concern and support for others, along with a vision for future generations. Unresolved conflict could be seen as preoccupation with personal needs or self-absorption. A. B. C. These are developmental stages for other age groups.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

9. ANS: B
Intimacy versus isolation is the young adults task, which is to develop relationships. This is likely to be threatened during illness and is most likely to be the highest priority for the patient. D. This statement represents industry versus inferiority, a developmental stage of childhood. A. This represents identity versus role confusion, a developmental stage of childhood. C. This represents generativity versus self-absorption, a developmental stage of a middle-aged adult.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Analysis

10. ANS: D
Teaching educates and empowers others to perform actions to maintain their own health. A. B. C. These actions help to identify health issues but not necessarily promote health.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

11. ANS: C
Rather than being exclusive concepts, health and illness are dynamic and ever-changing states of being.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

12. ANS: A
Coping with a chronic illness can be aided if the patient develops a positive attitude toward the illness. This can be accomplished if the patient gains knowledge, uses a problem-solving approach to difficulties, and becomes motivated to continue adapting to the illness. B. Hope needs to be facilitated in this patient. C. D. The patient does not need to relinquish favorite hobbies or accept that improvement is not possible.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Analysis

13. ANS: A
The psychological developmental task of this age group is developing generativity versus self-absorption. Generativity includes a sense of productivity and creativity. B. C. D. These terms would not be appropriate for this patients accomplishments.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

14. ANS: D
The psychological developmental task of this age group is developing generativity versus self-absorption. Unresolved conflict could be seen as preoccupation with personal needs or being self-focused. A. B. C. These terms would not be appropriate for the middle-aged patient who has not been able to fulfill expected developmental tasks.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

15. ANS: A
The developmental goal for older adults is integrity versus despair. Integrity refers to accepting responsibility for ones life so far. B. C. D. These terms would not be appropriate to describe the accomplishment of developmental tasks for a person of an older age.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

16. ANS: A
As a first step in therapeutic communication, it is important to allow patients to express concerns whenever they express them. Then based on what is expressed, care can be planned. B. C. D. False reassurance and subjective opinions are not therapeutic.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

17. ANS: A
The developmental goal for older adults is integrity versus despair. Integrity refers to accepting responsibility for ones life so far and reflecting on it in a positive way. Reaching this stage is a sign of maturity. B. C. D. These phrases do not describe the patients achievement of the developmental task of integrity.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

18. ANS: B
The accumulation of losses can overwhelm an older adults resources and coping mechanisms and is related to a high rate of suicide, especially for older men. Suicide is the ultimate expression of hopelessness. A. C. D. There is no evidence to suggest that this patient is experiencing anxiety, social isolation, or a knowledge deficit.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

MULTIPLE RESPONSE

19. ANS: A, C, D, F
Chronic illness is rising because people are living longer, due in part to more active lifestyles. Fewer people are dying from acute diseases. Medical advances have resulted in reduced mortality from some chronic illnesses. B. Birth rate has been relatively stable over the past few years and lower than it was in the 1930s; birth rate does not directly affect the incidence of chronic illnesses that primarily occur in older individuals. E. The number of hospitals does not affect the number of people with chronic illnesses.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

20. ANS: B, D, F
Middle-aged adults are those ages 45 to 65 years. Visual changes, hypertension, and heart disease are major health concerns of middle age. A. C. E. Kidney disease, stroke, and Alzheimers disease typically occur in older adults.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

21. ANS: A, B, C, F
Acquired chronic illnesses include cancer, cataracts multiple sclerosis, and chronic obstructive pulmonary disease. D. E. Muscular dystrophy and Huntingtons disease are genetic illnesses.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological IntegrityPhysiological Adaptation | Cognitive Level: Application

22. ANS: B, F
Malabsorption syndrome and spina bifida are congenital diseases. C. D. E. These are genetic disorders. A. Cancer is an acquired disease.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological IntegrityPhysiological Adaptation | Cognitive Level: Application

23. ANS: B, D, E
Appointments and rest periods, for example, must be considered in the patients schedule. To prevent complications, it is essential to understand the medical regimen. Planning for methods to adapt to limitations is very helpful for successful adaptation. C. Symptoms should not be ignored to prevent complications. A. To prevent isolation, maintain social contacts and activities.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological IntegrityPhysiological Adaptation | Cognitive Level: Application

24. ANS: B, D
An indication of unsuccessful completion of prior developmental stages can result in feelings of despair that life has been lived in vain and a fear of death. A. C. E. F. Socializing and exercise are indicative of positive adjustments and an active and productive lifestyle.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Analysis

25. ANS: D, E
Developing intimacy versus isolation is the sixth psychological developmental stage. The young adults task is to develop relationships with a spouse, family, or friends which are warm, affectionate, and developed through fondness, understanding, caring, or love. F. When this stage is not successfully resolved, the individual often experiences isolation from others. B. C. In the middle adult years, the psychological developmental stage is developing generativity versus self-absorption. Generativity includes a sense of productivity and creativity and is demonstrated by a concern and support for others, along with a vision for future generations. A. The developmental stage for older adults is integrity versus despair. In this stage, the older adult looks back and evaluates what has been done with his or her life. Integrity refers to accepting responsibility for ones life so far and reflecting on it in a positive way.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Analysis

26. ANS: B, C, D, E
The patient with chronic lung disease who smokes can make a choice to smoke or to quit smoking. Providing patients with knowledge to make informed decisions empowers them to take control of their lives and reach for their greatest potential. Establishing short-term goals or self-care activities that allow them to participate or have small successes are important nursing actions that can increase self-esteem. Assessment of previous attempts to stop smoking is an important part of assisting the patient to choose effective health promotion strategies. F. Health promotion is possible and necessary at all levels of age or disability. A. Electroshock therapy is not used to promote smoking cessation.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

27. ANS: A, B, D, E
These actions offer the caregiver encouragement and methods for coping as a caregiver. C. False hope does not help the caregiver with coping needs.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

28. ANS: A, C, D, E
The caregiver needs personal time to be alone and de-stress or perform activities such as shopping to cope as a caregiver. Caregivers who are too stressed by the caregiver role may become neglectful which can be a form of patient abuse, although they do not intentionally mean to abuse the patient. Rather, they have become overwhelmed with their caregiver role. B. Respite care is not used to evaluate the health of the patient.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

29. ANS: A, B, C, E
Working together, the patient, family, and members of the health care team develop a plan of care that includes wellness goals and a plan of action to accomplish those goals. The plan of care should focuses on mobilizing resources, recognizing potential crises, providing an adaptable environment, and helping the patient learn about his or her health problem and treatment. D. The patient and familys concerns should not be minimized.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

30. ANS: E
Young adults should understand the importance of diet and exercise in maintaining health for themselves and their children. Lifelong positive health practices help prevent long-term health complications. Avoiding sun exposure and using sunscreen are important to avoid sunburn, permanent sun damage to the skin, and increased risk of skin cancer. Tobacco use started in the teen years is often carried on throughout young adulthood and is linked to chronic bronchitis, emphysema, and oral, throat, and lung cancer in later life. Additional preventive measures that may be taught at this stage include breast self-examination (BSE) for women and testicular self-examination (TSE) for men. D. Restricting hours of sleep is not a healthy behavior.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

31. ANS: C, D
Overeating, alcohol use, drug use, cigarette smoking, and violence are risky lifestyle choices and poor coping mechanisms for stress. A. B. There is not enough information to determine if the patient is isolated or is having a crisis with intimacy. E. Positive coping mechanisms for stress include exercise, support groups, music, and meditation.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Analysis

32. ANS: B, E
The term empty nest has been used to describe the middle-aged couples home after their children have left. The middle-aged adult generation has been labeled the sandwich generation because of the need to care for their children and their aging parents at the same time. A. Ageism is a term that describes stereotypical misconceptions about older adults in society. C. Baby boomer is a term used to describe a generation of individuals born after the last World War. D. Digital immigrant is a term used to describe a person who is learning how to use electronic devices without the benefit from learning them in school.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

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