Chapter 22 My Nursing Test Banks

Kozier & Erbs Fundamentals of Nursing, 10/E
Chapter 22

Question 1

Type: MCSA

The nurse is providing pre-employment physicals to a group of adults, aged 30 to 40. In which generation should the nurse categorize these adults?

1. Baby Boomers

2. Generation X

3. Generation Y

4. Millennials

Correct Answer: 2

Rationale 1: The Baby Boomers were born in the years 1945 to 1964.

Rationale 2: Generation X includes individuals born in the years 1965 to 1978.

Rationale 3: Generation Y includes individuals born between the years 1979 and 2000.

Rationale 4: Millennials were born between the years 1979 and 2000.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1. Compare and contrast the following generational groups: baby boomers, Generation X, and Generation Y.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 353

Question 2

Type: MCSA

A colleague is telling the community health nurse that his adult child has just moved back in with him and his wife. They are finding this situation somewhat difficult to adjust to. The nurse offers support and listens, while understanding that which factor is least likely contributing to this particular trend?

1. Maladaptive behavior

2. High unemployment rate

3. High housing costs

4. High incidence of chronic disease

Correct Answer: 4

Rationale 1: These young adults, known as Boomerang Kids, have moved back into their parents homes after an initial period of independent living. A factor that has contributed to this trend is maladaptive behavior.

Rationale 2: These young adults, known as Boomerang Kids, have moved back into their parents homes after an initial period of independent living. A factor that has contributed to this trend is high unemployment rates.

Rationale 3: These young adults, known as Boomerang Kids, have moved back into their parents homes after an initial period of independent living. A factor that has contributed to this trend is high housing costs.

Rationale 4: These young adults, known as Boomerang Kids, have moved back into their parents homes after an initial period of independent living. Chronic disease is not a factor that has contributed to this trend.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1. Compare and contrast the following generational groups: baby boomers, Generation X, and Generation Y.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 354

Question 3

Type: MCSA

The nurse is observing a group of young adults engaged in a discussion regarding work schedules over the holidays. What should the nurse realize that these adults will use to balance the emotional as well as logical side of the discussion?

1. Formal operational stage

2. Postformal thought process

3. Kohlbergs theory of moral development

4. Fowlers spiritual development theory

Correct Answer: 2

Rationale 1: Young adults are able to use formal operations, characterized by the ability to think abstractly.

Rationale 2: Postformal thought, sometimes called the problemfinding stage, is characterized by creative thought, realistic thinking, problem forming, and problem solving. Postformal thinkers are able to comprehend and balance arguments created by both logic and emotion.

Rationale 3: Young adults enter the postconventional level of Kohlbergs moral theory.

Rationale 4: This would not be considered a spiritual dilemma, so Fowlers theory would not be utilized.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify characteristic tasks of psychosocial development during young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 355

Question 4

Type: MCSA

The nurse working in a community health office that is often frequented by young adults is assessing clients for suicide. Which factors should the nurse identify as indicating a problem in this area?

1. Decreased interest in work

2. Weight loss

3. Depression

4. Brain dysfunction, including tumors

5. Sleep disturbances

Correct Answer: 1, 2, 3, 5

Rationale 1: The nurses role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including decreased interest in work roles.

Rationale 2: The nurses role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including weight loss.

Rationale 3: The nurses role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including depression.

Rationale 4: Brain tumors are not an indicator for suicide.

Rationale 5: The nurses role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including sleep disturbances.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7. Identify selected health risks associated with young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 356

Question 5

Type: MCSA

An occupational health nurse is providing a hypertension screening at a local manufacturing plant. Among the employees, the nurse should focus on which population?

1. Males and females, equally

2. African American males

3. Asian American females

4. White females

Correct Answer: 2

Rationale 1: Hypertension is a problem for males and females equally.

Rationale 2: Hypertension is a major problem for young African American adults, particularly men. The causes for this are unknown.

Rationale 3: Hypertension is not a major problem for Asian American females.

Rationale 4: Hypertension is not a major problem for White females.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7. Identify selected health risks associated with young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 356

Question 6

Type: MCSA

A nurse is working in a community of factory workers and is planning an educational session for wellness, targeting the young adult group. In order to address one of the health problems of this group, the nurse plans to:

1. help the group become more aware of marketing efforts by tobacco companies.

2. tell this group that smoking is unacceptable.

3. make sure the group is aware of the increased risk of liver disease and cancer of the esophagus.

4. counsel the group regarding addiction.

Correct Answer: 1

Rationale 1: Smoking is a type of drug abuse prevalent in this age group, which can lead to lung cancer and cardiovascular disease. The

nurses role regarding smoking is to serve as a role model by not smoking, provide educational information regarding the dangers of smoking (not just tell or counsel about it), help make smoking socially unacceptable, suggest resources such as hypnosis, and assist with lifestyle training and behavior modification to clients who desire to stop smoking.

Rationale 2: The nurses role regarding smoking does not include making judgment statements.

Rationale 3: There is not current research to support the role of tobacco in the development of liver and esophagus cancers.

Rationale 4: The nursing role in this situation is to educate, not counsel.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7. Identify selected health risks associated with young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 356

Question 7

Type: MCSA

During an educational session regarding physical changes of the middle-aged adult, a participant asks about typical weight changes. How should the nurse respond?

1. Weight loss is no different during this time than at any other time of your life.

2. Metabolism slows during middle age, which may result in weight gain.

3. As long as you exercise appropriately, weight loss will be ensured.

4. Weight loss is always a good idea, regardless of your age.

Correct Answer: 2

Rationale 1: The nurse should educate clients regarding physical changes occurring in their bodies. Statements that generalize weight loss with all other age groups are neither accurate nor helpful to the person asking the question.

Rationale 2: The nurse should educate clients regarding physical changes occurring in their bodies. Age does make a difference in how the body responds to diet and exercise, and it is important for nurses to be well informed and educated regarding age-related changes.

Rationale 3: There are other factors in addition to exercise that can affect weight in this age group.

Rationale 4: Statements that generalize weight loss with all other age groups are neither accurate nor helpful to the person asking the question.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 9. List examples of health promotion topics for young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 358

Question 8

Type: MCSA

A client comes to the clinic with a history of pain in his testicle. During the interview assessment, what information should be of concern to the nurse?

1. The client works as an auto-detailer.

2. He smokes half a pack of cigarettes per week.

3. He has not had a yearly exam for 5 years.

4. He does not perform testicular self-exams.

Correct Answer: 3

Rationale 1: There is no current evidence to support such work as a risk factor for such symptoms.

Rationale 2: There is no current evidence to support smoking as a risk factor for such symptoms.

Rationale 3: Testicular cancer is the most common neoplasm in men between the ages of 20 and 34. Monthly testicular self-examination, a means of early identification of malignancy, used to be recommended for all men. More recent recommendations from the American Cancer Society (ACS) are that men should have a testicular exam as part of a yearly physical exam.

Rationale 4: Men who have risk factors for testicular cancer should discuss monthly testicular self-examination with their primary care provider.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8. Identify developmental assessment guidelines for young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 358

Question 9

Type: MCSA

A young female client comes into the emergency department with vague physical symptoms and does not make eye contact with the nurse during the interview. In order to best assess the client, what should the nurse ask the client?

1. Can you tell me whats been going on in your life lately?

2. What kind of problems are you having?

3. Is someone hurting you?

4. Can you explain what your family life is like?

Correct Answer: 3

Rationale 1: Generalized questions about life do not adequately address the clients needs during this assessment.

Rationale 2: Generalized questions about life problems do not adequately address the clients needs during this assessment.

Rationale 3: A nurse who works with women should explicitly ask if the young adult is frightened or hurt by someone she knows. It is essential that nurses make assessment for domestic violence part of their routine.

Rationale 4: Generalized questions about family life do not adequately address the clients needs during this assessment.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7. Identify selected health risks associated with young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 355

Question 10

Type: MCSA

The nurse is providing education regarding early detection of breast cancer to a group of women between the ages of 30 and 40. According to recommendations from the American Cancer Society, the nurse should explain that it is important for these women to

1. do monthly breast self-exams.

2. have a yearly mammogram.

3. see a physician if there is a strong family history of breast cancer.

4. have an annual breast exam performed by a health care provider.

Correct Answer: 4

Rationale 1: Breast self-exam is no longer recommended for all women.

Rationale 2: Yearly mammography for all women over the age of 40 is encouraged, as it decreases mortality from breast cancer.

Rationale 3: Although a family history of breast cancer is a risk factor, it is not the sole reason to monitor for breast cancer.

Rationale 4: The American Cancer Society recommends that a health care practitioner perform a breast examination at a yearly physical exam.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 9. List examples of health promotion topics for young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 357

Question 11

Type: MCSA

A community health nurse is doing a screening for cervical cancer at a womens health fair. Which client should the nurse identify as having the highest risk factor for cervical cancer?

1. The client who had a difficult vaginal delivery 2 years ago

2. The client who has a history of genital herpes

3. The client who was married at age 27

4. The client who has a sister with breast cancer

Correct Answer: 2

Rationale 1: There is not current evidence to support this option.

Rationale 2: High risk factors for cervical cancer include sexual activity at an early age, multiple sexual partners, and a history of syphilis, herpes genitalis, or trichomonas vaginitis.

Rationale 3: There is not current evidence to support this option.

Rationale 4: There is not current evidence to support this option.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8. Identify developmental assessment guidelines for young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 357

Question 12

Type: MCSA

A 30-year-old client who plans to travel extensively within the United States asks the nurse about appropriate immunizations. What should the nurse recommend to this client?

1. The client should have a tetanus booster if the client has not had one within the last 5 years.

2. The client should have the hepatitis B immunization series.

3. The client should receive a meningococcal vaccine if the client did not receive one as a teen.

4. The client should not worry about immunizations, as they are not recommended for this age group.

Correct Answer: 3

Rationale 1: Recommended immunizations for this age group include tetanus-diphtheria booster every 10 years.

Rationale 2: The hepatitis B series would not be recommended for travel within the United States.

Rationale 3: Recommended immunizations for this age group include the meningococcal vaccine if not given in early adolescence.

Rationale 4: There are recommended immunizations for this age group.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8. Identify developmental assessment guidelines for young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 358

Question 13

Type: MCSA

A nurse is presenting an educational session regarding psychosocial development to a group of middle-aged adults. According to Eriksons theory, what activity should the nurse select to best meet the needs of this stage?

1. Providing opportunities to mentor school-age children

2. Giving the group handouts regarding peer socialization

3. Helping the members of this group find appropriate civic responsibility

4. Assisting the group members to look at their life accomplishments

Correct Answer: 1

Rationale 1: Erikson viewed the developmental choice of the middle-aged adult as generativity versus stagnation. Generativity is defined as concern for establishing and guiding the next generation. This could be accomplished through a mentor program with school-age children.

Rationale 2: Peer socialization is a task of the young adult and adolescent.

Rationale 3: Finding civic responsibility is a task of the young adult and adolescent.

Rationale 4: Taking inventory of past accomplishments is the task of the older adult.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify characteristic tasks of psychosocial development during young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 359

Question 14

Type: MCSA

While assisting in a community health project for middle-aged adults, the nurse attempts to identify members of the community who have been successful in the tasks identified by Erikson. What characteristic should the nurse identify in the community members?

1. Ability to have satisfaction in their volunteer activities

2. Ability to find an acceptable social group

3. Satisfaction with rearing children

4. Ability to manage a home

Correct Answer: 1

Rationale 1: Erikson identifies this stage as generativity versus stagnation. Generative middle-aged persons are able to feel a sense of comfort in their lifestyle and receive gratification from charitable endeavors.

Rationale 2: This option identifies tasks associated with the young adult stage.

Rationale 3: This option identifies tasks associated with the young adult stage.

Rationale 4: This option identifies tasks associated with the young adult stage.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify characteristic tasks of psychosocial development during young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 359

Question 15

Type: MCSA

The nurse is providing assistance at a community health fair for middle-aged clients. Which information should the nurse use when working with this group of clients?

1. The middle-aged person has decreased intellectual and cognitive abilities as a result of the normal aging process.

2. Adults make the transition into this stage easily and without problems.

3. Physical capabilities and functions decrease with age, but mental and social capacities tend to increase in the latter part of life.

4. Cognitive and intellectual abilities are somewhat decreased due to slower reaction time, loss of memory, and changes in perception and problem solving.

Correct Answer: 3

Rationale 1: Cognitive and intellectual abilities change very little during this time.

Rationale 2: Transition into middle life can be as critical as during adolescence. Some refer to the midlife crisis and call the decade between 35 and 45 years the deadline decade.

Rationale 3: Physical capabilities and functions do decrease with age, but mental and social capacities actually increase in the latter part of life.

Rationale 4: Cognitive and intellectual abilities change very little during this time.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8. Identify developmental assessment guidelines for young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 359

Question 16

Type: MCSA

The nurse can identify movement into Kohlbergs postconventional level when the client, after being asked about work, makes which statement?

1. Oh, the work isnt so bad anymore. Im getting close to retirement.

2. Work is fine, but my family and friends are so much more important to me.

3. Ive done a good job for the company. Im proud of my years there.

4. I dont like to talk about work when Im not there.

Correct Answer: 2

Rationale 1: According to Kohlberg, the extensive experience of personal moral choice and responsibility is required to move into the postconventional level. A statement about work not being so bad shows a complacency about work that is not reflective of the postconventional level.

Rationale 2: According to Kohlberg, the extensive experience of personal moral choice and responsibility is required to move into the postconventional level. Movement from a law-and-order orientation to a social contract orientation requires that the individual move to a stage in which rights of others take precedenceas in the statement that work is OK, but family and friends are more important.

Rationale 3: Stating that the person has pride about work and the time spent doing it would be an example of Eriksons stage of integrity versus despair.

Rationale 4: According to Kohlberg, the extensive experience of personal moral choice and responsibility is required to move into the postconventional level. A statement about not wanting to talk about work shows complacency about work that is not reflective of the postconventional level.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Describe moral development according to Kohlberg throughout adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 360

Question 17

Type: MCSA

The nurse is preparing information for a community health education seminar. Which statement should the nurse include regarding disease for the middle-aged adult?

1. Cancer is the leading cause of death in the age group from 25 to 64 years.

2. Coronary heart disease is the leading cause of death.

3. Leading causes of death include suicide and motor vehicle crashes.

4. Injuries and chronic disease are the leading causes of death in this age group.

Correct Answer: 4

Rationale 1: Cancer is the second leading cause of death among people between the ages of 25 and 64 years.

Rationale 2: Coronary heart disease is the leading cause of death among all age groups in the United States.

Rationale 3: There is no evidence to support this statement regarding suicide.

Rationale 4: Motor vehicle crashes as well as occupational injuries along with chronic disease such as cancer and cardiovascular disease combined make up the leading causes of death in the middle-aged adult group.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5. Describe moral development according to Kohlberg throughout adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 360

Question 18

Type: MCSA

A middle-aged client is struggling with life changes, including menopause. What is the best response by the nurse to this client?

1. Dont worrymenopause cant last forever.

2. There are some very good antidepressants you can take.

3. What did your mother do to get through menopause?

4. There is a menopause support group that meets every 2 weeks.

Correct Answer: 4

Rationale 1: Telling a client who is struggling not to worry is not therapeutic and does not address the problem.

Rationale 2: Advice about medications is not within nurses scope of practice, as they do not prescribe.

Rationale 3: Comparing this clients situation to her mothers is neither relevant nor therapeutic. Her mothers age group was going through experiences in a different time and culture.

Rationale 4: Clients experiencing developmental stressors like menopause, the climacteric, aging, impending retirement, or any other situational stressors may experience anxiety and depression. These clients may benefit from support groups or individual therapy to help them cope with specific crises.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 9. List examples of health promotion topics for young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 360

Question 19

Type: MCSA

A group of middle-aged clients is inquiring about nutritionrelated health problems inherent in their age group. In order to best address these concerns of this specific age group, the nurse should take which action?

1. Provide information, including a website, regardingage specific diet plans.

2. Give all clients a handout on diets recommended by the ADA.

3. Tell the clients to check with their physician before dieting.

4. Have them write to the U.S. Department of Agriculture for more information.

Correct Answer: 1

Rationale 1: Decreased metabolic activity and decreased physical activity mean a decrease in caloric needs. This particular age group must be educated regarding nutrition, exercise, and the relationship of nutrition and exercise to chronic diseases such as diabetes mellitus and heart problems.

Rationale 2: This option does not necessarily address the concerns of this specific age group.

Rationale 3: Although this information is not incorrect, is the nurses responsibility to provide general information, education, and sources for clients seeking improvement in their nutrition that would include but not be limited to encouragement to check with their physician before dieting.

Rationale 4: Although encouraging the individuals to write for information is not incorrect, in this situation it is the nurses responsibility to provide information, education, and resources for clients seeking improvement in their nutrition.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7. Identify selected health risks associated with young and middle-aged adults.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 361

Question 20

Type: MCMA

The nurse is working with young adults in the community. What should the nurse realize as being the psychosocial developmental tasks of this population?

Standard Text: Select all that apply.

1. Selecting a mate

2. Rearing children

3. Achieving civic responsibility

4. Finding a congenial social group

5. Developing adult leisure-time activities

Correct Answer: 1, 2, 4

Rationale 1: Selecting a mate is a task appropriate for this age group.

Rationale 2: Rearing children is a task appropriate for this age group.

Rationale 3: Achieving civic responsibility is a task of the middle-aged adult.

Rationale 4: Finding a congenial social group is a task appropriate for this age group.

Rationale 5: Developing adult leisure-time activities is a task of the middle-aged adult.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify characteristic tasks of psychosocial development during young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 354

Question 21

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Question 21

Type: MCMA

A client approaching middle age asks for information to keep mentally sharp. What should the nurse explain about the cognitive abilities of the middle-aged client?

Standard Text: Select all that apply.

1. Reaction time stays much the same.

2. Memory is maintained during this time.

3. Learning declines and cannot be completed.

4. Problem-solving ability is maintained during this time.

5. Cognitive and intellectual abilities change very little at this time.

Correct Answer: 1, 2, 4, 5

Rationale 1: The middle-aged adults cognitive and intellectual abilities change very little. Reaction time during the middle years stays much the same.

Rationale 2: The middle-aged adults cognitive and intellectual abilities change very little. Memory is maintained during middle adulthood.

Rationale 3: The middle-aged adults cognitive and intellectual abilities change very little. Learning continues and can be enhanced with motivation.

Rationale 4: The middle-aged adults cognitive and intellectual abilities change very little. Problemsolving ability is maintained during middle adulthood.

Rationale 5: The middle-aged adults cognitive and intellectual abilities change very little.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Explain changes in cognitive development throughout adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 359

Question 22

Type: MCMA

The nurse is confident that a young adult has successfully achieved psychosocial development. What observations about the client did the nurse make to come to this conclusion?

Standard Text: Select all that apply.

1. Discusses plans to expand his exercise routine to include running

2. Is optimistic about finding a new job

3. Volunteers weekly at the local senior center

4. Recognizes that professional sports may be enjoyed but does not aspire to participating

5. May be too bald to play Santa Claus

Correct Answer: 1, 2, 4

Rationale 1: The psychosocial development of a young adult would include keeping good health habits.

Rationale 2: The psychosocial development of a young adult would include the ability to cope with stressors appropriately.

Rationale 3: The psychosocial development of a middle-aged adult would include pursuing charitable and altruistic activities.

Rationale 4: The psychosocial development of a young adult would include having a realistic self-concept.

Rationale 5: The psychosocial development of a middle-aged adult would include accepting his aging body.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify characteristic tasks of psychosocial development during young and middle adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 354

New Question:

Question 23

Type: MCMA

The nurse is completing a spiritual assessment with a middle-aged client. What should the nurse recognize as expected characteristics of moral development in this client?

Standard Text: Select all that apply.

1. Uses religion for comfort

2. Seeks religious explanations for death

3. Compares characteristics of various religions

4. Questions the purpose of religion in ones life

5. Relies upon spiritual beliefs to help with illness

Correct Answer: 1, 2, 5

Rationale 1: In middle age, people tend to be less dogmatic about religious beliefs, and religion often offers more comfort to the middle-aged person than it did previously.

Rationale 2: In middle age, people tend to be less dogmatic about religious beliefs, and religion often offers more comfort to the middle-aged person than it did previously. People in this age group often rely on spiritual beliefs to help them deal with death.

Rationale 3: Comparing characteristics of various religions is a characteristic of an earlier stage of development.

Rationale 4: Questioning the purpose of religion in ones life is a characteristic of an earlier stage of development.

Rationale 5: In middle age, people tend to be less dogmatic about religious beliefs, and religion often offers more comfort to the middle-aged person than it did previously. People in this age group often rely on spiritual beliefs to help them deal with illness.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Development

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Describe spiritual development according to Fowler throughout adulthood.

MNL Learning Outcome: 2.1.3. Analyze the young and middle adults physiologic and psychosocial development.

Page Number: 360

 

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