Chapter 6Nursing of Adults across the Life Span My Nursing Test Banks

Chapter 6Nursing of Adults across the Life Span

MULTIPLE CHOICE

1.The nurse is reviewing the number of elderly adult clients who were admitted during the previous 3-month period with complications from the seasonal flu. The nurse is reviewing which of the following illness patterns?

1.

Prevalence

2.

Incidence

3.

Trends

4.

Mortality rate

ANS: 2

Incidence is the number of new cases of a condition, symptom, death, or injury that arise during a specified period. Prevalence is the number of current cases per population at risk. Trends are the general direction of movement of any given topic. The mortality rate is the number of deaths that occur at a given time.

PTS: 1 DIF: Apply REF: Contemporary Trends Related to Adult Behavior

2.An elderly client is admitted with worsening dementia. Which of the following health problems should the nurse consider as causing this clients dementia?

1.

Depression

2.

Alzheimers disease

3.

Memory impairment

4.

Alcohol withdrawal

ANS: 2

Alzheimers disease accounts for about 50% of all clinical cases of dementia. Memory disturbances are a part of Alzheimers disease. Depression does not lead to dementia. Worsening dementia is not associated with alcohol withdrawal.

PTS:1DIF:AnalyzeREF:Alzheimers Disease

3.The nurse is instructing a client on ways to reduce the risk of developing coronary heart disease. Which of the following should be included in these instructions?

1.

Limit smoking.

2.

Exercise when able.

3.

Keep BMI at or above 30.

4.

Reduce cholesterol level.

ANS: 4

Hypercholesterolemia is one of the major modifiable risk factors for cardiovascular disease. To limit the risk of coronary heart disease, the nurse should instruct the client to stop smoking, exercise more frequently, and keep the BMI below 25.

PTS:1DIF:Apply

REF:Hypercholesterolemia; Obesity Rates; Coronary Artery Disease

4.When planning instruction for a client diagnosed with coronary artery disease, the nurse should identify which of the following risk factors that cannot be modified for the client?

1.

Heredity

2.

Hypertension

3.

Sedentary lifestyle

4.

Smoking

ANS: 1

Hypertension, physical activity, and smoking can all be changed to decrease the risk of coronary artery disease. A nonmodifiable risk factor for the development of coronary artery disease is heredity or a family history of heart disease.

PTS: 1 DIF: Apply REF: Coronary Artery Disease

5.A client tells the nurse that he is planning to retire and plans to become involved with charitable organizations. The nurse realizes this client is within which of the following stages of Levinsons Theory of Adult Development?

1.

Middle Age

2.

Late Adulthood

3.

Old Age

4.

The Thirties

ANS: 2

Late adulthood spans from the ages of 56 to 75. The lower boundary of late adulthood is retirement. Individuals within this stage may become active in political or community activities. Middle age includes the ages from 40 to 55 and is characterized by a midlife transition. Old age is beyond age 75 and is marked by declining powers, health, and loss of loved ones. The Thirties is characterized by time to assess gains and life experiences.

PTS: 1 DIF: Analyze REF: Theories of Adult Development

6.A client tells the nurse that she began having a particular health problem around the onset of the Iraqi War. The nurse determines that the client is utilizing which of the following perceptions of time?

1.

Life time

2.

Social time

3.

Historic time

4.

Actual time

ANS: 3

Historic time is a time of political, social, and economic events that influence ones life. The events affect what a person does and when. Life time is the biological clock time and chronological passage of time indicated by changes in the body and reduced activity. Social time is recognized by age grading and expectations such as time to go to school, to raise a family, or retire. Actual time is not a perceived time in an adults life.

PTS: 1 DIF: Analyze REF: Table 6-2 Perceived Times in Adult Life

7.The nurse is instructing a 55-year-old client on ways to reduce the development of illnesses that are the leading cause of death for persons in the same age group. Which of the following is the nurse instructing this client?

1.

Need to wear seat belts when operating a motor vehicle

2.

Reduction of alcohol intake

3.

Need for a annual mammogram, Pap smear, and colonoscopy every 10 years

4.

Weight reduction

ANS: 3

The number one cause of death in persons aged 45 to 64 is malignant neoplasms. The nurses instructions should be on the need for annual mammograms, Pap smears, and colonoscopies every 10 years. Wearing seat belts would address unintentional injury as a cause of death. Reducing alcohol intake would address liver disease as a cause of death. Weight reduction would address heart disease and diabetes mellitus as causes of death.

PTS:1DIF:Analyze

REF:Table 6-3 The Ten Leading Causes of Death in Americans

8.A middle-aged client tells the nurse that she is scheduled for a treatment to reduce facial wrinkles and the cost is much less than a plastic surgeon. Which of the following should the nurse respond to this client?

1.

I would like to schedule the same procedure for myself.

2.

Did you research why the cost is less than a plastic surgeons?

3.

It is so much better to avoid surgery if possible.

4.

I am sure you will feel much better afterwards.

ANS: 2

When considering cosmetic treatments, the nurse should encourage the client to be leery of inexpensive prices and unrealistic claims. The nurse should respond with the question Did you research why the cost is less than a plastic surgeons? The other responses do not help the client identify risks associated with cosmetic procedures and would be inappropriate.

PTS:1DIF:Apply

REF: Patient Playbook: Cosmetic Surgery and Treatments

9.The nurse is assessing a client who experienced bariatric surgery 5 years ago. The nurse would consider the clients surgery as successful when which of the following is assessed?

1.

Current weight is 100 lbs less than the starting weight of 600 lbs.

2.

Current weight is 300 lbs with a starting weight of 450 lbs.

3.

Current weight is 200 lbs with a starting weight of 400 lbs.

4.

Current weight is 50 lbs less than the starting weight of 400 lbs.

ANS: 3

Bariatric surgery is considered successful if the client maintains a weight loss of at least 48% over the term of 5 years. The current weight of 200 lbs with a starting weight of 400 lbs indicates successful bariatric surgery. The other choices would not be considered as successful.

PTS:1DIF:AnalyzeREF:Bariatric Surgery

10.A 35-year-old female client tells the nurse that she is having difficulty managing her job, family, and the needs of her aging parents. To help this client avoid chronic illnesses later in life, which of the following should the nurse instruct?

1.

Plan to change jobs to reduce stress.

2.

Do not smoke; keep weight within normal limits; exercise.

3.

Enlist the help of her children to aid with the aging parents care.

4.

Consider not working until the children are raised.

ANS: 2

Stress-related health problems for young and middle-aged adults are associated with work, finances, and multiple responsibilities with family. Since obesity, unhealthy diets, and insufficient exercise can be precursors to chronic disease in later life, the nurse should instruct the client to begin health-promoting behaviors such as not smoking, keeping weight within normal limits, and exercising. The nurse should not suggest that the client not work or have her children help with the aging parents.

PTS:1DIF:Apply

REF:Health and Illness Trends for Young and Middle-Aged Adults

11.An elderly client tells the nurse that he does not drink much fluid because it causes him to not be able to control his urine. Which of the following should this nurse assess first in this client?

1.

Hypertension

2.

Constipation

3.

Dehydration

4.

Lower extremity edema

ANS: 3

The frail elderly may eat less and drink less fluid to avoid getting up during the night to urinate or to help decrease episodes of incontinence. Since the client admits to reducing fluid intake, the nurse should first assess him for signs of dehydration. The client may also be experiencing constipation with the reduction in fluid; however, dehydration is the priority. Hypertension and lower extremity edema may or may not be an issue with the client who is dehydrated.

PTS:1DIF:ApplyREF:The Frail Elderly

12.An adult daughter drives, completes laundry, grocery shopping, and banking for two elderly parents. Which of the following should the nurse assess for in the adult daughter?

1.

Malnutrition

2.

Dehydration

3.

Sensory deprivation

4.

Caregiver role strain

ANS: 4

The daughter is providing care to her elderly parents that includes transportation, laundry, grocery shopping, and banking. The nurse should assess the caregiver for signs of role strain. The daughter is most likely not at risk for developing malnutrition, dehydration, or sensory deprivation.

PTS: 1 DIF: Apply REF: Chronically Ill Older Adults

13.The nurse is considering a health promotion program for a middle-aged adult. Which of the following should the nurse assess prior to planning this program?

1.

When are you going to retire?

2.

How many hours of sleep do you get every night?

3.

What motivates you to learn something new?

4.

How much exercise do you get every day?

ANS: 3

In preparation for a health promotion education program, the nurse should ask the client What motivates you to learn something new? The other questions are not helpful to the nurse when planning this type of educational program.

PTS: 1 DIF: Apply REF: Patient Playbook: Health Promotion Education

MULTIPLE RESPONSE

1.The nurse is concerned that a client is developing metabolic syndrome. Which of the following did the nurse assess in this client? (Select all that apply.)

1.

Elevated high-density lipoprotein level

2.

Blood pressure 150/88 mmHg during three different assessments

3.

Fasting glucose 120 mg/dL

4.

Poor appetite

5.

Abdominal obesity

6.

Elevated triglyceride level

ANS: 2, 3, 5, 6

Metabolic syndrome is diagnosed when three or more of the following factors are present: high blood pressure, abdominal obesity, high triglyceride levels, low high-density lipoprotein cholesterol, and high fasting blood glucose levels. The assessment findings that would support the clients developing metabolic syndrome are elevated blood pressure, fasting glucose of 120 mg/dL, and abdominal obesity. Poor appetite is not a factor for the development of metabolic syndrome. Elevated high-density lipoprotein level is not a factor for the development of metabolic syndrome.

PTS:1DIF:AnalyzeREF:Metabolic Syndrome

2.During the assessment of a client, the nurse becomes concerned that the client is at risk for suicide. Which of the following assessment findings would support the nurses conclusion? (Select all that apply.)

1.

Alcohol use

2.

Use of illegal substances most days of the week

3.

Recent death of spouse

4.

Laid off from employment 6 months ago

5.

Weather preventing the planting of an annual garden

6.

Family scheduled to visit in a few weeks

ANS: 1, 2, 3, 4

Risk factors associated with an increased risk for suicide include alcohol and drug abuse, loss of a loved one, joblessness, and lack of economic security. Inclement weather and family visits are not risk factors associated with an increased risk for suicide.

PTS: 1 DIF: Analyze REF: Suicide Incidence Rates

3.The nurse is instructing a client on ways to modify the diagnosis of hypertension. Which of the following should the nurse include in these instructions?

1.

Weight reduction

2.

Low-fat, high-fiber diet

3.

Relocation to a safer community

4.

Employment counseling

5.

Advance directives

6.

Increasing activity and exercise throughout the day

ANS: 1, 2, 6

Modifiable risk factors for the diagnosis of hypertension include obesity, diet, and lifestyle. The nurse should instruct the client on weight reduction, low-fat, high-fiber diet, and increasing activity and exercise throughout the day. Relocation to a safer community, employment counseling, and advance directives are not considered factors to reduce the risk of hypertension.

PTS:1DIF:ApplyREF:Hypertension

4.The nurse is planning an instructional session for an 80-year-old client. Which of the following strategies would be helpful for the nurse to use? (Select all that apply.)

1.

Limit distractions.

2.

Use a well-lit room.

3.

Use verbal instructions and follow-up with written information to reinforce.

4.

Use computer-assisted instruction.

5.

Plan for one long session.

6.

Include a family member if possible.

ANS: 1, 2, 3, 6

Strategies to use when instructing an older client include limiting distractions, using a well-lit room, using verbal instructions with written information to reinforce instruction, and including a family member if possible. Computer-assisted instruction and planning for a long session are not strategies to use when instructing an older adult client.

PTS:1DIF:Apply

REF: Nursing Strategy 360: Strategies to Use When Interacting with the Older Adult Patient

5.Which of the following should the nurse assess regarding an elderly clients ability to adhere to a prescribed medication regime? (Select all that apply.)

1.

Average hours of sleep each night

2.

Using medications prescribed for themselves

3.

Taking full doses and not cutting doses in half

4.

Sufficient funds to purchase prescriptions

5.

Total caloric intake each day

6.

Recreational activities

ANS: 2, 3, 4

When assessing an elderly clients ability to adhere to a prescribed medication regime, the nurse should assess if the client is using medications prescribed for themselves and not someone else; if the client is taking a full dose of the medication and not cutting a dose in half or taking the medication every other day to cut the costs; and if the client has sufficient funds to purchase the prescribed medications. Average hours of sleep each night, total caloric intake each day, and recreational activities do not need to be assessed to determine if an elderly client is able to adhere to a prescribed medication regime.

PTS: 1 DIF: Apply REF: Box 6-2 Medication Use by Older Adults

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