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Wold: Basic Geriatric Nursing, 5th Edition
Chapter 02: Theories of Aging
Test Bank
MULTIPLE CHOICE
a. | proves how different influences affect a particular phenomenon. |
b. | attempts to explain and give some logical order to observations. |
c. | is a collection of facts about a particular phenomenon. |
d. | shows a relationship among facts about a particular phenomenon. |
ANS: B
A theory is an unproven concept that attempts to explain and give some logical order to observations. For a theory to become a fact, there must be reproducible evidence.
DIF: Cognitive Level: Comprehension REF: 28 OBJ: 1
TOP: Fact vs. Theory KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
a. | each person will age exactly like those in the previous generation. |
b. | a biological clock ticks off a predetermined number of cell divisions. |
c. | genetic traits can overcome environmental influences. |
d. | age-related physical changes are controlled only by genetic factors. |
ANS: B
The biological theory of programmed process suggests that there is a biologic clock set with a predetermined number of cell divisions that will occur before the introduction of the aging process.
DIF: Cognitive Level: Application REF: 28 OBJ: 2
TOP: Biological Theory KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
a. | the presence of a master gene prolongs youth. |
b. | genes interact with each other to resist aging. |
c. | specific genes target specific body systems to initiate system deterioration. |
d. | the activation of harmful genes initiates the aging process. |
ANS: D
The Gene Theory suggests that there is an activation of harmful genes that initiate the aging process.
DIF: Cognitive Level: Application REF: 28 OBJ: 2
TOP: Gene Theory KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
a. | free radical |
b. | molecular |
c. | neuroendocrine |
d. | crosslink |
ANS: A
The free radical theory identifies free radicalsunstable moleculesthat will cause aging after accumulation in the body.
DIF: Cognitive Level: Application REF: 29 OBJ: 2
TOP: Free Radical Theory KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
a. | wear-and-tear |
b. | free radical |
c. | neuroendocrine |
d. | molecular |
ANS: A
The wear-and-tear theory suggests that health maintenance practices will prevent wear and tear on the cells of the body and will delay the aging process.
DIF: Cognitive Level: Analysis REF: 29 OBJ: 2
TOP: Wear-and-Tear Theory KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
a. | relating thyroid function to age-related changes. |
b. | the effects of adrenal corticosteroids, which inhibit the aging process. |
c. | stimulation and/or inhibition of the hypothalamus, causing age-related changes. |
d. | adrenal medulla inhibition of epinephrine, causing age-related changes. |
ANS: C
The neuroendocrine theory proposes that the hypothalamus stimulates or inhibits the pituitary gland to produce hormones that initiate the aging process.
DIF: Cognitive Level: Application REF: 29 OBJ: 2
TOP: Neuroendocrine Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
a. | focus on methods to delay the aging process. |
b. | are directed at decreasing depression in the older adult. |
c. | are organized to enhance the perception of aging. |
d. | attempt to explain responses to the aging process. |
ANS: D
Psychosocial theories attempt to explain the various responses of persons to the aging process.
DIF: Cognitive Level: Comprehension REF: 30 OBJ: 3
TOP: Focus of Psychosocial Therapies KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
a. | justifies ageism. |
b. | addresses the diversity of older adults. |
c. | does not clarify the aging process. |
d. | diminishes the self-esteem of the older adult. |
ANS: A
The disengagement theory seems to justify ageism by proposing that there is a mutual desire between the community and the older adult to be disengaged. According to the theory, this desire apparently does not diminish self-esteem because the older adult desires to be disengaged.
DIF: Cognitive Level: Application REF: 30 OBJ: 3
TOP: Disengagement Theory KEY: Nursing Process Step: N/A
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
a. | Newmans developmental |
b. | the life course |
c. | the activity |
d. | the disengagement |
ANS: C
Purposeful activity increases self-esteem and maintains cognitive function well into older age.
DIF: Cognitive Level: Application REF: 30 OBJ: 3
TOP: Activity Theory KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
a. | takes special care to dress for dinner in a manner that pleases his tablemates. |
b. | asks permission to sit on the patio with other residents. |
c. | asks persons in his hall if his television is bothering them. |
d. | wears a large cowboy hat at all times because he likes it. |
ANS: D
Jung describes a successful adjustment to aging as being accepting and valuing of self regardless of the view of others.
DIF: Cognitive Level: Application REF: 30 OBJ: 3
TOP: Jungs Developmental Theory KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
a. | avoiding animal fat. |
b. | use of antioxidants. |
c. | building up muscle mass. |
d. | outdoor exercise. |
ANS: B
Individuals who follow this theory believe that free radicals can be reduced by antioxidants such as vitamins A, C, E, zinc, and phytochemicals.
DIF: Cognitive Level: Comprehension REF: 29 OBJ: 2
TOP: Antioxidants KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
a. | Jung. |
b. | Havighurst. |
c. | Erikson. |
d. | Newmon. |
ANS: B
Havighurst proposes that the process of aging is defined by adjusting to the loss of a spouse, establishing a relationship with ones own age group, and establishing a satisfactory living arrangement.
DIF: Cognitive Level: Application REF: 30 OBJ: 3
TOP: Havighurst KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
MULTIPLE RESPONSE
a. | arthritis |
b. | colon cancer |
c. | osteoporosis |
d. | diabetes |
e. | atherosclerosis |
ANS: A, D, E
Cancer and osteoporosis are not considered to be diseases that accumulate free radicals.
DIF: Cognitive Level: Application REF: 29 OBJ: 2
TOP: Free Radical Influence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
a. | consistently eats high-nutrient, low-calorie foods |
b. | maintains a regular exercise program |
c. | consumes 2000 to 3000 mL of fluid a day |
d. | supports the diet with adequate fat-soluble vitamins |
e. | eats only organically grown foods |
ANS: A, B
This new theory encourages high-nutrient, low-calorie foods combined with regular exercise to delay the aging process.
DIF: Cognitive Level: Application REF: 30 OBJ: 2
TOP: Calorie Restriction Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
a. | wisdom and integrated self-image |
b. | comparing self with others |
c. | understanding self and relationships |
d. | seeking anothers opinion of his or her achievement |
e. | acceptance of self |
ANS: A, C, E
Acceptance of self and understanding self and relationships with accumulated wisdom is the goal of Erikson. Seeking the opinion of others suggests that the older adult is experiencing doubt and gloom, which are negative outcomes according to Erikson.
DIF: Cognitive Level: Application REF: 30 OBJ: 2
TOP: Eriksons Developmental Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
a. | fruits |
b. | vegetables |
c. | organ meat |
d. | folic acid |
e. | vitamin D |
ANS: A, B, D
Antioxidants can be obtained largely from fruits and vegetables. Organ meat and vitamin D are not antioxidants.
DIF: Cognitive Level: Comprehension REF: 29 OBJ: 4
TOP: Antioxidants KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
COMPLETION
ANS: error
The error theory proposes that errors in ribonucleic acid protein synthesis cause changes such as decreased muscle mass, increased body fat, and changes in reproductive function.
DIF: Cognitive Level: Comprehension REF: 28-29 OBJ: 2
TOP: Error Theory KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
ANS: rate; living
The rate of living theory proposes that individuals have a finite number of breaths or heartbeats that are used up over a period of time.
DIF: Cognitive Level: Comprehension REF: 28 OBJ: 2
TOP: Rate of Living Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
Wold: Basic Geriatric Nursing, 5th Edition
Chapter 20: Sleep and Rest
Test Bank
MULTIPLE CHOICE
a. | stage 1 nonrapid eye movement (NREM). |
b. | stage 3 NREM. |
c. | stage 5 NREM. |
d. | rapid eye movement (REM) sleep. |
ANS: B
Stage 3 NREM is the initial phase of deep sleep in which there is complete muscular relaxation and vital signs begin to decline.
DIF: Cognitive Level: Comprehension REF: 329, Box 20-1
OBJ: 1 TOP: Deep Sleep KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | stage 1 NREM. |
b. | stage 2 NREM. |
c. | stage 4 NREM. |
d. | REM sleep. |
ANS: C
Stage 4 NREM is the deepest stage of sleep in which sleep walking is most likely to occur.
DIF: Cognitive Level: Comprehension REF: 329, Box 20-1
OBJ: 1 TOP: Sleep Walking
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | increase in angiotensin |
b. | decrease in insulin |
c. | increase in growth hormone |
d. | decrease in melatonin |
ANS: D
A decrease in the melatonin level causes age-related sleep disturbances.
DIF: Cognitive Level: Application REF: 329 OBJ: 1
TOP: Hormonal Changes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | sleep initiation |
b. | sleep maintenance |
c. | terminal |
d. | undifferentiated |
ANS: C
Terminal insomnia is a sleep disturbance in which the patient consistently wakes at an early hour and cannot return to sleep.
DIF: Cognitive Level: Application REF: 330 OBJ: 2
TOP: Terminal Insomnia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | initiation related to anxiety of relocation. |
b. | maintenance related to unfamiliar environment. |
c. | initiation related to depression associated with relocation. |
d. | maintenance related to episodes of nocturnal movement disorders. |
ANS: A
Sleep initiation issues are usually associated with anxiety.
DIF: Cognitive Level: Application REF: 330 OBJ: 2
TOP: Insomnia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
a. | His loud snoring and jerking awake wakes me up, too. |
b. | I am black and blue from his kicking me every night. |
c. | He wakes up at 2 AM every morning and walks around the house. |
d. | His constant leg movements tear up the covers and keep me awake. |
ANS: B
Myoclonus is a periodic kicking movement of the lower extremities, which can be severe.
DIF: Cognitive Level: Application REF: 330 OBJ: 2
TOP: Myoclonus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | chronic obstructive pulmonary disease (COPD). |
b. | any form of dementia. |
c. | hypertension. |
d. | sleep apnea. |
ANS: D
Sedation may prevent the patient with sleep apnea to awaken to restore respiration.
DIF: Cognitive Level: Application REF: 330, Table 20-1
OBJ: 3 TOP: Lorazepam KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
a. | provide a heavy snack at bedtime. |
b. | reschedule the 8 PM albuterol inhalation treatment to 4 PM. |
c. | coach the resident in 10 minutes of exercise before bedtime. |
d. | provide a cola drink, strong tea, or cocoa at bedtime. |
ANS: B
Albuterol is a drug that may interfere with sleep schedules.
DIF: Cognitive Level: Analysis REF: 331, Table 20-2
OBJ: 7 TOP: Insomnia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
a. | increase fluids. |
b. | avoid aged cheese and red wine. |
c. | decrease sodium intake. |
d. | avoid excessive exposure to the sun. |
ANS: D
Trazodone makes persons photosensitive.
DIF: Cognitive Level: Application REF: 330, Table 20-1
OBJ: 7 TOP: Trazodone KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
a. | take two tablets of a sedative medication. |
b. | get up and do a mild stretching exercise for 15 minutes. |
c. | remain in bed with his eyes closed. |
d. | get up and read until he feels sleepy and then return to bed. |
ANS: D
Getting up and reading or watching TV is more restful than experiencing the frustration of inability to fall asleep. Sleep-inducing drugs frequently have a negative effect on older adults, exercising is stimulating, and lying in bed may increase tension.
DIF: Cognitive Level: Application REF: 331 OBJ: 7
TOP: Insomnia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | stimulating inspiration to be deeper. |
b. | taking over respiratory activity when the patient ceases to breathe. |
c. | sounding an alarm if respirations have ceased. |
d. | keeping alveoli from collapsing. |
ANS: D
The use of CPAP keeps alveoli from collapsing and causing periodic apnea.
DIF: Cognitive Level: Comprehension REF: 332 OBJ: 7
TOP: Continuous Positive Airway Pressure Machine
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
a. | myoclonus. |
b. | restless legs syndrome. |
c. | rapid eye movement (REM) sleep disorder. |
d. | epilepsy. |
ANS: C
REM sleep disorders excite excessive muscle activity during a nightmare, which causes the patient to thrash about to the point that he or she falls out of bed.
DIF: Cognitive Level: Application REF: 332 OBJ: 5
TOP: REM Sleep Disorder KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | 30 minutes |
b. | 1 hour |
c. | 2 hours |
d. | 3 hours |
ANS: C
Exercise should be avoided within 2 hours of bedtime because activity increases the metabolic rate and may interfere with sleep.
DIF: Cognitive Level: Knowledge REF: 334 OBJ: 7
TOP: Exercise KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | increased digestive processes in the bowel. |
b. | episodes of nocturia. |
c. | gastroesophageal reflux. |
d. | changes in body temperature. |
ANS: B
Reduced fluid intake in the evening will prevent nocturia, which interrupts sleep.
DIF: Cognitive Level: Knowledge REF: 334-335 OBJ: 7
TOP: Nocturia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | bright lights during the daytime. |
b. | dim lights to promote relaxation. |
c. | appropriate environmental temperature. |
d. | curtains for privacy. |
ANS: A
Bright lights during the day support normal circadian rhythm. Environmental temperature control and privacy are important but do not affect circadian rhythm.
DIF: Cognitive Level: Application REF: 333 OBJ: 7
TOP: Circadian Rhythm KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
MULTIPLE RESPONSE
a. | shift work |
b. | time zone changes |
c. | altered nutrition |
d. | illness |
e. | medications |
ANS: A, B, D, E
Nutrition does not alter diurnal patterns. All other options have the potential to alter the diurnal patterns of the older adult.
DIF: Cognitive Level: Knowledge REF: 328 OBJ: 1
TOP: Factors That Disrupt Diurnal Patterns
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | increased blood pressure |
b. | drop in core temperature |
c. | diminished food intake |
d. | diminished hormone production |
e. | decreased exposure to light |
ANS: B, E
Decrease in body temperature and diminished light exposure cause circadian changes, which result in going to bed early and rising early.
DIF: Cognitive Level: Analysis REF: 329 OBJ: 2
TOP: Age-Related Changes in Circadian Rhythm
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | confusion |
b. | urinary retention |
c. | hypotension |
d. | depression of respiration |
e. | diarrhea |
ANS: A, B, C
Benadryl can cause confusion, urinary retention, and hypotension in the older adult.
DIF: Cognitive Level: Application REF: 330, Table 20-1
OBJ: 7 TOP: Antihistamines as Sedatives KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
a. | relaxation therapy |
b. | taking a cool bath or shower before bedtime |
c. | listening to relaxing music |
d. | arranging the sleep environment to promote sleep |
e. | going to bed at a regular time after observing routine sleep rituals |
ANS: A, C, D, E
Taking a cool bath or shower will not promote relaxation. All other options listed would encourage sleep.
DIF: Cognitive Level: Comprehension REF: 331, Health Promotions
OBJ: 7 TOP: Insomnia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | obesity |
b. | diabetes |
c. | hypotension |
d. | African American heritage |
e. | use of alcohol |
ANS: A, B, D, E
Hypotension does not contribute to sleep apnea. All other options are considered to be factors that contribute to sleep apnea.
DIF: Cognitive Level: Comprehension REF: 331-332 OBJ: 5
TOP: Sleep Apnea KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
a. | snores loudly |
b. | interrupts snoring with several seconds of silence |
c. | complains of daytime drowsiness |
d. | frequently is incontinent of urine |
e. | has episodes of myoclonus |
ANS: A, B, C
Incontinence and myoclonus are not associated with sleep apnea.
DIF: Cognitive Level: Application REF: 331-332 OBJ: 5
TOP: Sleep Apnea KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | using the minimum light necessary when making rounds |
b. | making necessary sleep interruptions at the same time every night |
c. | keeping conversational noise at the nursing station to a minimum |
d. | answering call lights promptly |
e. | providing heavy blankets for warmth |
ANS: A, B, C, D
Heavy blankets may initially feel warm to the resident but eventually make the resident uncomfortable and unable to sleep. All other options listed will help diminish sleep interruptions.
DIF: Cognitive Level: Comprehension REF: 332-333 OBJ: 7
TOP: Sleep Support KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
a. | inability to sleep throughout the night |
b. | sleeping soundly all night |
c. | increase in the number of hours asleep at night |
d. | difficulty in arousing from deep sleep |
e. | waking up early |
ANS: A, E
The older adult has a decreased number of hours of sleep, wakes early, and rarely sleeps soundly.
DIF: Cognitive Level: Knowledge REF: 329 OBJ: 3
TOP: Effects of Disease Processes on Sleep
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
a. | I dont know why everything seems to bother me lately. |
b. | Ive been so clumsy. |
c. | Im having trouble concentrating. |
d. | My daughter says I talk in my sleep. |
e. | I cry for no reason at all. |
ANS: A, B, C, E
Sleep talking occurs within the sleep cycle. Irritability, increased accidents, difficulty paying attention, and altered emotional stability are symptoms of an altered sleep and rest pattern.
DIF: Cognitive Level: Comprehension REF: 328 OBJ: 3
TOP: Changes in Sleep and Rest Patterns
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
COMPLETION
ANS: 7.5; 7 1/2
DIF: Cognitive Level: Knowledge REF: 328 OBJ: 2
TOP: Sleep Requirements KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
ANS: tryptophan
DIF: Cognitive Level: Comprehension REF: 334 OBJ: 7
TOP: Tryptophan KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
ANS: circadian
diurnal
DIF: Cognitive Level: Knowledge REF: 328 OBJ: 1
TOP: Circadian Rhythm KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
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