Health Promotion Throughout The Life Span 7th Edition by Carole Lium Edelman -Test Bank

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Health Promotion Throughout The Life Span 7th Edition by Carole Lium Edelman -Test Bank

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Health Promotion Throughout The Life Span 7th Edition by Carole Lium Edelman -Test Bank

Edelman: Health Promotion Throughout the Life Span, 7th Edition

Chapter 02: Emerging Populations and Health

Test Bank

MULTIPLE CHOICE

  1. Which of the following statements is true about race?
a. Races can be distinguished very easily by physical properties.
b. Races can be distinguished easily by biological properties.
c. There is more variation within races than between them.
d. Racial taxonomies are more of a biological category than a social one.

 

ANS:   C

Research data indicate that there is more variation within races than between them. Races cannot be distinguished easily by physical or biological properties. Racial taxonomies are more of a social category than a biological one.

 

DIF:    Cognitive Level: Knowledge             REF:    29-30

 

  1. Which of the following terms is appropriately defined as a collective identity, a sense of uniqueness within the larger society, and a distinction from nonmembers?
a. Culture
b. Ethnicity
c. Race
d. Social standing

 

ANS:   B

Ethnicity is defined as a collective identity, a sense of uniqueness within the larger society, and a distinction from nonmembers.

 

DIF:    Cognitive Level: Knowledge             REF:    30

 

  1. Which of the following is a result of racial categorization?
a. Hispanic persons at the top of the social ladder, with white, black, and other minority persons beneath them
b. Policies and societal arrangements that limit the opportunities of stigmatized groups
c. Social class intermarriage and poverty that are apparent in developing countries
d. Interracial marriage that ultimately relieves a community of racial discrimination

 

ANS:   B

Racial categories reflect some of the inequalities that have emerged as attitudes and beliefs about racial groups have become policies and societal arrangements, thus limiting the opportunities of stigmatized groups.

 

DIF:    Cognitive Level: Application             REF:    30

 

  1. The term Arab:
a. Is a cultural and linguistic designation
b. Refers to a race of people in the Middle East
c. Refers to an ethnic group of people in the Middle East
d. Refers to Islamic populations in the Middle East

 

ANS:   A

The term Arab is a cultural, linguistic, and to some extent, political designation.

 

DIF:    Cognitive Level: Knowledge             REF:    33

 

  1. Which of the following is true in relation to acculturation and diabetes in Arab Americans?
a. Arab Americans are genetically predisposed to diabetes
b. Acculturation is responsible for higher rates of diabetes among Arab Americans
c. Adopting Western habits of healthy diets explains lower rates of diabetes among acculturated Arab Americans
d. Acculturation is unrelated to incidence of diabetes among Arab Americans

 

ANS:   C

Post-Westernizationadopting healthy Western health habitsis associated with lower rates of diabetes among acculturated Arab Americans.

 

DIF:    Cognitive Level: Application             REF:    33

 

  1. What would be the most appropriate health-related reason that a nurse could use to suggest to newly immigrated Asian American parents that their child should attend public school?
a. The child will get a good education.
b. According to law, all children must go to school.
c. The child can get health care at school.
d. Exposure to different cultures in school will enhance socialization.

 

ANS:   D

Exposure to different cultures in school facilitates the adoption of other cultural beliefs and aids in the socialization of the child into a new environment.

 

DIF:    Cognitive Level: Application             REF:    34-35

 

  1. The interrelationship of poverty and health care dollars spent by Blacks and other minorities is affected greatly by:
a. Lack of access to preventive health care services
b. Low numbers of minority health care providers
c. Use of emergency rooms for care
d. Increased infant mortality rates in Black populations

 

ANS:   A

A decrease in resources for preventive care leads to the use of emergency rooms and other more expensive health care services that are often used as resources when severe illness occurs.

 

DIF:    Cognitive Level: Synthesis                REF:    39

 

  1. In most minority groups, cultural beliefs related to health:
a. Transcend individuality
b. Are characteristically the same
c. Are transmitted from one generation to the next
d. Share some similar characteristics but have individual variations

 

ANS:   D

Although cultures share some similar beliefs, health beliefs must be assessed and managed on an individual basis. Being a member of a socially defined culture does not mean that ones health beliefs and practices are the same as those of all other members of that cultural group.

 

DIF:    Cognitive Level: Synthesis                REF:    35 | 38 | 40

 

Edelman: Health Promotion Throughout the Life Span, 7th Edition

Chapter 12: Exercise

Test Bank

MULTIPLE CHOICE

  1. Which 67-year-old is at most risk of developing coronary heart disease?
a. One on a beta-blocker for hypertension
b. One with a total cholesterol level of 201
c. One who does not participate in any form of regular physical activity
d. One with a family history of Type 2 Diabetes Mellitus

 

ANS:   C

Physical inactivity affects more people in the development of coronary heart disease than any other risk factor. At any level or combination of risk factors, sedentary individuals are at greater risk of developing coronary heart diseases. Exercise provides both primary and secondary prevention. Thus, the person who does not participate in any form of regular physical activity is at most risk of developing coronary heart disease.

 

DIF:    Cognitive Level: Application             REF:    295

 

  1. During an office visit, a nurse provides counseling to a 70-year-old female with osteoporosis who is otherwise very healthy. The nurse should advise the woman to:
a. Avoid all forms of exercise due to the risk of fractures
b. Walk with a partner at least 30 minutes a day 5 days a week
c. Use a wheelchair to get around so that she can prevent falls
d. Take a step aerobic class 5 days a week

 

ANS:   B

Regular physical activity helps maintain functional independence and improve quality of life throughout the aging process. The benefits of exercise have been documented for both healthy and chronically ill older adults. Exercise improves bone mineral density, especially weight-bearing activities such as walking, aerobic, and dance. Women 30 to 40 years past menopause also need to consider decreasing the risk of fractures by preventing falls. Advanced age and osteoporosis should not exclude anyone from exercise. Therefore, walking with a partner provides the exercise that is needed as well as a companion to help prevent falls or notify someone if a fall occurs.

 

DIF:    Cognitive Level: Application             REF:    294-295 | 299 | 301

 

  1. A 51-year-old woman begins menopause. The nurse emphasizes the importance of a diet high in calcium and vitamin D as well as exercise because by the time she is 56 it would be common for her to have experienced an additional:
a. 3% bone loss
b. 7% bone loss
c. 10% bone loss
d. 15% bone loss

 

ANS:   D

The rate of bone loss accelerates rapidly during the first 5 postmenopausal years, with annual losses of 3% to 5% being common. 3% x 5 years (56 51) = 15%.

 

DIF:    Cognitive Level: Application             REF:    299

 

  1. The estimated maximum heart rate (MHR) for a 42-year-old woman is:
a. 126
b. 142
c. 178
d. 184

 

ANS:   C

A generic formula for determining MHR is 220 minus age. 220 42 = 178.

 

DIF:    Cognitive Level: Application             REF:    304

 

  1. The most appropriate form of exercise for someone with moderate osteoarthritis of the knees is:
a. Step aerobics
b. Running
c. Water aerobics
d. Bike riding

 

ANS:   C

Water activities are good exercise alternatives for people with musculoskeletal limitations who need some weight relief with exercise. The water provides buoyancy while also providing resistance to the limbs as they move. Studies have also demonstrated that people who participate in aquatic exercise experienced greater pain reduction than those who participated in land activities. Thus, water aerobics would be the most appropriate form of exercise for this individual.

 

DIF:    Cognitive Level: Synthesis                REF:    300 | 306

 

  1. When discussing exercise intensity with a client, which medication may limit the usefulness of heart rate as an indicator of exercise intensity?
a. Ciprofloxacin (Cipro)
b. Metoprolol (Toprol)
c. Atorvastatin (Lipitor)
d. Lansoprazole (Prevacid)

 

ANS:   B

Beta-blockers may alter the relationship between heart rate and the rate of perceived exertion. Metoprolol is a beta-blocker and thus may limit the usefulness of heart rate as an indicator of exercise intensity.

 

DIF:    Cognitive Level: Application             REF:    305

 

  1. The nurse is discussing an exercise prescription with a client. To help the client determine the appropriate intensity, she tells him that he should monitor his rate of perceived exertion. She tells him while exercising he should be:
a. Talking and singing without difficulty
b. Extremely fatigued
c. Having mild musculoskeletal discomfort
d. Out of breath

 

ANS:   C

The rate of perceived exertion helps people determine a comfortable, beneficial level of exercise intensity. Being slightly short of breath, able to talk with difficulty, being pleasantly fatigued, and having mild musculoskeletal pain reflect a rate of perceived exertion which corresponds well with 50% to 85% of maximum heart rate, an appropriate target range for most individuals.

 

DIF:    Cognitive Level: Knowledge             REF:    305

 

  1. An appropriate heart rate range for a 40-year-old person to maintain while exercising is:
a. 70 to 140 beats/min
b. 80 to 143 beats/min
c. 90 to 153 beats/min
d. 100 to 180 beats/min

 

ANS:   C

The maximum heart rate for a 40-year-old is 180. Exercise should produce a heart rate that is 50% to 85% of maximum heart rate; this percentage corresponds to a rate of perceived exertion of 11 to 14. 50% of 180 = 90, 85% of 180 = 153. Thus, the range should be 90 to 153.

 

DIF:    Cognitive Level: Application             REF:    304-305

 

  1. A nurse is discussing resistance training with a 24-year-old female. The woman is resistant to weight lifting because she does not want to get too muscular. She prefers a program that is strictly aerobic. The appropriate response from the nurse would be:
a. Ok, just make sure you perform one hour of aerobics everyday.
b. Lifting weights is a necessary part of exercise.
c. Weight lifting has many purposes and benefits; can we talk about them?
d. Looking muscular at your age is attractive.

 

ANS:   C

Weight training helps develop healthy muscles that provide strength to perform activities of daily living (ADLs) without injury and it stimulates bone health. Additionally, the risk of injury outweighs the benefits of aerobic exercise more than 5 days a week. Not all weight lifting leads to a bodybuilder physique. Offering the patient the opportunity to discuss weight training will allow the patient the opportunity to open up and discuss fears and concerns. It also provides the nurse with the opportunity to discuss the risks and benefits.

 

DIF:    Cognitive Level: Synthesis                REF:    304 | 306

 

  1. A woman is going for a 2-hour hike in the Grand Canyon. She should be encouraged to bring at least:
a. One bottle of water with her
b. Two bottles of water with her
c. One bottle of Gatorade with her
d. Two bottles of Gatorade with her

 

ANS:   D

If the weather is hot, 5 to 12 oz of fluid should be taken every 15 to 20 minutes during exercise. Additionally, if exercise lasts more than 1 hour, a drink that provides carbohydrates and electrolytes helps delay fatigue and improve performance.

 

DIF:    Cognitive Level: Application             REF:    309-310 (Table 12-2)

 

  1. The best way for an occupational health nurse to promote regular activity at her institution is to:
a. Educate all employees regarding the benefits of exercise
b. Initiate a lunchtime walking group that employees can join
c. Provide all employees with an exercise prescription
d. Recommend that employees who do not exercise be terminated from their positions in the institution

 

ANS:   B

Individuals are more likely to initiate and maintain physical activity if they feel competent doing the activity, feel safe doing it, perceive no negative financial or social cost, can access the activity easily on a regular basis, and can fit the activity into their regular schedule. Knowledge is not enough to sustain activity. Role models are helpful. Initiating a lunchtime walking group demonstrates enthusiasm on the part of the nurse, provides an activity that is easy and mastered by most and provides a social activity that can promote reinforcement by others who participate.

DIF:    Cognitive Level: Synthesis                REF:    294 (Box 12-2) | 305 | 313-314

 

  1. The best approach for a person who states he is ready to start exercising is:
a. Do nothing because he has already made the decision to implement a change
b. Provide him with information on the benefits of exercising
c. Develop an exercise prescription with him
d. Schedule a follow-up in 2 months to see if he still feels the same way

 

ANS:   C

Working with a client to choose an activity that he likes will improve adherence. The client is displaying that he is in the action phase of change, and he should be given a prescription that promotes exercise and places him in the maintenance phase.

 

DIF:    Cognitive Level: Synthesis                REF:    313-314

 

  1. During an office visit, a nurse meets with a woman who states she does not have time to exercise. The best approach for this client is to:
a. Do nothing because she has already made the decision to not exercise
b. Provide her with information on the benefits of exercising
c. Develop an exercise prescription with her
d. Schedule a follow-up in 2 months to see if she still feels the same way

 

ANS:   B

The client is in the precontemplation state and thus should not be forced into a plan at this time. However, exercise has many benefits and it implementation should be encouraged. The nurse should continue to ask at each visit because when individuals are counseled by clinicians they are more likely to increase physical activity. As a result, providing the client with information regarding the benefits of exercising and bringing up the topic of exercise is the best approach at this stage.

 

DIF:    Cognitive Level: Synthesis                REF:    294 | 313-314

 

  1. A 19-year-old with Type 1 Diabetes Mellitus plans to play tennis with a friend. To avoid hypoglycemia, the woman should:
a. Inject the insulin into her abdomen
b. Inject the insulin into her arm
c. Inject the insulin into her thigh
d. Avoid any insulin product before she exercises

 

ANS:   A

When insulin is injected in a muscle that will be active, it will speed up the absorption of insulin and quickly decrease blood glucose. Because tennis involves a lot of leg and arm movement, insulin should be given in the abdomen. Additionally, not all insulins have the same onset or duration of action. Changes in insulin dosage schedules should not be made without knowing the onset or duration of action.

 

DIF:    Cognitive Level: Synthesis                REF:    297 | 312 (Box 12-5)

 

  1. During a home visit, a nurse notes that the client with hypertension lives on the 3rd floor of a subsidized housing project on a busy road with no sidewalks and few street lights. The best recommendation for exercise that the nurse can make for this client would be:
a. Do not exercise because you have high blood pressure
b. Use the stairs whenever you are entering or leaving the building
c. Go for short walks around the block during the daytime only
d. Purchase an exercise bike

 

ANS:   B

Exercise decreases blood pressure and thus should be encouraged in those with hypertension, especially aerobic activity. Participation in physical activity depends on the availability of facilities and a safe environment. Walking in the road is not safe, and it is also unlikely that this client who lives in a subsidized housing project has the funds to purchase an exercise bike. Therefore, using the stairs as much as possible would be a safe, inexpensive form of exercise for this person.

 

DIF:    Cognitive Level: Synthesis                REF:    295-296 | 314

 

  1. The best exercise to reduce pain in someone with lower back pain is:
a. Walking
b. Pilates
c. Swimming
d. Bike riding

 

ANS:   B

Maintaining proper curves of lordosis and kyphosis in the vertebrae is important for sustaining the spring and shock absorption quality of the spine. Poor posture can increase stress on the back and lead to pain. Exercises that train the paraspinal muscles to improve posture (like Pilates) are effective for people with lower back pain. Aerobic activity is recommended to maintain endurance and prevent debilitation from inactivity.

 

DIF:    Cognitive Level: Synthesis                REF:    301

 

  1. Which individual would require more attention and assistance in starting an exercise program?
a. A White male who works 50 to 60 hours a week as a business executive
b. An unemployed, obese Hispanic woman
c. An employed White woman with hypertension
d. A White male with a high school diploma

 

ANS:   B

The number of adults with no leisure-time physical activity varies by race, ethnicity, gender, education level, geographic location, disability status, and age. Women are less active than men. Lower income and less educated people are not as physically active as those with higher socioeconomic and educational levels. In addition, African Americans and Hispanics are less active. The unemployed, obese Hispanic woman has three risk factors for inactivity: (1) she is unemployed and therefore likely has no or a low income level; (2) she is a woman; and (3) she is Hispanic. All of these factors place her at risk for inactivity.

 

DIF:    Cognitive Level: Synthesis                REF:    292 | 313

 

  1. A primary prevention method for obesity is to:
a. Encourage an active lifestyle during childhood years
b. Prescribe orlistat (Alli)
c. Recommend the Jenny Craig program
d. Recommend gastric banding surgery

 

ANS:   A

Exercise is an important component of primary prevention. Less active children increase their risk of sedentary lifestyles as adults. Sedentary lifestyles lead to obesity. Therefore, a primary prevention method for obesity is to encourage an active lifestyle during the childhood years.

 

DIF:    Cognitive Level: Application             REF:    292 | 294

 

  1. The best exercise to prevent osteoporosis in a 35-year-old woman is:
a. Walking
b. Swimming
c. Weight training
d. Bike riding

 

ANS:   A

Weight-bearing activities have a positive effect on bone density, and walking is a weight-bearing activity. In young women, the goal is to increase bone mineral density; thus, walking is the best exercise to prevent osteoporosis in this woman.

 

DIF:    Cognitive Level: Application             REF:    299

 

  1. Activity that uses large muscle groups in a repetitive, rhythmic fashion over an extended period to improve the efficiency of the oxidative energy producing system and improve cardiorespiratory endurance is known as:
a. Aerobic activity
b. Anaerobic activity
c. Flexibility
d. Muscular fitness

 

ANS:   A

Aerobic activity is defined as activity that uses large muscle groups in a repetitive, rhythmic fashion over an extended period to improve the efficiency of the oxidative energy producing system and improve cardiorespiratory endurance.

 

DIF:    Cognitive Level: Knowledge             REF:    292

 

  1. According to the physical activity and fitness section of the Healthy People 2010 report, what percentage of adults 18 years of age or older report no leisure-time physical activity?
a. 10%
b. 20%
c. 30%
d. 40%

 

ANS:   D

According to the physical activity and fitness section of the Healthy People 2010 report, 40% of adults 18 years of age or older report no leisure-time physical activity.

 

DIF:    Cognitive Level: Knowledge             REF:    292

 

  1. A 10-year-old with a BMI at the 80th percentile is considered to be:
a. Normal weight
b. Overweight
c. Obese
d. Morbidly obese

 

ANS:   A

A child or adolescent is categorized as being overweight if his or her BMI is in the 95th percentile of age- and gender-specific BMI growth charts. Thus, the 10-year-old with a BMI at the 80th percentile is considered to be normal weight.

 

DIF:    Cognitive Level: Knowledge             REF:    293

 

  1. A 40-year-old with a BMI of 32 is considered to be:
a. Normal weight
b. Overweight
c. Obese
d. Morbidly obese

 

ANS:   C

An adult 20 years of age or older is considered overweight if his or her BMI is 25 to 29.9, obese if his or her BMI is 30 or higher, and morbidly obese if his or her BMI is 40 or higher. Thus, the 40-year-old with a BMI of 32 is considered obese.

 

DIF:    Cognitive Level: Application             REF:    293

  1. According to the 20032004 National Health and Nutrition Examination Survey, what percentage of 6- to 11-year-olds are overweight?
a. 14.8%
b. 18.8%
c. 24.8%
d. 28.8%

 

ANS:   B

According to the 20032004 National Health and Nutrition Examination Survey conducted by the CDCs National Center for Health Statistics, 18.8% of 6- to 11-year-olds are overweight.

 

DIF:    Cognitive Level: Knowledge             REF:    293

 

  1. What percentage of adults aged 75 years and older engage in no leisure-time physical activity?
a. 35%
b. 45%
c. 55%
d. 65%

 

ANS:   D

According to the Healthy People 2010 report, 65% of adults aged 75 years and older engage in no leisure-time physical activity.

 

DIF:    Cognitive Level: Knowledge             REF:    295

 

  1. An inborn set of physiological changes that offset those of the fight or flight response is known as:
a. Self-efficacy
b. Catecholamine surge
c. Relaxation response
d. Metabolism

 

ANS:   C

Relaxation response is an inborn set of physiological changes that offset those of the fight or flight response.

 

DIF:    Cognitive Level: Knowledge             REF:    308

 

MULTIPLE RESPONSE

 

  1. Select the individual(s) who should receive a recommendation for a minimum of 30 minutes of activity on most days of the week. Select all that apply.
a. A 54-year-old with hypercholesterolemia
b. A 66-year-old with hypertension
c. A 48-year-old with obesity
d. A 58-year-old with Type 2 Diabetes Mellitus

 

ANS:   A, B, D

The risk of CHD decreases with an increase in physical activity. Exercise positively affects lipoprotein metabolism and is a common part of the treatment for hypertriglyceridemia. Regular exercise also decreases blood pressure in adults. Exercise improves glycemic control by increasing insulin sensitivity in people with Type 2 Diabetes Mellitus. Exercise also has a positive effect on obesity. However, the American College of Sports Medicine recommends a minimum of 40 to 60 minutes of exercise 5 to 7 days a week for those with obesity.

 

DIF:    Cognitive Level: Application             REF:    295-297

 

  1. A well-written exercise prescription includes which of the following? Select all that apply.
a. Frequency of exercise
b. Intensity level of exercise
c. Time and duration of exercise
d. Type of exercise

 

ANS:   A, B, C, D

An exercise prescription should include frequency of exercise, intensity level of exercise, time and duration of exercise, and type of exercise.

 

DIF:    Cognitive Level: Knowledge             REF:    304

 

Edelman: Health Promotion Throughout the Life Span, 7th Edition

Chapter 24: Older Adult

Test Bank

MULTIPLE CHOICE

  1. When planning health promotion projects, the nurse should keep in mind that the fastest growing population is comprised of:
a. Children under the age of 12
b. Young Black American adults
c. White middle-age adults
d. Non-White older adults age 65 and older

 

ANS:   D

Older adults age 75 and above are the fastest growing population in the United States, and the percentage of White Americans over the age of 65 is decreasing compared to other ethnic groups.

 

DIF:    Cognitive Level: Knowledge             REF:    620

 

  1. A nurse interested in conducting a health promotion program for older adult Korean Americans will be most successful if he or she:
a. Relies on family members to teach their elders the majority of the information
b. Plans for weekly meetings during which topics of interest are discussed
c. Focuses on changing dietary habits
d. Uses printed material as the presentation method

 

ANS:   B

Research has demonstrated that structured programming has the greatest impact on the target audience. As with any age group, discussing topics of interest to the participants yields the greatest benefit.

 

DIF:    Cognitive Level: Analysis                  REF:    622

 

  1. Which of the following statements made by a client best identifies someone who will benefit from health-promotion interventions?
a. I have a new grandchild and want to be part of her life.
b. My mother lived until she was 90, so a long life is in my genes.
c. Some chronic illness is just a part of aging.
d. I hope Ill live a lot longer, but one never knows.

 

ANS:   A

Motivation to adopt a healthy lifestyle is a primary predictor of successful interventions. Feeling that illness is just part of aging or leaving health up to chance will not help the person make necessary lifestyle changes.

 

DIF:    Cognitive Level: Application             REF:    623-624

 

  1. Which of the following statements concerning nutrition and older adults is true?
a. Older adults who live in their own homes are more likely to be malnourished than older adults living in a nursing home.
b. Older adults lose their desire for high-fat, salty foods.
c. Meals served in long-term care institutions are usually more well-balanced than foods eaten by older adults living at home.
d. Most older adults are not aware of food assistance programs.

 

ANS:   D

The percent of older adults who live in their own homes and are malnourished is lower than that of older adults who live in a nursing home. Older adults do not lose their desire for high-fat/cholesterol, high-sodium foods. Fresh fruits and vegetables are not always available for older adults living in nursing homes.

 

DIF:    Cognitive Level: Comprehension       REF:    624-625

 

  1. Which of the following statements concerning urinary incontinence is correct?
a. Urge incontinence occurs when someone has the urge to void but cannot empty the bladder
b. Stress incontinence is associated with emotional turmoil
c. Overflow incontinence occurs when someone laughs or sneezes
d. Physiological changes cause overflow incontinence

 

ANS:   D

Stress incontinence occurs when someone coughs or sneezes, urge incontinence occurs when someone cannot wait to void once the urge to void is felt, and overflow incontinence is caused by physiological changes that affect voiding, such as an enlarged prostate gland.

 

DIF:    Cognitive Level: Knowledge             REF:    625

 

  1. Which of the following nursing diagnoses is a priority related to the problem of urinary incontinence?
a. Risk for social isolation
b. Risk for impaired skin integrity
c. Risk for inadequate fluid intake
d. Risk for impaired coping

 

ANS:   B

Although social isolation and decreased fluid intake may occur because of urinary incontinence, impaired skin integrity is a major concern because of its impact on physical and psychological health.

 

DIF:    Cognitive Level: Analysis                  REF:    625-626

 

  1. A 75-year-old client tells the nurse that he has difficulty staying asleep during the night. Which response made by the nurse is correct?
a. Older adults need as much sleep as middle-age and younger adults. Lets talk about your sleep patterns.
b. Ill ask the nurse practitioner to prescribe a sleeping pill for you.
c. Taking naps during the day can help relieve excessive fatigue and will help you sleep better.
d. Lets talk about your sleep schedule and things that may prevent you from getting a restful nights sleep.

 

ANS:   D

Older adults need less sleep than younger adults. Daytime naps may prevent sleeping adequately at night. Medications to assist in sleeping are not the initial therapy choice because of side effects.

 

DIF:    Cognitive Level: Application             REF:    628

 

  1. The nurse conducting a community education program about cognition in older adults should stress that:
a. Some form of mild dementia is a normal part of aging
b. All forms of dementia have the same symptoms, but progress at different rates
c. Assessment for dementia should be part of routine physical exams
d. Elders who score below 27 points on the Mini-Mental State Exam (MMSE) are not likely to have a cognition problem

 

ANS:   C

Dementia is not a normal part of aging. Dementia symptoms vary according to the specific type of dementia. A score of 23 or lower on the MMSE indicates a problem with cognition.

 

DIF:    Cognitive Level: Comprehension       REF:    628-629

 

  1. The new unit nurse manager of a long-term care unit should include which of the following directives for staff nurses?
a. Encourage residents to participate in unit activities such as Scrabble and bingo
b. Demonstrate the caring aspect of nursing by dressing residents before breakfast
c. Fill in missing words during conversation with the residents in order to avoid embarrassment
d. Instruct the aides to get residents ready for breakfast as quickly as possible in order to make sure that they are ready to eat

ANS:   A

Residents should be encouraged to perform self-care activities themselves. When help is required, it should be provided in an unhurried manner. Filling in missing words makes the resident dependent on the staff and reduces motivation to communicate, and the words supplied may not be the intended words.

 

DIF:    Cognitive Level: Analysis                  REF:    629-630

 

  1. Which of the following menus is recommended for older adults?
a. One egg over easy, one slice of whole wheat toast with sugar-free jam, 4-oz orange juice
b. 5-oz cheeseburger cooked medium well with lettuce and tomato, 10 baked potato chips, and 1 cup of decaf coffee with low-fat milk and artificial sweetener
c. Chef salad with 2 oz each ham and turkey, lettuce, tomato, bean sprouts, onion, green pepper with low-fat dressing, and one small roll with low-fat spread
d. Turkey bacon, lettuce, and tomato sandwich on whole wheat bread with two teaspoons of low-fat mayonnaise, 10 vegetable chips, and ice tea with artificial sweetener

 

ANS:   D

Older adults should not consume raw or undercooked eggs, raw sprouts, or undercooked beef.

 

DIF:    Cognitive Level: Analysis                  REF:    630-631

 

  1. Which of the following people is at greatest risk of injury?
a. An 80-year-old who does not have air conditioning or a fan
b. A 70-year-old who has new dentures
c. A 68-year-old who has difficulty tasting salt in food
d. An 84-year-old who needs hearing aids

 

ANS:   A

Sweating decreases in older adults, predisposing them to heat stroke.

 

DIF:    Cognitive Level: Evaluation              REF:    631

 

  1. According to Eriksons theory of development, which of the following older adults has successfully navigated the stage of ego integrity versus despair?
a. A 72-year-old male who is reluctant to retire because work is everything to me
b. A 78-year-old female who has scheduled her third face lift
c. An 80-year-old male who has informed his children that he has made his funeral arrangements
d. A 67-year-old female who is depressed because she has not been promoted at work for the past 10 years

 

ANS:   C

Successfully navigating the stage of ego integrity versus despair requires that the individual accept normal bodily changes associated with aging, find meaning in life apart from work, accepts the inevitability of death, and is at peace with his or her life.

 

DIF:    Cognitive Level: Analysis                  REF:    631-632

 

  1. A nurse conducting a staff development program about human sexuality for nurses who work in long-term care facility is correct in stating:
a. The desire for sexual intimacy declines rapidly with age.
b. Older adults are very well-informed about sexuality.
c. Older adults need to practice safe sex.
d. The danger of contracting STDs during sexual intimacy is extremely low in older adults.

 

ANS:   C

The desire for sexual intimacy remains a primary force throughout life. Older adults need teaching related to safe sexual practices, STD transmission, and so on. HIV infection is a concern in all age groups.

 

DIF:    Cognitive Level: Application             REF:    633

 

  1. The clinic nurse has seen the following four clients today. Which of the clients is demonstrating a healthy coping pattern?
a. The client who discusses very little except the loss of her husband 3 years ago
b. The client who talks about the good times she and her husband had prior to his illness and death 1 year ago
c. The client who states that life is not worth living without her husband, who died 2 years ago
d. The client who blames herself for her husbands death because she did not make him go to the doctor

 

ANS:   B

Research has demonstrated that rumination, self-blame, and catastrophisizing have negative effects on coping, while positive reappraisal has a positive effect.

 

DIF:    Cognitive Level: Application             REF:    633-634

 

  1. A nurse is assigned to provide care for a 96-year-old bedridden client who experiences severe pain from a chronic neurological disease. The client asks the nurse to please help him leave this world so that his suffering ends. According to the 1994 ANA position statement about assisted suicide, the nurse should:
a. Assist the doctor with the clients request
b. Refuse to care for the client
c. Contact the pain care specialist
d. Provide the clients family with names of doctors who participate in assisted suicide

ANS:   C

The 1994 ANA position statement stresses that nurses should not participate in assisted suicide. Refusing to care for the client could be construed as abandonment and is not necessary. Consulting a pain care specialist is the correct action.

 

DIF:    Cognitive Level: Application             REF:    634-635

 

  1. During a home visit occurring in the summer, the nurse should assess for which of the following items in the home?
a. Fan
b. Porch chair
c. Synthetic blend clothing
d. Thermometer

 

ANS:   A

Older adults are susceptible to heat stroke. The availability of a fan will help cool the ambient air. Light-weight cotton clothing breathes and facilitates cooling, while synthetic material retains heat.

 

DIF:    Cognitive Level: Evaluation              REF:    635-636

 

  1. The community health nurse has obtained a grant to offer a Safe Driving series for older adults. What information should the nurse stress during the series?
a. Traffic fatalities involving older adults occur mainly at dusk
b. The cause of two-vehicle accidents is frequently an older driver striking another car
c. The average blood alcohol level in older adults involved in accidents is higher than the blood alcohol level of younger drivers involved in accidents
d. Relearning the art of defensive driving can help reduce the likelihood that an older driver will be involved in a motor vehicle accident

 

ANS:   D

Traffic fatalities involving older adults occur mainly during the daytime. The cause of two vehicle accidents is frequently a younger driver striking the car driven by an older adult. The average blood alcohol level in older adults involved in accidents is lower than the blood alcohol level of younger drivers involved in accidents.

 

DIF:    Cognitive Level: Knowledge             REF:    636-637

 

  1. As part of a community-wide flu vaccination program for older adults, the nurse is assisting at a vaccination clinic. What question should the nurse ask prior to administering the vaccine?
a. Do you have any food allergies?
b. Have you had the pneumococcal vaccine?
c. Have you had the flu in the past 5 years?
d. Do you have Medicare?

ANS:   A

An allergy to eggs is a contraindication to receiving flu vaccine grown in chick embryo cells.

 

DIF:    Cognitive Level: Application             REF:    637

 

  1. A 72-year-old client comes to the clinic complaining of sweating at night, a loss of appetite, and a fever. He is accompanied by his daughter who reports that her father has periods of acute confusion. The priority nursing intervention related to this client is to:
a. Prepare the client for a chest x-ray
b. Inform the daughter that her father will likely need to take medication for 10 days to cure the infection
c. Prepare to perform a tuberculin skin test
d. Ask the daughter if her father had a flu vaccine within the past 4 months

 

ANS:   A

This clients signs and symptoms indicate an active TB infection. If the active infection is confirmed by chest x-ray, he will need a 9-month course of treatment. A tuberculin skin test is useful for routine screening. This client has classic signs of TB, not the flu.

 

DIF:    Cognitive Level: Application             REF:    637

 

  1. The son of a 70-year-old client dying of cancer asks the nurse to tell him about the Hospice program, so he can help his father decide if the program would be of benefit to him. The nurse should reply:
a. At Hospice, your father will be heavily medicated, so he will not experience pain.
b. All of your fathers care will be provided by nurses at Hospice.
c. Hospice care can take place either at home or in a Hospice facility.
d. Visiting hours are about the same at Hospice as they are here in the hospital.

 

ANS:   C

The focus of Hospice care is to help the client remain alert but free of pain. Families are encouraged to participate in care giving. There are no restrictions to visiting hours.

 

DIF:    Cognitive Level: Application             REF:    641

 

  1. Which of the following statements is correct concerning cultural views of older adults?
a. In the Anglo-Saxon Protestant culture, older adults are an important part of the family.
b. The older an East Asian person is, the more respect they receive from others in the family.
c. In Hispanic families, older adults are expected to live on their own.
d. Black Americans have similar views about caring for older adults as do White Americans.

 

ANS:   B

In the Anglo-Saxon Protestant culture, older adults are expected to live independently and not be dependent on their children. Many Hispanic families live in multigenerational households. Black Americans show more respect to older adults in their communities than do White Americans.

 

DIF:    Cognitive Level: Knowledge             REF:    621 (Multicultural Awareness box)

 

MULTIPLE RESPONSE

 

  1. A couple in their 60s has assumed responsibility for raising their two grandchildren ages 9 and 12 because the childrens parents died in a car accident. The priority nursing interventions that the nurse can implement in order to help the grandparents cope with the responsibility of raising their grandchildren include which of the following? Select all that apply.
a. Providing contact information about a Grandparents Raising Grandchildren support group
b. Reminding them that they successfully raised their own children and encourage them to discuss parenting skills
c. Providing them with contact information about counselors who specialize in custodial grandparent issues
d. Reminding them that the stress they currently are experiencing will lessen as they gain confidence

 

ANS:   A, C

Stress experienced by grandparents who must raise grandchildren can be lessened by counseling and participation in support groups.

 

DIF:    Cognitive Level: Application             REF:    632

 

  1. A nurse has accepted a position as director of health services in a retirement community. Which of the following statements is important for the nurse to

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