Ch 13 Into Young and Middle

A 25-year-old male complains to the nurse that he feels embarrassed to participate in social activities because he is of very short stature. He asks the nurse to give some suggestions to increase his height. Which would be the most appropriate response given by the nurse? 1 "You cannot become taller now, because the body stops growing after a certain age." 2 "Don't worry. You will grow within 3 years." 3 "You could increase your height if you modify your diet." 4 "Many pills are available on the market that could make you taller."

1 "You cannot become taller now, because the body stops growing after a certain age." In a young adult, physical growth usually ends by age 20. Therefore, informing the patient that he cannot increase height at his age is the most appropriate response by the nurse. Modifying the diet would not help the patient become taller. The nurse should not suggest taking pills on the market that claim to increase height.

Sexually transmitted infections (STIs) continue to be a major health problem in young adults. Men ages 20 to 24 years have the highest rate of which STI? 1 Chlamydia 2 Syphilis 3 Gonorrhea 4 Herpes zoster

1 Chlamydia In 2008, 20- to 24-year-old men had the highest rate of chlamydia among all men (1056.1 per 100,000 population), with chlamydia rates in men of this age-group increasing by 12.6% from the previous year.

The nurse is teaching a group of young adults about the prevention of sexually transmitted diseases (STDs). Which intervention by the participants best indicates effective teaching? 1 Demonstrating the proper application of a condom 2 Avoiding sexual relationship with a single partner 3 Listing some common sexually transmitted diseases 4 Initiating moderate physical activity at least 5 days per week

1 Demonstrating the proper application of a condom Demonstrating the correct usage of a condom indicates effective learning by the participants. Listing common sexually transmitted diseases (STDs) indicates the participants' knowledge but does not help to prevent STDs. Engaging in a sexual relationship with a single partner may promote avoidance of STDs. Moderate physical activity promotes strength, fitness, and cardiopulmonary function in individuals.

A health care team plans to conduct Lamaze classes in their center. The nurse has been asked to study the medical records and select patients who can join the classes. Which group of people would benefit from these classes? 1 Pregnant women 2 Patients who have had a stroke 3 Girls who have recently attained menarche 4 Patients who have undergone cardiac surgery

1 Pregnant women Lamaze classes prepare pregnant women and their partners to participate in the process of childbirth. Lamaze classes are specially designed for pregnant women. Patients who have had a stroke, girls who have recently begun menarche, and patients who have undergone cardiac surgery do not require these classes.

The nurse assesses a patient with Raynaud's disease. On assessment, the nurse finds that the patient is a jackhammer operator by profession. Which is the most likely reason the patient has this disorder? 1 Vibrations 2 Cement dust 3 Metal powders 4 Radiation

1 Vibrations A jackhammer operator is exposed to continuous strong vibrations, as a result of using a jackhammer for drilling purposes. Cement dust is not known to cause Raynaud's disease. Similarly, metal powders and radiation are also not known to be causes of Raynaud's phenomenon.

The nurse has taught a group of nursing students about caffeine and its effects on the body. To evaluate student understanding, the nurse asks the students to describe the effects of catecholamine release on the body. Which answers given by the students indicate a good understanding of caffeine and its effects? Select all that apply. 1 "Catecholamine increases diuresis." 2 "Catecholamine decreases gastric secretion." 3 "Catecholamine alters the blood pressure." 4 "Catecholamine stimulates the nervous system." 5 "Catecholamine causes contraction of the skeletal muscles."

1 "Catecholamine increases diuresis." 3 "Catecholamine alters the blood pressure." 4 "Catecholamine stimulates the nervous system." Caffeine stimulates the production of catecholamine. Catecholamine acts on nerve receptors to increase diuresis and blood pressure and to stimulate central nervous system activity. Catecholamine release also causes an increase in gastric secretions and relaxation of skeletal muscles due to activation of the autonomic nervous system.

The nurse is performing a personal lifestyle assessment of a patient. Which questions should the nurse ask while performing this assessment? Select all that apply. 1 "What is your occupation?" 2 "Do you have pets at home?" 3 "How much time do you devote to exercising?" 4 "Does anyone in your family have any psychiatric disorder?" 5 "Have you ever been admitted to the hospital?

1 "What is your occupation?" 2 "Do you have pets at home?" 3 "How much time do you devote to exercising?" personal lifestyle is an important area for the nurse to assess in a patient. This assessment helps the nurse determine the risk a patient has for developing cardiac, malignant, pulmonary, renal, or other chronic diseases. While doing this assessment, the nurse should ask about the patient's occupation, whether there are pets at home, frequency of exercise, and the type of diet the patient follows. Asking if there is a history of psychiatric disorders in the family should be done when documenting the patient's family history. Information about previous medical admissions is included in documentation of past medical history.

The nurse delivers a lecture to a group of people on the benefits of regular exercise. Which statements regarding the long-term effects of exercise are correct? Select all that apply. 1 Exercise decreases insomnia. 2 Exercise decreases fatigue. 3 Exercise helps increase blood pressure. 4 Exercise decreases the size of the muscles. 5 Exercise helps decrease the resting heart rate.

1 Exercise decreases insomnia. 2 Exercise decreases fatigue. 5 Exercise helps decrease the resting heart rate. The long-term benefits of exercise include improved sleep, thereby decreasing insomnia, lowering fatigue, and decreasing the basal heart rate. The immediate effect of exercise is an increase in blood pressure, but the long-term effect reduces the blood pressure at rest. Exercise causes muscle hypertrophy over a period of time. Decrease in muscle size indicates muscle atrophy. Exercise improves so many physiologic parameters! As you review the choices for this question, you could ask yourself, "Is this a positive result for patients?" If not, then it is not likely the result of exercise. For this question, an increase in blood pressure is not a positive result, and it is not caused by exercise, so you can eliminate that choice. You know from physiology that exercise increases the size of muscles, so you can eliminate that choice as well. The other three choices are positive results produced by exercise.

Which are the most visible normal physical changes that appear in patients in the age group of 35 to 64 years? Select all that apply. 1 Graying hair 2 Wrinkling skin 3 Thickening waist 4 Drooping upper eyelid 5 Reduced peripheral vision

1 Graying hair 2 Wrinkling skin 3 Thickening waist Physical changes can be observed in the age group of 35 to 64 years. The most visible physical changes include graying of the hair and wrinkling of the skin, the latter of which occurs due to loss of subcutaneous fat. Thickening of the waist results from increased weight of individuals. Drooping of the upper eyelid, or ptosis, is related to various medical disorders. Reduced peripheral vision is an abnormal finding that occurs due to damage or blockage of internal eye structure or the optic nerve. These are abnormal changes and require evaluation in order to prevent future complications.

A pregnant woman in her first trimester approaches the nurse for a regular checkup. Which physiological changes should the nurse expect to find in the patient? Select all that apply. 1 Morning sickness 2 Breast tenderness 3 Braxton Hicks contraction 4 Milk secretion from the breast 5 Perception of fetal movements

1 Morning sickness 2 Breast tenderness The physiological changes occurring in the first trimester of pregnancy are morning sickness, breast enlargement, and breast tenderness. Braxton Hicks contraction and perception of fetal movements occur in later trimesters of pregnancy. Milk secretion usually occurs in the postpartum period.

A certified midwife has been asked to perform prenatal care for a pregnant woman. Which interventions should be included in prenatal care? Select all that apply. 1 Routine physical assessment 2 Teaching breast self-examination 3 Teaching diet for pregnant women 4 Assessing for presence of any genital or urinary tract infections 5 Teaching the workout regimen to improve athletic performance

1 Routine physical assessment 3 Teaching diet for pregnant women 4 Assessing for presence of any genital or urinary tract infections Prenatal care includes routine physical assessment, teaching about diet and exercise during pregnancy, assessing for the presence of any genitourinary infection that could adversely affect the fetus. The certified midwife should also check for signs of any genital or urinary tract infections. Prenatal classes do not include teaching self-breast examination for detection of a tumor. The certified midwife is not responsible for teaching or advising patients on performing rigorous exercise required for improving athletic performance.

Formation of positive health habits may prevent the development of chronic illness later in life. Which are examples of positive health habits? Select all that apply. 1 Routine screening and diagnostic tests 2 Unprotected sexual activity 3 Regular exercise 4 Excessive alcohol consumption 5 Driving without a seat belt

1 Routine screening and diagnostic tests 3 Regular exercise Routine screening and diagnostic tests (e.g., laboratory screening for serum cholesterol or serum glucose levels, mammography, or colonoscopy) provide early detection of health issues. Regular exercise helps to maintain weight and improve musculoskeletal functioning.

A 45-year-old obese patient wants to lose weight, and the nurse conducts a thorough assessment. Which factors may be contributing to the patient's obesity? Select all that apply. 1 The patient works in an executive position that is very demanding. 2 The patient works out at the corporate gym at 5:00 two mornings per week 3 The patient has little time to prepare meals at home and eats out at least four nights a week. 4 The patient tries to eat low-cholesterol foods to help lose weight. 5 The patient gets plenty of sleep each night.

1 The patient works in an executive position that is very demanding. 3 The patient has little time to prepare meals at home and eats out at least four nights a week. Demanding and stressful work environments can lead to frequent stress eating of nonnutritious foods. Frequently eating away from home and eating fast food have been identified as contributing factors to obesity.

The nurse assesses a pregnant woman who is a victim of intimate partner violence. Which adverse health outcomes would the nurse expect the patient to have? Select all that apply. 1 Vaginal bleeding 2 Low blood pressure 3 Preterm delivery of baby 4 Low-birth-weight infant 5 High maternal weight gain

1 Vaginal bleeding 3 Preterm delivery of baby 4 Low-birth-weight infant Pregnant women are at increased risk of being victims of intimate partner violence (IPV). Women who experience IPV are likely to delay prenatal care. The adverse health outcomes related to IPV for pregnant women are vaginal bleeding, preterm delivery of the baby, and delivering a low-birth-weight infant. Pregnant women who experience IPV are likely to have pregnancy-induced hypertension and have low maternal weight gain.

The nurse is interviewing a 19-year-old pregnant woman. The nurse discovers that the woman is a victim of intimate partner violence (IPV). Which conditions are more likely to occur in this patient? Select all that apply. 1 High blood pressure 2 Low blood pressure 3 Increased risk of diabetes 4 Delivery of a preterm infant 5 Delivery of a low-birth-weight infant

1,4,5 Intimate partner violence (IPV) was previously termed domestic violence. The pregnant woman may be at risk of developing high blood pressure due to stress. The woman may delay prenatal care, which may lead to an increased risk of preterm delivery and delivery of a low-birth-weight baby. IPV does not predispose the pregnant woman to low blood pressure or diabetes.

The nurse explains substance abuse to a group of nursing students. The nurse explains that a legalized drug is readily available in the market and is in chocolate and some over-the-counter drugs for colds, coughs, and allergies. Which drug do these substances have in common? 1 Nicotine 2 Caffeine 3 Marijuana 4 Cocain

2 Caffeine Chocolates and foods that contain chocolate, as well as over-the-counter drugs for colds, coughs, and allergies all contain caffeine. Caffeine is the most widely ingested stimulant drug in North America. These substances do not have nicotine, cocaine, or marijuana.

A 50-year-old male patient is seen in the clinic. He tells the nurse that he has recently lost his job, and his wife of 26 years has asked for a divorce. He has a flat affect. Family history reveals that his father committed suicide at the age of 53. The nurse should assess for which of the following? 1 Cardiovascular disease 2 Depression 3 Sexually transmitted infection 4 Iron deficiency anemia

2 Depression Depression is common among middle-aged adults and has a variety of causes. Risk factors for depression include disappointments or losses at work, at school, or in family relationships, along with family history.

The nurse observes factors that cause stress across various ages. The nurse assesses a group of 30-year-old adults. Which factor is most likely to cause stress in this age group? 1 Physical appearance 2 Failure in career 3 Inability to set goals in life 4 Inability to have an intimate relationship

2 Failure in career At 30 years of age, a person likely focuses on achieving success in career and/or family life. A person's failure to achieve career success may cause stress within this age group. Physical appearance and the inability to have an intimate relationship are the most likely stressors for adults 23 to 28 years of age. Inability to set any goals in life is the most likely cause of stress in adults 35 to 43 years of age.

The nurse assesses a patient who delivered a child 2 days ago. The patient is irritable, has mood swings, and overall emotional instability. Which condition do these signs indicate? 1 Schizophrenia 2 Postpartum depression 3 Postpartum psychosis 4 Bipolar mood disorder

2 Postpartum depression Dramatic physical and psychological changes occur following childbirth, causing some women to experience postpartum depression. The signs of this condition include mild irritability, mood swings, and emotional instability. Postpartum women are unlikely to have schizophrenia. Clinical manifestations of postpartum psychosis are very severe; the patient may have delusions, hallucinations, thoughts of harming the baby, unwillingness to eat or sleep, risk of suicide, and severe depression. The mood swings in postpartum depression are not as severe as seen in a bipolar mood disorder.

The nurse performs a routine health assessment of a patient who is a glass worker. In addition to the routine health assessment, which other test should the patient have? 1 Patch test 2 Visual acuity 3 Liver function test 4 Pulmonary function test

2 Visual acuity Glass workers are constantly exposed to heat, solvents, and metal powders. This makes them susceptible to develop cataracts. The visual acuity test is one of the tests for determining loss of vision due to cataracts. A patch test is used to diagnose the presence of contact dermatitis. Unlike cement and automobile workers, glass workers are less likely to develop dermatitis. Unlike dry cleaners, glass workers are less likely to develop liver conditions; thus, these patients need not be referred for liver function testing. Unlike agricultural workers and cement workers, glass workers are less likely to develop lung disorder; therefore, they need not be referred for a pulmonary function test.

The nurse teaches a group of nursing students about perimenopause and menopause. Which statement about perimenopause is true? 1 Women no longer have menstruation cycles. 2 Women experience irregularities in their menstrual cycles. 3 Women no longer produce estrogen or progesterone. 4 Women's neurohormonal system fails to stimulate the endocrine system.

2 Women experience irregularities in their menstrual cycles Perimenopause is the period before menopause when the ovarian function starts declining. Ova production decreases and menstrual cycles become irregular. The cessation of menses, the cessation of the production of estrogen and progesterone, and failure of the neurohormonal system to stimulate the endocrine system are characteristics of menopause.

The nurse is instructing a group of students about physical changes that occur in young and old adults. Which statement given by the nurse is correct? 1 Younger adults are less active than older adults. 2 Younger adults have less severe physical illnesses than older adults. 3 Younger adults have less tendency to ignore physical symptoms than older adults. 4 Younger adults are more likely to seek health care than older adults.

2 Younger adults have less severe physical illnesses than older adults. Older adults report more severe physical illnesses than younger adults. Younger adults are generally more active than older adults and have a greater tendency to ignore physical symptoms related to illnesses than older adults. Younger adults are also more likely to postpone seeking health care when compared to older adults.

Which factors affect a young adult's adherence to decisions about smoking cessation? Select all that apply. 1 Workplace 2 Desire to learn 3 Family history 4 Education level 5 Socioeconomic status

2 Desire to learn 4 Education level 5 Socioeconomic status Factors that could affect a young adult's adherence to decisions include the desire to learn or acquire new skills, self-motivation, educational level, and socioeconomic status of the patient. A workplace is not responsible for a young adult's adherence to smoking cessation. Family history has no role with the young adult's adherence to lifestyle modification such as smoking cessation.

A 19-year-old male is diagnosed with diabetes. The patient belongs to a very low socioeconomic status group and has never gone to school. He informs the nurse that he is willing to learn anything to be healthy. Which factors in this patient may hinder adherence to a treatment regimen? Select all that apply. 1 Gender 2 Education level 3 Motivation 4 Desire to learn 5 Socioeconomic status

2 Education level 5 Socioeconomic status Factors such as low socioeconomic class and low education level may interfere in making decisions related to adherence to treatment regimen. The patient may not have access to health care services and may not be able to afford treatment due to low economic status. Due to his low education level, the patient may not be able to understand the self-care instructions provided and the consequences of untreated diabetes. However, the patient has a high motivation level and the desire to learn, which could help him follow the nurse's instructions. Gender has no bearing on treatment decisions.

Which information should the nurse find in the personal lifestyle assessment section of the medical history of a patient? Select all that apply. 1 Educational level Correct2 Hobbies Correct3 General life satisfaction Correct4 Home condition and pets Correct5 Diet, sleep, and sexual habits

2 Hobbies 3 General life satisfaction 4 Home condition and pets 5 Diet, sleep, and sexual habits The nurse performs a personal lifestyle assessment in order to identify a patient's habits that increase the risk of illnesses. The assessment components include general life satisfaction, hobbies, and interests; home condition and pets; and diet, sleep, exercise, and sexual habits. This assessment helps to identify the interventions that the patient needs to reduce unhealthy lifestyle behaviors. Educational level is not included in the personal lifestyle assessment.

A middle-aged patient who has been smoking for the past 10 years expresses that it is hard to quit this habit. The patient also seems to smoke more during times of stress. Which measures should the nurse implement to help the patient tackle the stress? Select all that apply. 1 Emphasize the regular use of sedatives. 2 Teach relaxation therapy. 3 Teach ways to increase stress resistance. 4 Promote the use of alcohol to overcome stress. 5 Emphasize minimizing the frequency of stress-producing situations.

2 Teach relaxation therapy. 3 Teach ways to increase stress resistance. 5 Emphasize minimizing the frequency of stress-producing situations. Techniques to overcome stress include the use of relaxation techniques, imagery, and biofeedback mechanisms. Elevating self-esteem, improving assertiveness, redirecting goals, and reorienting appraisal are various methods of increasing stress resistance. Habituation, time blocking, time management, change avoidance, and environmental modification are methods of reducing stress-producing situations. Use of sedatives and alcohol are not medically acceptable modes of overcoming stress.

With the exception of pregnant or lactating women, by what age has the young adult usually completed physical growth? 1 18 2 20 3 25 4 30

20

The nurse taught a group of nursing students the changes that occur during adulthood. To evaluate how well the students understood the instruction, the nurse asks them why middle adults are referred to as the "sandwich generation." What is the most appropriate response? 1 "They tend to move out of the home and become melancholic." 2 "They do not like being burdened by looking after children or their parents." 3 "They become responsible for their children and look after their parents too." 4 "They are focused on their careers and are unable to look after their parents."

3 "They become responsible for their children and look after their parents too." The middle-aged adult years extend from the mid-thirties to the late sixties. During middle age, people help their aging parents and are also responsible for their own children. Thus, this generation is referred to as the sandwich generation. Middle-aged adults typically do not move out of their homes and become melancholic. Middle-aged adults enjoy looking after children and their parents; they have a sense of commitment and do not feel their parents and children are a burden. Middle-aged adults are usually settled in their careers and focused on their families.

A 50-year-old patient has elevated cholesterol profile values that increase the patient's cardiovascular risk factor. One method to control this risk factor is to identify current diet trends and describe dietary changes to reduce the risk. What form of nursing activity does this represent? 1 Referral 2 Counseling 3 Health education 4 Stress management technique

3 Health education The nurse is engaged in health education as she offers dietary information to enable the patient to make decisions about dietary health practices in an attempt to lower cholesterol.

The nurse is completing an assessment of a patient, age 24. Following the assessment, the nurse notes that the physical and laboratory findings are within normal limits. Based on these findings, which intervention would be most appropriate? 1 Instructing the patient to return in 2 years 2 Instructing the patient in secondary prevention 3 Instructing the patient in health promotion activities 4 Implementing primary prevention with vaccines

3 Instructing the patient in health promotion activities Although young adults generally have a minimum of major health problems, lifestyles such as tobacco or alcohol abuse, risky sexual activity, obesity, and lack of physical activity put them at risk for health problems. Instructing young adults in health-promotion activities can decrease lifestyle-related health issues.

Which best describes a lay doula? 1 A person who assists in personal tasks of a mother 2 A woman who is skilled in aiding the deliveries of babies 3 A certified health care provider focused on the care of patients 4 A support person to assist women who have no other source of support during labor

4 A support person to assist women who have no other source of support during labor A lay doula is a support person present during labor to assist women who may not have another source of support. A person who assists in personal tasks of a mother during or after delivery is known as an assistant. A midwife is a woman who is skilled in aiding the deliveries of babies. The nurse is a certified health care provider focused on the care of patients.

A 34-year-old executive has a job with frequent deadlines. When deadlines appear the executive has a tendency to eat high-fat, high-carbohydrate foods. The executive also gets frequent headaches and stomach pain during these deadlines. The nurse provides a number of options, and the executive chooses yoga. How is yoga used in this scenario? 1 As an outpatient referral 2 As a counseling technique 3 As a health promotion activity 4 As a stress-management technique

4 As a stress-management technique Relaxation techniques such as imagery, biofeedback, and yoga help recondition the patient's response to stress. Yoga is an ancient practice of controlling body and mind through physical and mental harmony. It is frequently used as an effective intervention for stress and stress-related physical symptoms.

A patient is laboring with her first baby, which is coming 2 weeks early. Her husband is in the military and might not get back in time, and neither family is able to be with her during labor. Which support person employed by the birthing area is the doctor most likely to call in to be present during labor? 1 Nurse 2 Midwife 3 Assistant 4 Lay doula

4 Lay doula A lay doula is a support person who is present during labor to assist women who have no other source of support. This woman has no family available to support her during the laboring process and delivery. Although the nurse and a midwife would be supportive during labor, the scope of practice for nurses and midwives far exceeds that of a support person present during labor. An assistant is incorrect.

Sharing eating utensils with a person who has a contagious illness increases the risk of illness. Which gives rise to this type of health risk? 1 Lifestyle 2 Community 3 Family history 4 Personal hygiene habits

4 Personal hygiene habits In all age groups personal hygiene habits can be risk factors for the spread of contagious diseases. Sharing eating utensils with a person who has a contagious illness increases the risk of illness. Sharing utensils is not a lifestyle, community, or family history risk.

A patient in the labor room has been seen and cared for by an obstetrician, a midwife, and a lay doula. What is the role of the lay doula? 1 To deliver the infant 2 To give pain medications to the patient in labor 3 To check the vital signs when the patient is in labor 4 To provide emotional support and physical assistance to the patient in labor

4 To provide emotional support and physical assistance to the patient in labor The lay doula is a support person who is present during labor to assist women who have no other source of support. The lay doula does not have a medical background and is not licensed to give pain medications to the patient or check vital signs. The obstetrician delivers the infant. Only a licensed nurse practitioner or health care provider can administer pain medications. The nurse checks the patient's vital signs when the patient is in labor.

A middle-aged patient who has been smoking for the past 10 years finds it hard to quit this habit. Which nursing interventions would be helpful in changing the patient's smoking habit? Select all that apply. 1 Offer positive reinforcement. 2 Emphasize milder brands of cigarettes. 3 Explain physiological principles of changing habits. 4 Inform the patient that being motivated may be of little help in quitting smoking. 5 Provide information about the impact of this behavior on health.

A middle-aged patient who has been smoking for the past 10 years finds it hard to quit this habit. Which nursing interventions would be helpful in changing the patient's smoking habit? Select all that apply. Correct1 Offer positive reinforcement. 3 Explain physiological principles of changing habits. 5 Provide information about the impact of this behavior on health. Positive reinforcement techniques are effective in changing human habits, and they act as motivating factors for further reducing negative habits. Explaining the physiological principles behind quitting smoking helps the patient to overcome the grief that may be associated with quitting. Even though most smokers know the health concerns, further emphasis on the serious effects of smoking may be helpful. Smoking milder brands, even though they contain less nicotine, does not help in quitting this habit. With strong willpower and motivation, many patients have overcome the habit of smoking.