Ch. 23: Middle-Age Adult

A community health nurse is caring for a variety of different people in the community. Which of the following individuals would the nurse recognize as being at risk to experience increased stress related to family dynamics? (Select all that apply.) a. A 54-year-old couple whose young adult daughter and grandson move back into their home b. A 44-year-old single mother raising three adolescent children without child support c. A 60-year-old couple whose children have established successful careers in another state d. A 36-year-old couple whose child plays competitive tennis

a. A 54-year-old couple whose young adult daughter and grandson move back into their home b. A 44-year-old single mother raising three adolescent children without child support d. A 36-year-old couple whose child plays competitive tennis

Which of the following individuals is at risk for developing osteoporosis? (Select all that apply.) a. A 55-year-old man who is on a low dose of oral prednisone every day because of rheumatoid arthritis b. A 40-year-old woman who works as a secretary c. A 60-year-old woman who walks three miles a day d. A 50-year-old man who works as a mason

a. A 55-year-old man who is on a low dose of oral prednisone every day because of rheumatoid arthritis b. A 40-year-old woman who works as a secretary

Which of the following middle-age adults has successfully transitioned to Erikson's generativity-versus-stagnation stage of development? a. A 60-year-old woman who retired last year and volunteers at a homeless shelter 2 days a week b. A 63-year-old man who regrets his career choice and feels he cannot change careers at this late stage of his life. c. A 45-year-old woman who resents having to care for her aging mother-in-law d. A 50-year-old man who has not saved for retirement and also spends his discretionary income on solo vacations.

a. A 60-year-old woman who retired last year and volunteers at a homeless shelter 2 days a week.

A 45-year-old care recipient who has experienced a ten pound weight gain during the past year asks the nurse if she thinks iron supplements would help increase her energy. Which of the following would be the most appropriate action for the nurse to take? a. Ask the care recipient to describe her daily activity and diet. b. Leave a note requesting an iron supplement on the care recipient's chart for the doctor. c. Provide the care recipient with information related to aerobic exercise classes. d. Ask the care recipient if she is still menstruating.

a. Ask the care recipient to describe her daily activity and diet.

Which of the following medications is generally recommended to help preserve cardiovascular health in middle-age women? a. Aspirin b. Folic acid c. Estrogen d. Estrogen receptor modulator

a. Aspirin

Which of the following diseases disproportionately affects non-Hispanic black persons? These persons are affected with a greater incidence than what would be expected based on population demographics OR because they have a higher morbidity/mortality for the disease as compared to Whites. (Select all that apply.) a. Cancer b. Heart disease c. HIV disease d. Osteoporosis

a. Cancer b. Heart disease c. HIV disease

A nurse has received a grant to provide a community-based education series for middle-age adults. Which of the following topics would allow the nurse to have the greatest impact on the health of members of this age group? a. Diet and exercise b. Seat belt use c. Depression screening d. Cancer prevention

a. Diet and exercise

The occupational health nurse is asked to develop a plan to reduce work-related injuries. Which of the following recommendations would the nurse implement as the most effective way to reduce work-related injuries? a. Make the work environment smoke-free. b. Reduce environmental noise levels. c. Conduct regular walk-through assessments at the work site. d. Increase paid personal days from one to three.

a. Make the work environment smoke-free.

The occupational health nurse working for a large corporation is a member of a task force to improve the work environment. Which of the following suggestions by the nurse would help to improve work conditions? (Select all that apply.) a. On-site walking paths b. On-site food vendors c. On-site counseling services d. On-site meetings of support groups such as Alcoholics Anonymous

a. On-site walking paths c. On-site counseling services d. On-site meetings of support groups such as Alcoholics Anonymous

Which of the following statements is correct concerning lifestyle change programs? a. Programs lasting 8 to 12 weeks are appropriate. b. Evaluation components should be discouraged in the interest of increasing enrollment and participation. c. Cultural factors, but not corporate policies, should be included in the content. d. All of the above statements are correct.

a. Programs lasting 8 to 12 weeks are appropriate.

Which of the following statements about alcohol intake is correct? a. Women have a higher death rate related to alcoholism than men. b. A woman who drinks two glasses of wine per day with her evening meal is considered a moderate drinker. c. More women than men are considered problem drinkers. d. Women who experience fewer cognitive effects from drinking are less likely to drink excessively.

a. Women have a higher death rate related to alcoholism than men.

A nurse conducted a 5-week education series about health maintenance. Which of the following statements by a participant indicates the analysis stage of cognition as defined by Bloom's taxonomy? a. "If I eat too much food and do not exercise, I will gain weight." b. "Fat is more calorie-dense than is protein. If I eat calorie-dense foods and do not moderately exercise at least 5 days a week, I will gain weight." c. "I will walk briskly at least a mile a day, 6 days a week, to maintain a healthy weight." d. "I can eat more if I exercise more."

b. "Fat is more calorie-dense than is protein. If I eat calorie-dense foods and do not moderately exercise at least 5 days a week, I will gain weight."

The nurse collects the following assessment data from a woman: Hispanic ethnicity, BMI 29 kg/m2, age 41. Which of the following actions should be taken by the nurse? a. Encourage the care recipient to continue her dietary and exercise patterns. b. Discuss her current dietary and exercise lifestyle habits. c. Formulate a plan for increased exercise incorporating her preferences for type of exercise. d. Encourage the care recipient to adopt a low-calorie diet to help control her weight.

b. Discuss her current dietary and exercise lifestyle habits.

An occupational health nurse is planning injury-prevention educational sessions. Which of the following considerations should be made by the nurse? a. Food handlers should have TB testing every 2 years. b. Employees may need to be educated concerning the use of protective clothing or devises when needed. c. OSHA rules apply to all companies with more than 25 employees. d. In a union shop, the union steward's approval is needed to remove a worker from a job.

b. Employees may need to be educated concerning the use of protective clothing or devises when needed.

A 62-year-old person states to the nurse, "I have trouble with my peripheral vision. Sometimes, I do not notice objects unless they are in front of me." Which of the following disorders is the client likely experiencing? a. Presbyopia b. Glaucoma c. Cataracts d. Diabetic retinopathy

b. Glaucoma

A nurse is conducting a community education program. Which of the following should be stressed the leading cause of death in middle-age adults? a. Automobile accidents b. Malignant disease c. Homicide d. Suicide

b. Malignant disease

A nurse has been asked to develop a visit plan for a mobile mammogram van. Which of the following considerations would be made by the nurse when deciding which neighborhoods to visit? a. Hispanic women have the highest rate of breast cancer as compared to other demographic groups in the United States. b. The death rate from breast cancer is higher in Hispanic women than for women in other ethnic groups. c. The death rate from breast cancer in Hispanic women has risen in the past 10 years. d. Breast cancer in Hispanic women is usually diagnosed at an early stage.

b. The death rate from breast cancer is higher in Hispanic women than for women in other ethnic groups.

A 63-year-old woman complains to the nurse that she has insomnia and sleeps only 6 h a night. Which of the following responses should be made by the nurse? a. "Prescription sleeping pills are preferable. Over-the-counter sleeping aids have more undesirable side effects" b. "Make sure that you do not nap during the day, even if you are tired." c. "Do you feel excessively tired during the day?" d. "The nurse practitioner may want to run some simple tests to find out why you are having trouble sleeping."

c. "Do you feel excessively tired during the day?"

A 52-year-old woman going through menopause tells the nurse working in the women's health center that she is interested in slowing down the aging process and asks if she should take estrogen. Which of the following statements would be the best response by the nurse? a. "The latest research has shown that estrogen is safe to take and will help keep you healthy. I'll tell the nurse practitioner that you are interested in estrogen therapy." b. "Estrogen is safe to take for about 10 years. I'll get you some information on estrogen therapy that you can take home and read." c. "The safety of long-term estrogen therapy is inconclusive. It is primarily used short-term to relieve hot flashes." d. "You can get the same effects from natural products in a health food store, and each product is backed up by research showing that it is effective."

c. "The safety of long-term estrogen therapy is inconclusive. It is primarily used short-term to relieve hot flashes."

A 35-year-old person asks the nurse working in a dermatology clinic what causes skin to wrinkle. Which of the following statements would be most appropriate way for the nurse to reply? a. "It is simply a part of normal aging and it is not preventable" b. "As we age, we develop more cellulite under the skin which results in wrinkles." c. "Wrinkles appear for a number of reasons, including loss of fat beneath your skin and too much sun exposure." d. "Wrinkles are caused by genetic factors combined with Vitamin D deposits under the skin."

c. "Wrinkles appear for a number of reasons, including loss of fat beneath your skin and too much sun exposure."

A nurse working in a rural location is interested in starting a weight management group for care recipients in the area. Which of the following interventions is most likely to ensure success? a. Using a pre-set list of topics for discussion to be sure to cover all important areas b. Using standardized, validated State materials/tools to relay information to the group c. Asking for a list of topics that interest the group d. Beginning each session with a 1 to 2-mile walk

c. Asking for a list of topics that interest the group

Which of the following effects of divorce on middle-age adults and children has been documented by research? a. Children adapt to divorce more rapidly than do adults. b. Emotional healing after a divorce takes approximately 24 months in adults. c. Children of divorced parents may have emotional effects lasting for decades d. Children of divorced parents undergo similar emotional turmoil as their parents.

c. Children of divorced parents may have emotional effects lasting for decades.

A nurse formed a political action committee to advocate for health insurance for the uninsured. On which of the following populations would the nurse focus the group's efforts? a. Asian Americans b. Blacks c. Hispanic Americans d. Working-poor White Americans

c. Hispanic Americans

Which of the following is a normal physiological change that occurs during middle age? a. Increase in gastric emptying resulting in acid reflux b. Reduction in height resulting in kyphosis c. Reduction of glomerular filtration by 50% d. Increase in the amount of estrogen produced in both genders

c. Reduction of glomerular filtration by 50%

A 52-year-old postmenopausal woman tells the nurse that she is afraid she will develop osteoporosis like her mother did. Which of the following statements is the most appropriate response by the nurse? a. "The American diet is much better now than when your mother was your age." b. "You have a strong genetic risk factor. The odds are that you will also develop osteoporosis." c. "You need about 1000 mg of calcium a day to keep your bones strong. Let's talk about your diet." d. "Tell me about your diet, how much walking you do each day, and what medications you take."

d. "Tell me about your diet, how much walking you do each day, and what medications you take."

Which of the following people has exceeded the recommended guidelines for activity? a. A 36-year-old man who engages in bike riding and has a pulse rate of 137 during activity b. A 45-year-old woman who swims and has a pulse rate of 145 during activity c. A 50-year-old man who jogs and has a pulse rate of 120 during activity d. A 60-year-old woman who walks briskly to achieve a pulse rate of 135 during activity

d. A 60-year-old woman who walks briskly to achieve a pulse rate of 135 during activity

The occupational health nurse is planning a health fair for employees. Which of the following information about dental health should be included? a. Drinking bottled water helps prevent tooth decay. b. Gingivitis results in bone destruction and can be eliminated by flossing daily. c. Preventive dental care requires a visit to the dentist every 4 months. d. In addition to screening for tooth decay, dentists often screen for mouth cancer.

d. In addition to screening for tooth decay, dentists often screen for mouth cancer.

A nurse is discussing sexuality with middle-age men and women. Which of the following information should be stressed by the nurse? a. Contraception usage should be decreased as a woman nears menopause. b. Men are less vulnerable to sexual dysfunction than are women. c. Cardiovascular disease but not diabetes can result in erectile dysfunction. d. The majority of new HIV/AIDS cases occur among middle-age adults.

d. The majority of new HIV/AIDS cases occur among middle-aged adults.