Geri Williams Ch 11, 12, 13
Which statement by a patient could be related to symptoms of stress? a. "I have to urinate every 10 minutes, and there are only a few drops." b. "I haven't had to urinate for the past 8 hours." c. "I void large amounts of urine every 2 hours." d. "My urine has absolutely no color. It looks like water."
A p226
What is the status of any role based upon? a. Age b. Responsibility c. Society d. Health
C p214
The nurse explains that according to the general adaptation syndrome theory, if coping skills do not resolve the initial alarm response, the body becomes depleted of its reserve and the person enters the __________ stage.
exhaustion p226
A society that has numerous subcultures with different or conflicting expectations is said to be a(n) __________ society.
heterogeneous p215
The nurse uses a diagram to depict __________, which is a term for interaction between different roles.
relationships p214
What would have the largest impact on maintaining a positive self-perception? a. Ability to control life's choices b. Financial success attained in life c. Family relationships d. Degree of wellness
A p201
What is a common feeling for an older adult who is placed in a long-term care facility? a. Rejection b. Safety c. Making a fresh start d. Immediate assistance at hand
A p203
What actions by the nurse would help a patient who is experiencing a loss of self-control? (Select all that apply.) a. Allowing the patient to make choices whenever possible b. Assisting the patient to perform all self-care activities c. Respecting the patient's right to refuse treatment d. Explaining all procedures ahead of time e. Adapting the environment to enhance self-care
A, C, D, E p211
When is avoidance an effective stress reducer? (Select all that apply.) a. When the stressor has great personal significance b. When the outcome of the event will not be affected c. When the stressor is not a frequently recurring event d. When continued avoidance does not add stress e. When avoidance does not diminish the self-image
B, C, D, E p228
An older adult has recently been placed in a long-term care facility. What would the nurse expect to see exhibited in the patient? a. Feeling unloved and unlovable b. Feeling angry with the isolation c. Feeling unworthy for attention d. Feeling determined to be his or her own support
A p202-203
An older adult in a long-term care facility has been diagnosed with depression. What would indicate a need for further assessment of suicide risk? a. Asking for assistance in writing a will b. Voicing the intention to visit his brother c. Donating excess clothing to charity d. Asking the young widow next door for a dinner date
A p203
What would the home health nurse expect the depressed patient to use in excessive amounts as the depression increases? a. Alcohol b. Corticosteroids c. Caffeine drinks d. Comfort foods
A p203
Which patient would have the highest risk of suicide? a. 85-year-old male with a history of an affective disorder b. 50-year-old female with a recent divorce c. 70-year-old female with high blood pressure d. 65-year-old male with chronic asthma
A p203
The nurse admits a 70-year-old female to the long-term care facility. While assisting with the assessment, the nurse notes that the patient's husband died 2 months ago and that she has pain daily in her deformed hands from rheumatoid arthritis, needs assistance to dress herself, and has become incontinent of urine. What is the most appropriate nursing diagnosis for this patient? a. Risk for disturbed self-perception b. Powerlessness c. Hopelessness d. Impaired social reaction
A p205
The newly admitted 80-year-old female resident sits in her room and stares at the TV all day. What action by the nurse would best aid the patient in increasing self-esteem? a. Encouraging her to participate in self-care activities b. Suggesting that she change the channel to an intellectually stimulating program c. Giving her privacy until she becomes accustomed to the long-term care facility d. Arranging for a meal tray rather than having her eat in the dining room
A p205-206
The 75-year-old woman newly admitted to a long-term care facility seems fearful of her surroundings and is frequently tearful, saying, "I don't know what to do!" What action by the nurse would most help decrease her fear? a. Help the resident identify and verbalize her specific fears. b. Assure the resident that she has nothing to be afraid of. c. Keep the light on in the resident's room 24 hours a day. d. Play quiet music on the resident's radio.
A p208-209
Which of the following accurately reflects a homogenous society? a. Members share a common cultural history b. Members are diverse in role expectation c. Members have conflicted role status d. Members may choose or change role performance
A p215
The nurse assesses that although the college professor has retired, he still perceives himself as an educator and retains his academic title and professional association membership. How could the change in employment status be reflected in the professor? a. Altered self-image b. Neglect of his family c. Identity crisis d. Habitual professional behavior
A p216
Which stage of grief usually resolves after approximately 4-7 months? a. Disorientation b. Shock and numbness c. Reorganization d. Searching and yearning
A p218
What is a typical response for friends when dealing with a grieving person? a. Avoid discussing the source of grief. b. Encourage discussion of the source of grief. c. Schedule an intervention. d. Try to resolve the grief.
A p219
The nurse assesses a behavior as a sign of depression in the new admission to a long-term care facility when the resident exhibits disorganization and a. frequently comes to breakfast only partially dressed. b. eats excessive amounts of food at mealtime. c. socializes with only three or four other residents. d. arranges daily activities in order to watch Jeopardy at 4:30.
A p226-227
What is the intent of problem-focused coping strategies? a. To eliminate the cause of stress b. To deny the cause of stress c. To repress the response to stressors d. To use prescription drugs to alter perception of the problem
A p228
Why is depression a common symptom in older adults who have been admitted to a long-term care facility? (Select all that apply.) a. Their usual coping skills have been overwhelmed. b. They think that they have no family support. c. They have self-knowledge that will enable them to cope with new situations. d. They find support of self-worth through activities and making new friends. e. They actively seek assistance to reduce depression.
A, B p231
What influences an older adult's self-concept? (Select all that apply.) a. Financial security b. Social life c. Physical health d. Mobility e. Cognitive function
A, B, C, D p202
What must an older adult develop in order to achieve Erikson's task of integrity versus despair? (Select all that apply.) a. A positive attitude toward aging b. Positive self-esteem c. A manageable degree of illness d. A ready support system e. Control of all life choices
A, B, C, D p202
The nurse notices there has been a change in the behavior of an 84-year-old home patient over the past few weeks. What methods can be used to assess the patient's self-perception and self-concept? (Select all that apply.) a. Observing his physical appearance b. Monitoring for changes in his vital signs c. Encouraging him to verbalize his feelings d. Observing for changes in activities e. Participating in group activities
A, B, C, D p203-204
Which of the following are expected standards within various roles in a culture? (Select all that apply.) a. Housing b. Clothing c. Choice of vehicle d. Family size e. Support system
A, B, C, D p215
The nurse is aware that an older adult may become socially isolated related to the loss of __________. (Select all that apply.) a. a spouse b. friends to death or relocation c. health d. home e. culture
A, B, C, D p219-220
What symptoms would indicate depression in an older adult who has recently been admitted to a long-term care facility? (Select all that apply.) a. Appetite changes b. Weight loss c. Complaints of minor physical ailments d. Sleep disturbances e. Taking part in only one social activity a day
A, B, C, D p226
When are older adults at a greater risk for stress-related problems? (Select all that apply.) a. When there is a chronic illness b. When they have suffered the loss of a spouse c. When they have relocated d. When their income is reduced e. When they have general adaptation syndrome
A, B, C, D p228
When is it appropriate for the nurse to encourage a patient to use the problem-focused approach to reduce stress? (Select all that apply.) a. To confront a stressor b. To use emotional distancing to alter perception of the stressor c. To develop alternative coping skills d. To identify all stressors e. To practice a strategy with small stressors
A, B, C, E p228
What methods for coping with stress would be included in a teaching session with a group of older adults? (Select all that apply.) a. Meditation b. Talking with family and friends c. Swimming d. Alcohol use in moderation e. Massage therapy
A, B, C, E p228-229
What are the positive effects of geriatric massage? (Select all that apply.) a. Improved circulation b. Increased range of motion c. Reduction of anxiety d. Increased sexual potency e. Improved mobility
A, B, C, E p229
What is grief a normal response to? (Select all that apply.) a. Loss of loved ones b. Loss of professional roles c. Loss of dependence d. Loss of health e. Loss of relationships
A, B, D, E p217
What measures would be appropriate for the nurse to use to assess dysfunctional grieving in the older adult? (Select all that apply.) a. Ask the patient to describe his or her relationship within the family. b. Observe the behavior of the patient when family members and friends come to visit. c. Ask questions about the patient's profession and work history. d. Observe for changes in eating habits. e. Monitor for changes in mental status.
A, B, D, E p218-219
What would be appropriate sources of support for the grieving patient? (Select all that apply.) a. Friends b. Family c. Self-help magazines d. Support groups e. Therapist
A, B, D, E p219
What forms an individual's self-identity? (Select all that apply.) a. Values b. Ambition c. Interaction with others d. Self-esteem e. Ability to control his or her life
A, C, D, E p200
How can an older adult with a failing memory assume control to improve self-image? (Select all that apply.) a. Attitude toward aging b. Financial needs c. Physical appearance d. Time use e. Relationships
A, C, D, E p201
What influences the older adult's self-perception? (Select all that apply.) a. Family support b. Ethnic heritage c. Health status d. Financial status e. Sense of independence
A, C, D, E p202
Why is it important for the newly admitted patient to be included in his care-planning session? (Select all that apply.) a. So he can maintain some degree of control b. So he can reject the care plan c. So he can voice his preferences d. So he can improve his problem-solving capabilities e. So he can gain insight to overall goals of care
A, C, E p230-231
An older adult has recently moved to a long-term care facility. The family asks what can be done to ease the transition. What would be the most appropriate suggestion of the nurse? a. Send cards or gifts instead of personal visits. b. Visit and call often to remind the resident that she or he is cared for. c. Limit contact for several weeks to encourage independence. d. Communicate with the long-term facility's staff to inquire about the resident's well-being.
B p203
The nurse in a long-term care facility notes signs of depression in a resident who is ordinarily positive. What newly prescribed medication could contribute to the depression? a. Erythropoietin b. Corticosteroids c. Calcium replacement d. Broad-spectrum antibiotics
B p203
What symptom could be an indicator of depression in an 80-year-old man? a. Repetitive routines b. Agitation and irritability c. Constant talking d. Seeking the company of family members
B p203
How does the nurse define a role? a. Positive standard of behavior b. Accepted behavior standard c. Sexually linked standard d. Unchangeable standard
B p214
What is the correct term for a society in which members of many diverse subcultures must interact? a. Homogeneous b. Heterogeneous c. Impersonal d. Superficial
B p215
A nurse is counseling an older man who retires from his work and changes his role status. What will likely result in the man having fewer adjustment problems? a. He is financially secure. b. He has other roles and relationships. c. He is healthy. d. He has a supportive family.
B p216
Which of the following would be most likely to experience a problem with role conflict? a. 65-year-old grandmother who cares for her grandchildren while the mother works. b. 70-year-old retired business owner who comes to help his son run the business. c. 75-year-old retired physician who volunteers at a medical screening clinic. d. 80-year-old retired school administrator who takes educational foreign cruises several times a year.
B p216
What behavior would indicate that the bereaved widow has entered the searching and yearning stage of grief? a. Renewed interest in social activities b. Signs of depression c. Making plans for the future d. Denial of the loss of her husband
B p218
Which stage of grief usually resolves after approximately 2 weeks? a. Disorientation b. Shock and numbness c. Reorganization d. Searching and yearning
B p218
What would be the best method for the nurse to help a grieving widow begin the grief resolution process? a. Distract her with social conversation. b. Encourage her to verbalize her grief. c. Point out behaviors that are not helpful to grief resolution. d. Focus on her loneliness and loss.
B p219
A woman is in the emergency department after a car wreck. She is breathing rapidly and complains of dizziness and tingling in her extremities. She says, "I think I'm having a heart attack!" The nurse is aware that the symptoms may be related to which of the following? a. A transient ischemic attack b. Hyperventilation c. Hypotension d. Asthma
B p226
How does the body respond physically to stress? a. Decreased heart rate b. Decreased production of digestive enzymes c. Decreased blood glucose levels d. Decreased blood pressure
B p226
In general adaptation syndrome (GAS), what is the stage after the first alarm reaction has been successfully resolved in which body systems return to normal? a. Regeneration b. Resistance c. Restoration d. Reorganization
B p226
What is a positive effect of mild stress? a. Indecision b. Excessive alertness c. Inability to focus d. Ineffective in problem solving
B p226
How does physical illness increase stress in the older adult? a. It is an acceptable reason to request assistance. b. It takes away energy to cope with new stressors. c. It stimulates the family to be more attentive. d. It causes additional medications to be ordered.
B p227
What is true of an older adult who used coping skills effectively during his younger years? a. He will continue to use the same skills without modification. b. He will modify old skills and develop new ones. c. He will be at a loss when different types of stresses present themselves. d. He will be resistant to learning new skills.
B p229
What does a person experience as stress increases? (Select all that apply.) a. Widened focus b. Decreased problem-solving ability c. Indecisiveness d. Irrational behavior e. Attention to detail
B, C, D p226
What would be considered the most important indicator of a positive self-image in an older adult living in a long-term care facility? a. Feeding self independently b. Maintaining urinary continence c. Having family visitors every week d. Neat grooming and wearing fresh clothing
D p201
What can the long-term care nurse do to best relieve anxiety in a female resident? a. Stimulate her with group activity. b. Sedate her to allow her to sleep. c. Provide her with coffee for relaxation. d. Offer her a diversion of a quiet activity.
D p209
What would be indicative of dysfunctional grieving in an 80-year-old man? a. Despair after 3 months b. Guilt and self-doubt after 4 months c. A sense of disorganization after 6 months d. A sense of depression and despair after 1 year
D p218
Which stage of grief usually resolves after approximately 2 weeks to 4 months? a. Disorientation b. Shock and numbness c. Reorganization d. Searching and yearning
D p218
A 59-year-old construction worker living with his divorced son and 9-year-old grandson was admitted to the hospital 3 days ago with a massive heart attack. His son is out of town on a business trip and has been unable to visit him. His grandson had to go stay with a friend. The social worker tells the nurse that the son stated he will not be able to care for his father when he gets out of the hospital and does not know how he will afford the skilled nursing facility. What is the most appropriate nursing diagnosis? a. Impaired social interaction b. Dysfunctional grieving c. Social isolation d. Interrupted family process
D p220
How can a nurse most effectively promote social contact and interaction in the long-term care facility? a. Make a telephone available for family contact. b. Post a list of activities on the bulletin board. c. Tell the patient about social rooms in the facility. d. Accompany the patient to a craft activity.
D p220
The nurse is assessing an older adult who has been recently admitted to the long-term care facility. The resident has become active in the facility, goes to every activity, carefully makes her bed every day, does jigsaw puzzles, and chats with tablemates at mealtime. What defense mechanism is the resident exhibiting? a. Projection b. Rationalization c. Intellectualization d. Substitution
D p228
The timid, newly admitted 84-year-old widow has stayed in her room at the long-term care facility listening to her radio, which is playing loud jazz, and has been lying in bed fully clothed. How can the nurse help to relieve the resident's stress related to the relocation? a. Insist that she come out and interact with other residents. b. Turn her radio to a more soothing station. c. Bring two other residents into the room to socialize with her. d. Encourage her to verbalize feelings related to relocation.
D p230
The nurse explains that a Japanese stress reduction strategy that increases the energy of life force by laying-on of hands is called __________.
Reiki p229
What causes the greatest damage to self-worth? a. Measuring self against internal ideals b. Measuring self against individual values c. Measuring self against external standards d. Measuring self against expressions of positive feedback
C p200
How does the concept of ageism portray older adults? a. An inactive population of self-indulgent persons b. A group that has opted to isolate themselves c. Physically inept and nonproductive d. An antisocial but active group
C p202
What would cause the most damage to the self-concept of an older adult who lives in a long-term care facility? a. Being perceived as a single group rather than an individual b. Having individual needs that are not met c. Losing many personal belongings d. Losing social contact
C p202
The long-term care facility nurse is aware that the resident most at risk for suicide related to depression is the a. 70-year-old man with diabetes. b. 75-year-old woman with chronic obstructive pulmonary disease. c. 80-year-old woman with a bipolar disorder. d. 85-year-old man with schizophrenia.
C p203
The 70-year-old woman who had a stroke 3 months ago has a body image disturbance related to her spastic right arm and contracted fingers of the right hand. How can the nurse assist the patient in improving her body image? a. Teach her to write with her left hand. b. Place articles within easy reach of her left hand. c. Help her select colorful scarves or accessories to cover her right arm. d. Show her massage techniques to increase circulation in her right arm.
C p205
Which older adult would be at the highest risk for suicide? a. One with a lack of activity b. One with an altered nutritional intake c. One who abuses alcohol d. One who has a chronic disease
C p209
A man has roles of father, husband, professional businessman, son, and community leader. What may he be at risk of experiencing? a. Role confusion b. Isolation c. Internal role conflict d. Diminished self-esteem
C p215
The recently widowed 65-year-old man has told the nurse that he is so lost without his wife that he is planning to retire, sell his home, and move to a retirement village in another state. What assessment by the nurse would be the most correct? a. Positive, because it represents a new beginning b. Positive, because it allows him more time to resolve his grief c. Risky, because he is giving up significant supports to his self-image and grief resolution process d. Negative, because he has not thought his plan through
C p217
When the home health nurse suggests a grief resolution group to the older widow, the widow furiously states, "I don't want or need any help! I want my husband back!" What stage of grief would this be characteristic of? a. Shock b. Searching c. Disorientation d. Reorganization
C p218
Which stage of grief may last up to 2 years? a. Disorientation b. Shock and numbness c. Reorganization d. Searching and yearning
C p218
When are stress-related physical, behavioral, and cognitive changes more likely to occur? a. When the stress has a sudden onset b. When stress is low level but constant c. When stress is varied and cumulative d. When stress is suppressed or denied
C p224
The student sitting in class waiting for the final examination develops nausea and excessive gas. What is a probable cause of these symptoms? a. Increase in the blood glucose level b. Increase in heart rate c. Reduction of peristalsis d. Decrease in adrenalin
C p226
The 80-year-old man who is experiencing stress because visual loss has caused him to quit driving says, "I have friends and family who will be my transportation. I can still get around and I'll have entertaining company." What coping mechanism is the man using? a. Confrontation b. Escape c. Emotional distancing d. Avoidance
C p228
The nurse is aware that the use of a defense mechanism is a normal response to stress. When does a defense mechanism become problematic? a. When more than one defense mechanism is used at a time b. When the defense mechanism is used for longer than 1 week c. When the defense mechanism is used excessively d. When the defense mechanism is used until a more durable coping mechanism is formed
C p228
An 80-year-old man recently became widowed, moved into a long-term care facility, and had to quit driving. He complains of fatigue and is irritable when questioned about his health. What would be the most appropriate action of the nurse? a. Suggest he take a daytime nap and go to bed early. b. Report the complaints as expected adjustments to relocation. c. Approach him to talk about his perceptions related to his relocation. d. Suggest that he find some quiet time in the facility's library and read a book.
C p230
