Geriatric Chapter 11 Self-Perception and Self-Concept

A Making or altering a will is an indication of suicidal ideation.

16. The home health nurse interviews the 70-year-old male patient about possible suicidal ideation after the patient: a. asks for assistance in writing a will. b. voices the intention to visit his brother. c. donates excess clothing to charity. d. asks the young widow next door for a dinner date.

C The selection of colorful accessories to cover the arm will help with her damaged body image. Learning to write with the left hand, learning massage techniques, and being able to reach items are good nursing care but do nothing for enhancement of body image.

17. The pretty 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. The nurse can assist the patient to improve her damaged body image by: a. teaching her to write with her left hand. b. placing articles within easy reach of her left hand. c. helping her select colorful scarves or accessories to cover her right arm. d. showing her massage techniques to increase circulation in her right arm.

A Participation in self-care activities increases self-esteem and independence and puts the resident in control of her appearance.

18. The newly admitted 80-year-old female resident who sits in her room and stares at the TV watching cartoons can be supported to maintain her self-esteem by: 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 Identification of specific fears helps crystallize the resident's concern and can help define the remedy.

19. 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!" The nurse can help allay her fear by: a. helping her identify and verbalize her specific fears. b. assuring the resident that she has nothing to be afraid of. c. keeping the light on in the room 24 hours a day. d. playing quiet music on the resident's radio.

C The use of external standards rather than internal values is an inadequate platform for self-worth. The use of positive feedback and internal individual values supports a positive perception of self- worth.

1. The nurse cautions a group of older adults that the greatest damage to self-worth is measuring self against: a. internal ideals. b. individual values. c. external standards. d. expressions of positive feedback.

A,C,D,E Ambition is not a part of self-identity.

1. The nurse is aware that self-identity is formed by a person's attitudes about her or his __________. (Select all that apply.) a. values b. ambition c. interaction with others d. high self-esteem e. ability to control his or her life

B Depression can be caused by the initiation of drugs such as corticosteroids, glycosides, hormones, and antihypertensive agents.

10. The nurse in a long-term care facility notes signs of depression in a resident who is ordinarily positive. The nurse suspects this new affective change is related to the initiation of a drug protocol of: a. erythropoietin. b. corticosteroids. c. calcium replacement. d. broad-spectrum antibiotics.

B Irritability and agitation are signs of depression, as are mood swings, social withdrawal, and unwillingness to talk.

11. The home health nurse instructs the family caring for an 80-year-old man to be alert for signs of depression, which include: a. daytime napping. b. agitation and irritability. c. constant talking. d. seeking the company of family members.

A Antianxiety prescription drugs, along with tobacco and alcohol, are frequently used excessively as depression increases.

12. The home health nurse takes into consideration that as depression develops, the patient may begin to use excessive amounts of: a. antianxiety agents as a sedative. b. corticosteroids as a mood elevator. c. caffeine drinks as an energy booster. d. comfort foods as a morale booster.

D Reduced muscle mass decreases tolerance to alcohol, so relatively small amounts can cause alcohol toxicity.

13. The nurse counseling a 75-year-old man who admits to the overuse of alcohol cautions him that alcohol has an increased effect on the older adult related to: a. lack of activity. b. altered nutritional intake. c. reduced kidney function. d. reduced lean muscle mass.

C Many signs that would alert the nurse to the possibility of substance abuse can be mistaken for changes associated with aging—unsteady gait, forgetfulness, sleep disturbances, and incontinence.

14. The home health nurse assesses the depressed 80-year-old widow carefully for signs of substance abuse; indicators of substance abuse can easily be missed because these signs: a. occur only in the late evening or nighttime. b. are not particularly harmful to the older adult. c. mimic changes anticipated with the aging process. d. are disguised by the patient.

C Persons with affective disorders are most at risk for suicide related to depression.

15. 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.

A Being in control of life's choices increases and maintains a positive self-perception.

2. The nurse is aware that a positive self-perception is largely dependent on the: a. ability to control life's choices. b. financial success attained in life. c. family relationships. d. degree of wellness.

A,C,D,E Persons who take control of the many aspects of their personal lives and well-being will have a good self-image.

2. To improve the self-image of the 80-year-old man who lives with his daughter due to a failing memory, the home health nurse urges that he take control of his __________. (Select all that apply.) a. attitude toward aging b. financial needs c. physical appearance d. time use e. relationships

D Involving the anxious resident in a pleasant activity such as music therapy, conversation, or a craft can allay anxiety. Stimulation frequently adds to anxiety, and sedation does not address the need for anxiety-reducing coping skills.

20. The long-term facility nurse is aware that the anxious female resident can frequently be calmed by: a. stimulating her with group activity. b. sedating her to allow her to sleep. c. allowing time alone to control her anxiety. d. offering a diversion of quiet activity, such as a jigsaw puzzle.

A Patients at risk for disturbed self-perception have had conditions that have resulted in changes in their body image, body function, loss, recent relocation, and chronic pain.

21. 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. The most appropriate nursing diagnosis at this time is: a. risk for disturbed self-perception. b. powerlessness. c. hopelessness. d. risk for suicide. e. impaired social reaction.

D Neat grooming and care in personal appearance are cardinal indicators of a positive self-image.

3. The nurse recognizes that a major indicator of a positive self-image in an older adult living in a long-term care facility is: a. feeding self independently. b. maintaining urinary continence. c. having family visitors every week. d. neat grooming and wearing fresh clothing.

A,B,C,D It is necessary for the older adult to have some degree of control but not complete control of life choices for the development of integrity rather than despair.

3. To achieve Erikson's developmental stage of integrity, the older adult must develop __________. (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, Cognitive function is not directly related to a person's self-concept.

4. Self-concept of the older adult is influenced by the amount and degree of change experienced in his or her __________. (Select all that apply.) a. financial security b. social life c. physical health d. mobility e. cognitive function

C Ageism has defined the older adult as physically inept, nonproductive, and essentially unattractive.

4. The nurse explains that older adults often resort to cosmetic surgery to maintain the appearance of youth and self-worth because the concept of ageism has painted old age as: 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 The losses of home, spouse, car, and independence in making choices are devastating blows to someone's self-image, even if he or she has social contacts and individual needs are met.

5. The long-term care facility nurse sees evidence that the most devastating blow to the self-concept of the older adult is institutional placement because persons in a long-term care facility: a. are perceived as a single group. b. have individual needs that are not met. c. have lost many belongings that made up their identity. d. have lost social contact.

B,C,D,E Urinary incontinence is not a sign of possible substance abuse.

5. The nurse lists indicators for the detection of substance abuse, which include __________. (Select all that apply.) a. urinary incontinence b. frequent falls c. unsteadiness d. altered sleep pattern e. stomach complaints

A Without an emotional support system, the older adult comes to feel unloved and unlovable.

6. The nurse explains that the loss of emotional support of loved ones through death or separation makes the older adult feel: a. unloved and unlovable. b. angry with the isolation. c. unworthy for attention. d. determined to be his or her own support.

A,C,D,E Assisting the patient in all self-care activities is going to increase the perception of powerlessness.

6. The nurse, who is aware that a sense of powerlessness is related to loss of control, can help reduce this perception by __________. (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 Placement equals rejection in the minds of many older adults, even if the placement was unavoidable and necessary.

7. The nurse explains that long-term care facility placement for the older adult usually makes the older adult feel a sense of: a. rejection. b. safety. c. making a fresh start. d. immediate assistance at hand.

A,C,D,E A patient's sense of independence is the most significant aspect of self-perception.

7. The nurse knows that a patient's self-perception is influenced most significantly by his or her __________. (Select all that apply.) a. family support b. ethnic heritage c. health status d. financial status e. sense of independence

B Frequent visits and calls by family and friends help maintain self-esteem and self-worth in the newly admitted resident.

8. The admission nurse at the long-term care facility suggests that to help the older adult make an easier transition to relocation, the family should: 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.

A,B,C,D Patients' self-perception is not assessed by having them participate in group activities.

8. The nurse notices there has been a change in the behavior of an 84-year-old home patient over the past few weeks. Methods used to assess his self-perception and self-concept include __________. (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

D Studies show that 46% of older adults who are hospitalized have symptoms of depression.

9. The nurse takes into consideration that depression affects almost 50% of older adults who: a. live at home with a spouse. b. live alone. c. live in a long-term care facility. d. are hospitalized.

A,B,C,E

The nurse is caring for an older client who is complaining of insomnia. What are some of the contributing factors to insomnia in the acute and long-term care setting? Select all that apply a.Pain b. Chronic disease c.Staff conversations d..Daily laboratory diagnostic tests e..Environmental noise and lighting f..Giving pain medications with supper

C

The nurse is performing an assessment on an older client who is having difficulty sleeping at night. Which statement by the client indicates the need for further teaching regarding measures to improve sleep? a."I swim 3 times a week." b.I have stopped smoking cigars." c.I drink hot chocolate before bedtime." d.I read for 40 minutes before bedtime.