NURS 299 exam 6

Which of the following are examples of the conventional reasoning form of cognitive development? (Select all that apply.) 1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. 2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son. 3. A teenage girl is encouraged by her peers to engage in shoplifting. She decides not to join her peers in this activity because she is afraid of getting caught in the act. 4. A single mother of two children is unhappy with her employer. She has been unable to secure alternate employment but decides to quit her current job. 5. A young man drives over the speed limit regularly because he thinks he is an excellent driver and will not get into a car accident.

1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. 2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son. - A person using conventional reasoning sees moral reasoning based on their own personal internalization of societal and others' expectations. A person wants to fulfill the expectations of the family, group, or nation and also to develop a loyalty to and actively maintain, support, and justify the order

Older adults physiological changes

-skin loses resilience and moisture -facial features more pronounced -salivary secretion reduced, taste buds lose sensitivity -•Respiratory muscle strength decreases. -•Decreased contractile strength of the myocardium results in decreased cardiac output. -•Milk ducts of the breasts are replaced by fat, making breast tissue less firm. -increase in the amount of fatty tissue in the trunk and abdomen -Gastrointestinal function changes include a slowing of peristalsis, noted by auscultating reduced bowel sounds, and alterations in secretions -•Changes in the structure and function of the reproductive system occur as the result of hormonal alterations. -•Bone density and bone mass decrease with age. -•All voluntary reflexes are slower, and individuals often have less of an ability to respond to multiple stimuli.

A family consisting of a grandparent, two adults, and three school-age children just immigrated to the United States. They come to a community wellness center to establish health care. Which of the following questions does the nurse ask to assess the family's function? (Select all that apply.) 1. "What does your family do to keep members healthy?" 2. "How does your family usually make decisions?" 3. "What health services are available in your neighborhood?" 4. "Which rituals or celebrations are important for your family?" 5. "Is there a lot of crime in your neighborhood?" 6. "How many parks are there in your community?"

1. "What does your family do to keep members healthy?" 2. "How does your family usually make decisions?" 4. "Which rituals or celebrations are important for your family?" -Cultural practices, decision making, and rituals and celebrations describe what is important to a family. This set of assessment data helps you gain insight into how the family functions and what family members consider important to their health and family functioning.

A nurse is caring for a 66-year-old patient who lives alone and is receiving chemotherapy and radiation for a new cancer diagnosis. He is unable to care for himself because of severe pain and fatigue. He moves into his 68-year-old brother's home so his brother can help care for him. Which assessment findings indicate that this family caregiving situation will be successful? (Select all that apply.) 1. Both the patient and his brother attend church together regularly. 2. The brothers are living together and enjoy eating the same foods. 3. Other siblings live in the same city and are willing to help. 4. The patient and his brother have a close network of friends. 5. The patient has obsessive-compulsive disorder and has difficulty throwing away possessions.

1. Both the patient and his brother attend church together regularly. 3. Other siblings live in the same city and are willing to help. 4. The patient and his brother have a close network of friends. -Many older adults use their faith and spirituality to cope with life changes. Having a close social network and other family members who are willing to assist with caregiving helps to alleviate the stress experienced by caregivers. Potential risk factors for caregiver distress and burden in this relationship include that the brothers are living together and that one of the brothers has a mental illness

According to Piaget, the school-age child is in the third stage of cognitive development, which is characterized by: 1. Concrete operations 2. Conventional thought 3. Postconventional thought 4. Identity vs. role diffusion

1. Concrete operations -children achieve the ability to perform mental operations.

A nurse is completing an assessment on a 27-year-old female patient. Which questions best assess the psychosocial aspects of this young woman's health? (Select all that apply.) 1. Do you feel safe in your home and at work? 2. How many fruits and vegetables do you typically eat every day? 3. Describe your relationship with your family. 4. Have you had the vaccine to prevent HPV? 5. What are your long-term career goals?

1. Do you feel safe in your home and at work? 3. Describe your relationship with your family. 5. What are your long-term career goals? -. Young adults need physical and emotional resources and support systems to meet the many challenges, tasks, and responsibilities they face. Asking assessment questions such as those involving feeling safe at home and at work, satisfaction with family relationships, and identifying long-term career goals provides information about the young adult's psychosocial health that supports successful maturation in this developmental stage. Assessment questions about the intake of fruits and vegetables and the HPV vaccine do not assess the patient's psychosocial health

Ms. Dale states that she does not need the TV turned on because she cannot see very well. Normal visual changes in older-adults include all of the following except: 1. Double vision 2. Sensitivity to glare 3. Decreased visual acuity 4. Decreased accommodation to darkness

1. Double vision -Often the result of retinal damage, reduced pupil size, development of opacities in the lens, or loss of lens elasticity

A patient who is newly divorced states, "Although I'm really scared about what happens next to my children and myself, I know that divorce is not uncommon today." What term does the nurse use in the patient's medical record to describe the characteristic displayed in this statement? 1. Durability 2. End-of-life care 3. Family functioning 4. Family's culture

1. Durability -Family durability is a system of support and structure within a family that extends beyond the walls of the household. For example, marriages may end in divorce or death, and remarriage may occur, or children may leave home as adults, but in the end the "family" transcends long periods and inevitable lifestyle changes

A nurse is caring for a man who is recently retired and who appears withdrawn. He says he is "bored with life." The nurse helps this individual find meaning in life by: 1. Encouraging him to reflect on his relationships with others. 2. Encouraging relocation to a new city. 3. Explaining the need to simplify life. 4. Encouraging him to adopt a new pet.

1. Encouraging him to reflect on his relationships with others. -You can enhance feelings of integrity by encouraging older adults to reflect upon meaningful relationships, such as relationships with a higher power, family members, or the community

A family is facing job loss of the father, who is the major wage earner, and relocation to a new city where there is a new job. The children will have to switch schools, and his wife will have to resign from the job she enjoys. Which of the following contribute to this family's hardiness? (Select all that apply.) 1. Family meetings 2. Established family roles 3. New neighborhood 4. Willingness to change in time of stress 5. Passive orientation to life

1. Family meetings 2. Established family roles 4. Willingness to change in time of stress -Family hardiness refers to the internal strengths and durability of the family unit. A sense of control over the outcome of life, a view of change as beneficial and growth producing, communication with family members (as in family meetings), well-established family roles among family members, and an active rather than passive orientation in adapting to stressful events all contribute to family hardiness.

A 9-year-old child has a difficult time making friends at school and being chosen to play on teams. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson's theory, failure at this stage of development results in: (Select all that apply.) 1. Feelings of inadequacy. 2. A sense of guilt. 3. A poor sense of self. 4. Feelings of inferiority. 5. Mistrust.

1. Feelings of inadequacy. 4. Feelings of inferiority. -School-age children need to feel real accomplishment and be accepted by peers to develop a sense of industry. Without proper support for learning new skills, or if skills are too difficult, they develop a sense of inadequacy and inferiority

You are caring for a young female patient who is currently homeless. You believe she is experiencing IPV. Your assessment of the patient reveals several socioeconomic factors. Which ones are linked to IPV? (Select all that apply.) 1. History of smoking marijuana 2. Income below poverty level 3. Recent divorce 4. High school education 5. Unemployment

1. History of smoking marijuana 2. Income below poverty level 4. High school education 5. Unemployment -In an assessment, risk factors that suggest perpetration of IPV include using drugs or alcohol, especially heavy drinking; unemployment; low self-esteem; gambling; and antisocial or borderline personality traits. In addition, factors that predispose individuals to violence include poverty, family breakdown, child abuse and neglect, opioid and other drug use (dealing or illegal use), repeated exposure to violence, and ready access to guns

When assessing the health-related knowledge base of both the middle-age patient with an illness and the family, the assessment should include which of the following? (Select all that apply.) 1. Medical course of the illness 2. Prognosis for the patient 3. Coping mechanisms of the patient and family 4. Socioeconomic status 5. Need for community and social services

1. Medical course of the illness 2. Prognosis for the patient 3. Coping mechanisms of the patient and family 5. Need for community and social services

In planning patient education for Mrs. Smith, a 45-year-old woman who had an ovarian cyst removed, which of the following facts is true about the sexuality of middle-aged adults? 1. Menstruation ceases after menopause. 2. Estrogen is produced after menopause. 3. With removal of the ovarian cyst, pregnancy cannot occur. 4. After reaching climacteric, a man is unable to father a child

1. Menstruation ceases after menopause. -Menopause is the disruption of the menstrual cycle primarily because of the inability of the neurohormonal system to maintain its periodic stimulation of the endocrine system.

When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of: 1. Object permanence. 2. Sensorimotor play. 3. Schemata. 4. Magical thinking.

1. Object permanence. -.He is now in Piaget's later stage of sensorimotor thought and has learned that objects exist even though he cannot see or touch them

A 36-year-old patient newly diagnosed with type 1 diabetes shares with you that he is frustrated with the time it takes to prepare meals and monitor his blood sugar. He also is having trouble understanding his insulin schedule. Which of the following suggestions would be most appropriate? (Select all that apply.) 1. Provide patient education materials that are easy to read. 2. Refer this patient to a diabetes support group. 3. Refer the patient to his endocrinologist. 4. Suggest that the patient make an appointment with a registered dietitian. 5. Suggest ways to modify his schedule.

1. Provide patient education materials that are easy to read. 2. Refer this patient to a diabetes support group. 4. Suggest that the patient make an appointment with a registered dietitian. 5. Suggest ways to modify his schedule. -. Adults are often impatient with the time and energy requirements that a chronic health problem requires for proper management. Patient-centered educational materials and support groups often help patients deal with these challenges. Working with a dietitian will help patients identify ways to modify their eating habits. Helping the patients incorporate nutritional and exercise health behaviors into their daily schedule is also important

A nurse sees a 76-year-old woman in the outpatient clinic. The patient states that she recently started to notice a glare in the lights at home. Her vision is blurred, and she is unable to play cards with her friends, read, or do her needlework. Which of the following nursing interventions are appropriate? (Select all that apply.) 1. Refer her to an ophthalmologist. 2. Suggest large-print books and playing cards. 3. Reassure her that the visual changes are part of normal aging. 4. Suggest lower-wattage light bulbs to decrease glare. 5. Assess her home environment for safety.

1. Refer her to an ophthalmologist. 2. Suggest large-print books and playing cards. 5. Assess her home environment for safety. -. This patient most likely has cataracts and should be referred to an ophthalmologist

A daughter is beginning to assume caregiver responsibility for her 90-year-old widowed father. Her father has hypertension, coronary artery disease, and type 2 diabetes mellitus. Home health services are set for once a week. During the first visit, the daughter expresses concern about all the medications that her father has been prescribed by different doctors and that he has obtained from different pharmacies. The daughter states that her father cannot really tell her what each medication is for or when he should take them. From this initial information the nurse suspects polypharmacy. What medication assessment data are needed? (Select all that apply.) 1. Review all medication prescriptions 2. Match medication prescriptions with the patient's medication bottles or unit-dose blister packs 3. Identify involvement of the caregiver in helping with medication administration 4. Identify and delete duplicate medications 5. Obtain a listing of any over-the-counter medications

1. Review all medication prescriptions 2. Match medication prescriptions with the patient's medication bottles or unit-dose blister packs 3. Identify involvement of the caregiver in helping with medication administration 5. Obtain a listing of any over-the-counter medications

A 63-year-old patient is retiring from his job at an accounting firm where he was in a management role for the past 20 years. He has been with the same company for 42 years and was a dedicated employee. His wife is a homemaker. She raised their five children, babysits for their grandchildren as needed, and belongs to numerous church committees. What are the major psychosocial concerns for this patient? (Select all that apply.) 1. The loss of his work role 2. The risk of social isolation 3. A determination on whether the wife will need to start working 4. How the wife may now expect assistance with household tasks and with babysitting the grandchildren 5. The age the patient chose to retire

1. The loss of his work role 4. How the wife may now expect assistance with household tasks and with babysitting the grandchildren -The psychosocial stresses of retirement are usually related to role changes with a spouse or within the family and to loss of the work role. Often there are new home responsibilities and family expectations of the retired person. This patient is unlikely to become socially isolated because of the size of the family. Whether the wife will have to work is not a major concern at this time, nor is the age of the patient

A nurse is caring for a 76-year-old female patient in the home setting. She just lost her husband from COVID-19 and has four children who live nearby. The patient was an educator and retired only 2 years ago. The nurse applies knowledge of developmental changes and the nature of loss in older adults when assessing which of the following situations? (Select all that apply.) 1. The nature of her relationships with her adult children 2. The total number of medications the patient is taking, including over-the-counter medications 3. The patient's perception of the need for caregiving assistance from the family with activities her husband performed 4. The impact of her husband's death on her monthly income 5. The patient's current physical functional status

1. The nature of her relationships with her adult children 3. The patient's perception of the need for caregiving assistance from the family with activities her husband performed 4. The impact of her husband's death on her monthly income 5. The patient's current physical functional status

A 45-year-old woman who is obese tells a nurse that she wants to lose weight. Which assessment findings may be contributing factors to the woman's obesity? (Select all that apply.) 1. The woman works in an executive position that is very demanding. 2. The woman says that she has little time to prepare meals at home and eats out at least four nights a week. 3. The woman works out at the corporate gym at 5 a.m. three mornings per week. 4. The woman says that she tries to eat "low-cholesterol" foods to help lose weight. 5. The woman says that she vacations annually.

1. The woman works in an executive position that is very demanding. 2. The woman says that she has little time to prepare meals at home and -Demanding and stressful work environments can lead to frequent "stress" as can the eating of nonnutritious foods. Frequently eating away from home and eating fast food have been identified as contributing factors to obesity

The greatest cause of illness and death in the young adult population is: 1. Violence 2. Substance abuse 3. Cardiovascular disease 4. Sexually transmitted disease

1. Violence -Factors that predispose include poverty, family breakdown, child abuse and neglect, repeated exposure to violence, and access to guns.

According to Erikson's developmental theory, the primary developmental task of the middle years is to: 1. Achieve intimacy 2. Achieve generativity 3. Establish a set of personal values 4. Establish a sense of personal identity

2. Achieve generativity -The adult focuses on supporting future generations and the ability to expand one's personal and social involvement.

A patient's family member is considering having her mother placed in a nursing center. The nurse has talked with the family before and knows that this is a difficult decision. Which of the following criteria does the nurse recommend in choosing a nursing center? (Select all that apply.) 1. The center needs to be clean, and rooms should look like a hospital room. 2. Adequate staffing is available on all shifts. 3. Social activities are available for all residents. 4. The center provides three meals daily with a set menu and serving schedule. 5. Staff encourage family involvement in care planning and assisting with physical care.

2. Adequate staffing is available on all shifts. 3. Social activities are available for all residents. 5. Staff encourage family involvement in care planning and assisting with physical care. -adequate staffing, provision of social activities, and active family involvement are essential. Meals should be high quality with options for what to eat and when it is served. A nursing center should be clean, but it should look like a person's home rather than a hospital

A nurse is assessing an older adult brought to the emergency department following a fall and wrist fracture. The patient lives with her son, is very thin and unkempt, has a Stage 3 pressure injury on her coccyx, and has old bruising to the extremities in addition to her new bruises from the fall. She defers all of the questions to her caregiver son, who accompanied her to the hospital. What is the nurse's next step? 1. Call social services to begin nursing home placement. 2. Ask the son to step out of the room so that she can complete her assessment. 3. Call adult protective services because you suspect elder mistreatment. 4. Assess the patient's cognitive status.

2. Ask the son to step out of the room so that she can complete her assessment. -Such assessment findings may lead you to suspect elder mistreatment, but the nurse needs more information directly from the patient before calling social services or the adult protective services or telling the patient she cannot return home. The nurse will best get this information by asking the son to leave so that she can privately ask the patient direct questions. If the son refuses to leave, this will be another indication that elder mistreatment may be occurring. Cognitive testing will be important but is not the priority

A nurse is completing a health history with the daughter of a newly admitted patient who is confused and agitated. The daughter reports that her mother was diagnosed with Alzheimer disease 1 year ago but became extremely confused last evening and was hallucinating. She was unable to calm her, and her mother thought she was a stranger. On the basis of this history, the nurse suspects that the patient is experiencing: 1. Normal aging. 2. Delirium. 3. Depression. 4. Worsening dementia.

2. Delirium. -Hallmark characteristics of delirium are acute confusion, hallucinations, and agitation. These symptoms are not part of the normal aging process

A nurse conducted an assessment of a new patient who came to the medical clinic. The patient is 82 years old and has had osteoarthritis for 10 years and diabetes mellitus for 20 years. He is alert but becomes easily distracted during the assessment. He recently moved to a new apartment, and his pet beagle died just 2 months ago. He is most likely experiencing: 1. Dementia. 2. Depression. 3. Delirium. 4. Anxiety.

2. Depression. -. Factors that often lead to depression include presence of a chronic disease or a recent change or life event (such as loss of a spouse, friend, or beloved pet). Patients are alert but easily distracted in conversation

A nurse is participating in a health and wellness event at the local community center. A woman approaches with her father and relates that she is worried that her widowed father is becoming more functionally impaired and may need to move in with her. The nurse asks about his ability to complete activities of daily living (ADLs) by asking which of the following questions? (Select all that apply.) 1. Tell me if you are still driving. 2. Describe any problems you have in sitting or getting up from your toilet. 3. Tell me how often you take a bath during the week and how you bathe. 4. Estimate for me the amount of time you spend exercising each day. 5. Tell me how you do your grocery shopping.

2. Describe any problems you have in sitting or getting up from your toilet. 3. Tell me how often you take a bath during the week and how you bathe. -Activities of daily living are self-care tasks that measure function and are markers for the ability to live independently. Although driving, shopping, and daily exercise are important to quality of life and health maintenance, they are not ADLs. Shopping and driving are IADLs

A 48-year-old patient visiting the primary health clinic presents with fatigue and recent weight loss. It is the patient's first visit to the clinic in 2 years. The patient has a family history of cancer and heart disease. During assessment, the nurse finds that the patient has two jobs and works about 12 to 14 hours every weekday. The patient drinks three or four alcoholic drinks a day, relies on fast foods or prepared foods at work, sleeps only 4 to 6 hours a day, and exercises infrequently. The patient takes a nonsteroidal antiinflammatory drug (NSAID) daily for knee pain. Which of the following places this patient at risk for development of a chronic illness later in life? (Select all that apply.) 1. Working 10 to 12 hours a day 2. Eating high-calorie and fatty foods 3. Exercising infrequently 4. Taking a daily analgesic 5. Excessive alcohol consumption

2. Eating high-calorie and fatty foods 3. Exercising infrequently 5. Excessive alcohol consumption -. The patient fails to follow a number of positive health behaviors that might decrease the likelihood of chronic disease. Positive health behaviors include regular exercise, adherence to healthy dietary habits, avoidance of excess alcohol consumption, participation in routine screening and diagnostic tests, lifestyle changes to reduce stress, and elimination of health risk factors (e.g., smoking, eating foods with little or no nutritional value)

A hospice nurse is caring for a family that is providing end-of-life care for their grandmother, who has terminal breast cancer. The nurse focuses on symptom management for the grandmother and on helping the family with developing coping skills. This approach is an example of which of the following? 1. Family as context 2. Family as patient 3. Family as a system 4. Family as structure

2. Family as patient -When the family as patient is the approach, the family's needs, processes, and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care

During a visit to a family clinic, a nurse teaches a mother about immunizations, the use of car seats, and home safety for an infant and toddler. Which type of nursing interventions are these? 1. Restorative 2. Health promotion 3. Acute care 4. Growth and development

2. Health promotion -Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit, including information about specific health behaviors and family coping techniques

According to Erikson, the developmental task of adolescence is: 1. Industry vs. inferiority 2. Identity vs. role confusion 3. Autonomy vs. shame and doubt 4. Role acceptance vs. role confusion

2. Identity vs. role confusion -Puberty, marked preoccupation with appearance and body image

A nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson's stages of development? 1. Trust versus mistrust 2. Initiative versus guilt 3. Industry versus inferiority 4. Autonomy versus sense of shame and doubt

2. Initiative versus guilt -. Toddlers are learning that parents and society have expectations about behaviors and that they must learn to control their behavior.

A home health nurse is caring for a 48-year-old woman with newly diagnosed diabetes mellitus type 2. She is prescribed to take Metformin IR three times a day. The woman lives alone but has a sister who lives just 5 miles away. The doctor orders the patient to measure her blood glucose daily for the next month. Which of the following show the nurse's ability to minimize common barriers to change as she helps this patient manage her diabetes? (Select all that apply.) 1. Encourages the patient to have an eye examination 2. Provides a simple-language brochure that explains the long-term implications of diabetes type 2 3. Tells the patient to always take metformin the same times each day 4. Informs the patient about availability of a support group in her community 5. Recommends that the patient's sister be involved in the discussion about medication and glucose monitoring

2. Provides a simple-language brochure that explains the long-term implications of diabetes type 2 4. Informs the patient about availability of a support group in her community 5. Recommends that the patient's sister be involved in the discussion about medication and glucose monitoring -The nurse's interventions aim at the external and internal barriers to change, such as motivation, limited social support, and lack of knowledge. Recommending an eye examination for the patient is good health promotion but does not deal directly with a barrier to change. Recommending the patient take metformin at the same times each day does not address the patient's ability to choose administration times, a decision that might be more motivating

A mother and her two children are homeless and enter a free health care clinic. Which statements most likely describe the effects of homelessness on this family? (Select all that apply.) 1. The children have stability in their education. 2. The family members may have symptoms of malnutrition, such as anemia. 3. The family is at a low risk for experiencing violence. 4. The children are at higher risk for developing ear infections. 5. All family members may have mental health issues.

2. The family members may have symptoms of malnutrition, such as anemia. 4. The children are at higher risk for developing ear infections. 5. All family members may have mental health issues. -Families who are homeless often experience difficulty in accessing food and have a poor nutritional status. Children are at a higher risk for developing ear infections. Homelessness puts all family members at risk for developing mental health issues. Children have difficulty proving residency for school enrollment, so they are more likely to not be in school or to drop out. Families that are homeless are also at a higher risk for experiencing physical and emotional violence

A 78-year-old male is going through preoperative screening and preparation for his surgery in 1 week. His wife is with him, and initially they both appear anxious. He will be undergoing a colon resection for colon cancer and will have a permanent colostomy. The nurse knows the patient's age and developmental status will affect how the assessment is conducted. The nurse wants to provide a database that will be useful to the nurses in the hospital and therefore applies clinical judgment appropriately through which of the following: (Select all that apply.) 1. While examining the patient, the nurse notes the physical changes of decreased bowel sounds, dry mouth, and reduced skin elasticity are physical changes likely related to the cancer. 2. When the patient has difficult remembering current medications, the nurse asks the wife to supplement information. 3. The nurse anticipates the effect of the colostomy on functioning and asks the patient how he perceives life with a colostomy. 4. While gathering the history of the patient's illness, the nurse anticipates him having the classic signs of fatigue and unexplained weight loss. 5. Knowing that elderly patients have less interest in sexual intimacy, the nurse does not ask about the impact the patient thinks his surgery will have on sexual function.

2. When the patient has difficult remembering current medications, the nurse asks the wife to supplement information. 3. The nurse anticipates the effect of the colostomy on functioning and asks the patient how he perceives life with a colostomy. -Memory deficits, if present, can affect the accuracy and completeness of an assessment. Information contributed by a family member is sometimes necessary to supplement an older adult's recollection of medication adherence. Older adults' concepts of health generally depend on personal perceptions of functional ability. The symptoms of decreased bowel sounds, dry mouth, and reduced skin elasticity are likely not related to colon cancer but are normal physical changes of aging. Classic signs of a disease are sometimes absent, blunted, or atypical in older adults. All older adults, whether healthy or frail, need to express their need for intimacy and sexual feelings

According to Piaget's cognitive theory, a 12-year-old child is most likely to engage in which of the following activities? (Select all that apply.) 1. Using building blocks to determine how houses are constructed 2. Writing a story about a clown who wants to leave the circus 3. Drawing pictures of a family using stick figures 4. Writing an essay about patriotism 5. Hanging out with a best friend

2. Writing a story about a clown who wants to leave the circus 5. Hanging out with a best friend - As adolescents mature, their thinking moves to abstract and theoretical subjects. They have the capacity to reason with respect to possibilities. They typically have a close friend and enjoy spending time with friends

Interventions used by the nurse when providing care to a rigidly structured family include: 1. Attempting to change the family structure 2. Providing solutions for problems as they arise 3. Exploring with the family the benefits of moving toward more flexible modes of action 4. Administering nursing care in a manner that provides minimal opportunity for change

3. Exploring with the family the benefits of moving toward more flexible modes of action -. Very rigid structures impair functioning.

A 50-year-old woman has elevated serum cholesterol levels that increase her risk for cardiovascular disease. The nurse helps this patient control this risk factor by assessing the patient's current diet trends and describing dietary changes to reduce the patient's risk for developing cardiovascular disease. This nursing activity is a form of: 1. Referral 2. Counseling 3. Health education 4. Stress-management techniques

3. Health education -Health teaching offers dietary information to the woman to enable her to make decisions about her dietary health practices in an attempt to lower her cholesterol

A married couple has three children. The youngest child just graduated from college and is moving to a different city to take a job. The other two children left home several years ago. The parents of both spouses are older and are beginning to need help to maintain their home. What assessment questions will help the nurse determine the family's functioning? (Select all that apply.) 1. "Which transitions or changes in your family are you currently experiencing?" 2. "Are your children having any problems that are affecting your family right now?" 3. "Describe a recent family conflict and how your family resolved it." 4. "What coping strategies do you typically use as a family?" 5. "Who is involved in helping care for your parents?"

3. "Describe a recent family conflict and how your family resolved it." 4. "What coping strategies do you typically use as a family?" 5. "Who is involved in helping care for your parents?" -This couple no longer has children living at home and has older parents to assist. Assessment questions about family functioning address how individuals behave in relation to one another, which is reflected in questions that determine how the family completes routine activities (e.g., making meals, doing laundry), communicates, and solves problems

A nurse is completing an assessment on a male patient, age 24. Following the assessment, the nurse notes that his family history is not significant for chronic illnesses, and his physical and laboratory findings are within normal limits. Because of these findings, nursing interventions are directed toward activities related to which of the following? (Select all that apply.) 1. Instructing him to return in 2 years 2. Instructing him in secondary prevention 3. Instructing him in health promotion activities 4. Instructing him about routine screenings 5. Instructing him about proper vaccinations

3. Instructing him in health promotion activities 4. Instructing him about routine screenings 5. Instructing him about proper vaccinations -Although young adults generally have a minimum of major health problems, lifestyle factors 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 the risk for lifestyle-related health issues in the young adult. Proper vaccinations (e.g., flu vaccines and boosters to routine childhood vaccinations, such as tetanus) and regular health screenings are also important to main

A married couple has three children. The youngest child has graduated from college and is moving to a different city to take a job. The other two children left the home several years ago. What developmental tasks does the nurse expect this family to experience at this point in time? (Select all that apply.) 1. Take on parenting roles 2. Making room for the wisdom of older adults 3. Refocusing on marital issues 4. Determining new focus on recreational activities 5. Developing intimate relations with others

3. Refocusing on marital issues 4. Determining new focus on recreational activities

A family includes a mother, a stepfather, two teenage biological daughters of the mother, and a biological daughter of the father. The father's daughter just moved home following the loss of her job in another city. The family is converting a study into a bedroom and is in the process of distributing household chores. Nursing assessment reveals that all members of the family think that their family can adjust to lifestyle changes. This is an example of family: 1. Diversity 2. Durability 3. Resiliency 4. Configuration

3. Resiliency - Resiliency is the ability of the family to cope with the unexpected. This family used resources to provide some short-term solutions for the return home of an adult child.

Family structure can best be described as: 1. A complex set of relationships 2. A basic pattern of predictable stages 3. The pattern of relationships and ongoing membership 4. Flexible patterns that contribute to adequate functioning

3. The pattern of relationships and ongoing membership -Ongoing membership of the family and the pattern of relationships, which are often numerous and complex

Which physiological change would be a normal assessment finding in a middle adult? 1. Increased breast size 2. Reduced auditory acuity 3. Thickening of the waistline 4. Increased anteroposterior diameter of the thorax

3. Thickening of the waistline -The most visible changes are the graying of hair, wrinkling of the skin, and thickening of the waist.

A 7-year-old child was recently diagnosed with asthma. A nurse is providing education to the child and her parents about the treatment and management of asthma and changes they need to make in their home environment to promote her health. Which statement made by the parents requires follow-up by the nurse? 1. "We've made an appointment to talk with the school nurse about the change in our child's health." 2. "We forgot to give our daughter her medications before bedtime, so we made a list of her medications to help us remember." 3. "We worked out a schedule to check on her before and after school." 4. "We haven't been spending time with our parents because we're so busy taking care of our daughter."

4. "We haven't been spending time with our parents because we're so busy taking care of our daughter." -Changes in family relationships indicate possible family caregiver stress

According to Kohlberg, children develop moral reasoning as they mature. Which of the following is most characteristic of a preschooler's stage of moral development? 1. The rules of correct behavior are obeyed. 2. Behavior that pleases others is considered good. 3. Showing respect for authority is important behavior. 4. Actions are determined as good or bad in terms of their consequences.

4. Actions are determined as good or bad in terms of their consequences. -Level I: Preconventional reasoning Stage 1: Punishment and obedience orientation

A nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of: 1. Logical reasoning. 2. Egocentrism. 3. Concrete thinking. 4. Animism.

4. Animism. -This is the belief that inanimate objects have lifelike qualities; it is a component of magical thinking evident in preoperational thought

Which statement describing delirium is correct? 1. Symptoms of delirium are irreversible. 2. The onset of delirium is slow and insidious. 3. Symptoms of delirium are stable and unchanging. 4. Causes include electrolyte imbalances and cerebral anoxia

4. Causes include electrolyte imbalances and cerebral anoxia -It is a potentially reversible cognitive impairment that often has physiological causes.

Dave reports being happy and satisfied with his life. What do we know about him? 1. He is in one of the later developmental periods, concerned with reviewing his life. 2. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives. 3. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships. 4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.

4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages. -Each of the life stages, including old age, can be achieved successfully and result in satisfaction.

When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use? 1. Allowing the child to watch another child undergoing the same procedure 2. Showing the child pictures of what will be experienced 3. Talking to the child in simple terms about what will happen 4. Preparing the child through play with a doll and toy medical equipment

4. Preparing the child through play with a doll and toy medical equipment - Preschoolers are in the preoperational stage of cognitive development and learn more easily when play is used to teah

Mr. DeLone states that he is worried about his parents' plans to retire. All of the following would be appropriate responses regarding retirement of older-adults except: 1. Retirement may affect an individual's physical and psychological functioning. 2. Positive adjustment is often related to how much a person planned for the retirement. 3. Reactions to retirement are influenced by the importance that has been attached to the work role. 4. Retirement for most persons represents a sudden shock that is irreversibly damaging to self-image and self-esteem.

4. Retirement for most persons represents a sudden shock that is irreversibly damaging to self-image and self-esteem. -It is the stage of life characterized by transitions and role changes.

Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, "Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!" This is an example of adolescent: 1. Imaginary audience. 2. False-belief syndrome. 3. Personal fable. 4. Sense of invulnerability.

4. Sense of invulnerability. -. Adolescents can be risk takers and believe that they are immune to the negative consequences of behaviors; they are just beginning to be future oriented in their thought process and see everything as black or white

A 34-year-old female executive has a job with frequent deadlines. She notes that when the deadlines appear, she tends to eat high-fat, high-carbohydrate foods. She also explains that she gets frequent headaches and stomach pain during these deadlines. After receiving health education from the nurse, the executive decides to try yoga. In this scenario yoga is best described as which one of the following? 1. Outpatient referral 2. Counseling technique 3. Health promotion activity 4. Stress-management technique

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

Which of the following might be a cause of stress for young adults? (select all that apply) A. Being single B. Career C. Sexuality D. Activity

A. Being single B. Career C. Sexuality

Mr. Lawrence becomes confused on the third day of hospitalization. Mrs. Lawrence wants toknow what is causing this confusion. Katy explains that the confusion could be the result of whatfactors? (Select all that apply.) A. Cerebrovascular accident B. Electrolyte imbalance C. Emotional distress D. Unfamiliar environment E. Adverse effect of medication

A. Cerebrovascular accident B. Electrolyte imbalance C. Emotional distress D. Unfamiliar environment E. Adverse effect of medication

Cherise teaches Ms. Scott about the physiological changes of the gastrointestinalsystem that occur in older adults. Which of the following changes may occur inthe older adult's gastrointestinal system? (Select all that apply.) A. Delayed gastric emptying B. Constipation C. Increased peristalsis D. Diarrhea

A. Delayed gastric emptying B. Constipation D. Diarrhea -Gastrointestinal changes in the older adult include slowing of peristalsis, alterations in secretions, food intolerance, delayed gastric emptying, constipation, flatulence, and diarrhea

Katy is to first determine whether Mr. Lawrence is meeting the development tasks for an olderadult. Which of the following would Katy use to determine this? (Select all that apply.) A. He has adjusted to retirement. B. He maintains satisfactory living arrangements. C. He has a good relationship with his daughter. D. He is adjusting to having a cardiac disease

A. He has adjusted to retirement. B. He maintains satisfactory living arrangements. C. He has a good relationship with his daughter. D. He is adjusting to having a cardiac disease -developmental tasks in older adults are associated with varying degrees of change andloss. All of the above are related to change or loss.

a nurse is caring for a client who has left-sided hemiplegia resulting from a cerebral vascular accident. The client works as a carpenter and is now experiencing a situation in role changed based on physical limitations. The client is the primary wage earner in the family. which of the following describes the client's role problem A. Role conflict B. role overload C. role ambiguity D. Role strain

A. Role conflict

mr. Sampson is 5 feet 11 inches and weighs 238 pounds. Wayne teaches Mr.Sampson that obesity is linked to which of the following illnesses? (Select all thatapply.) A. Type 2 diabetes B. High cholesterol C. Asthma D. Joint problems E. Urinary tract infections

A. Type 2 diabetes B. High cholesterol C. Asthma D. Joint problems

A patient comes from a close-knit family. The patient's family functions as context. You will need to evaluate: A. attainment of patient needs. B. family attainment of developmental tasks. C. individual family members caring about one another. D. family satisfaction with its new level of functioning.

A. attainment of patient needs.

A nurse is preparing a health promotion course for a group of middle adults. which is the following strategies should the nurse recommend (select all that apply) A. eye examination every one to three years B. Decrease intake of calcium supplements C. DXA screening for osteoporosis D. increase intake for carbohydrate in the diet E. screening for a depressive disorders

A. eye examination every one to three years C. DXA screening for osteoporosis D. increase intake for carbohydrate in the diet E. screening for a depressive disorders

a nurse is talking with an older adult client about improving nutritional status which of the following intervention should the nurse recommend (Select all that apply) A. increase protein intake to increase muscle mass B. decrease fluid intake to prevent urinary incontinence C. increase calcium intake to prevent osteoporosis D. limit sodium intake to prevent edema E. increased fiber intake to prevent constipation

A. increase protein intake to increase muscle mass C. increase calcium intake to prevent osteoporosis D. limit sodium intake to prevent edema E. increased fiber intake to prevent constipation

the nurse is collecting history and physical examination data for a middle adult. The nurse should expect to find decreases in which of the following physiological functions (select all that apply) A. metabolism B. ability to hear low-pitch sounds C. gastric secretions D. far vision E. glomerular filtration

A. metabolism C. gastric secretions E. glomerular filtration

a nurse is planning a presentation for a group of older adults about health promotion and disease prevention which in the falling intervention should the nurse plan to recommend (SATA) A. HPV immunization B. Pneumococcal immunization C. yearly eye exam D. Periodic mental health screening E. Annual fecal blood test

B. Pneumococcal immunization C. yearly eye exam D. Periodic mental health screening E. Annual fecal blood test

delirium

Acute confusional state -abrupt -potentially reversable -daily fluctuations in symptoms; worse at night, in darkness, and on awakening

Discrimination against people due to increasing age

Ageism -banned by current laws

A nurse is discussing the plan of care for a client who reports following Islamic practices which the following statements by the nurse indicates culturally responsive care to the client A. "I will make sure the menu includes kosher options B. "I will ask the client if they want to schedule some time to pray during the day" C. "I will avoid discussing care when the client's family is around" D. "I will make sure daily communion is available for this client"

B. "I will ask the client if they want to schedule some time to pray during the day"

The nurses counseling a middle adult client who describes having difficulty dealing with several issues. which the following client statement should the nurse identify as the priority to assess further? A. "I am struggling to accept that my parents are aging and need so much help" B. "It's been so stressful for me to think about having intimate relationships" C. "I know I should volunteer my time for a good cause but maybe I'm just selfish" D. "I love my grandchildren, but my child expects me to relive my parenting days"

B. "It's been so stressful for me to think about having intimate relationships" - when using the urgent versus non urgent approach to client care the counseling priority is the problem that reflects a lack of completion of the previous stage and progression to the current stage of development. According to Erickson developing intimacy versus isolation is a task of young adulthood. This middle adult is still struggling with this task and needs assistance in working through searching for and developing intimate relationships with others

Jeff wants to include the most frequent cause of mortality and morbidity in his teaching to Lisa (28 y/o). What is the most common cause of death in this age group? A. Heart disease B. Accidents and violence C. Cancer D. Stroke

B. Accidents and violence

Cherise explores Ms. Scott's diet and cooking habits. Preparing meals is anexample of an activity of daily living (ADL). A. True B. False

B. False

Jane is developing a care plan for Mr. Thomas. She wants to make sure that she includes notonly physical needs but also psychological. She refers to Erikson's stages of development to helpher in planning care. Which stage of development is Mr. Thomas (44 y/o) in? A. Intimacy versus isolation B. Generativity versus self-absorption C. Identity versus role confusion D. Integrity versus despair

B. Generativity versus self-absorption

Mrs. Thomas tells Jane that her 5-year-old son has been acting up since Mr. Thomas came homefrom the hospital. Jane tells Mrs. Thomas that her son is in the initiative versus guilt stage ofdevelopment. What are some signs that he is progressing appropriately through this stage? A. He chooses not to eat the same food his father is eating. B. He cooperates with the request from his mother to play quietly instead of jumping on his father's bed. C. He starts putting things in his mouth. D. He cries when his mother leaves him with a sitter while she goes to the grocery store

B. He cooperates with the request from his mother to play quietly instead of jumping on his father's bed. -During the initiative versus guilt stage, the preschooler will control impulses and havecooperative behavior. The other choices are within the first two stages of Erikson's stages ofdevelopment

Carol is 21 years old. Which phase of Erikson's theory of psychosocialdevelopment is Carol experiencing? A. Identity versus role confusion B. Intimacy versus isolation C. Trust versus mistrust D. Initiative versus guilt

B. Intimacy versus isolation

Mr. Lawrence is prescribed a diuretic by his cardiologist and a sleeping aid by his primary care physician. Since these are both new medications, what nursing diagnosis should Katy add to Mr.Lawrence's plan of care? A. Potential for fluid deficit B. Risk for injury by falling C. Sleep deprivation D. Risk for impaired skin integrity

B. Risk for injury by falling -Because of the diuretic causing an increase in the need to get up to urinate and thesleeping medication causing drowsiness, there is a much greater potential for the patient to get up andgo to the bathroom without waiting for help

a nurse is collecting data to evaluate a middle adult psychosocial development. The nurse should expect middle adults to demonstrate which of the following developmental tasks (select all that apply) A. develop an acceptance of diminished strength and increased dependence on others B. Spend time focusing on improving job performance C. welcome opportunities to be creative and productive D. commit to finding friendship and companionship E. become involved with community issues and activities

B. Spend time focusing on improving job performance C. welcome opportunities to be creative and productive E. become involved with community issues and activities

A nurse is caring for a client whose partner passed away four months ago. The client has a recent diagnosis of diabetes mellitus. The client is tearful in states "How could you possibly understand what I'm going through?" Which of the following responses should the nurse make A. it takes time to get over the loss of a loved one B. You are right I cannot really understand. Perhaps you'd like to tell me more about what you're feeling C. Why don't you try something to take your mind off your troubles like watching a funny movie D. I might not share your exact situation, but I do know what people go through when they deal with loss

B. You are right I cannot really understand. Perhaps you'd like to tell me more about what you're feeling - by stating there is a lack of understanding the nurses using the therapeutic communication technique of validation the nurse is also creating a supportive and nonjudgmental environment and inviting the client to express frustrations

The nurses carrying for a client who has a new diagnosis of Type 2 diabetes mellitus. Which of the following nurse interventions for stress, coping and adherence to the treatment plan should the nurse initiate at this time (Select all that apply) A. Suggesting coping skills for the client to use in this situation B. allow the client to provide input in the treatment plan C. assist the client with the time management and address the client's priorities D. Provide extensive instructions on the client's treatment regimen E. encourage the client in the expression of feelings

B. allow the client to provide input in the treatment plan C. assist the client with the time management and address the client's priorities E. encourage the client in the expression of feelings

Nurses collecting data from an older adult client as part of a comprehensive physical examination. which of the following findings should the nurse expect as associated with aging (select all and apply) A. Skin thickening B. decreased height C. increased saliva production D. Nail thickening E. decreased bladder capacity

B. decreased height D. Nail thickening E. decreased bladder capacity

Rochelle adds the social and family information to Mr. Sanders' existing care plan. She knows that family nursing practice involves three levels of approach. These levels of approach are the family as ___________, _________, and__________.

Context, patient, system -Rationale: Family nursing practice has three levels of approach: family as context; familyas patient; and family as system.

You are caring for a patient. Visitors at the bedside include the patient's life partner, widowed father, brother, and niece. The nurse acknowledges that current trends in American families include: A. couples without children. B. more singles choosing to live alone. C. a very different look from 15 years ago. D. a mother, father, and more than one child.

C. a very different look from 15 years ago.

a nurses caring for a client awaiting transport to the surgical suite for a coronary artery bypass graft. Just as the transport team arrives the nurse takes the client's vital signs and notes and elevation in blood pressure and heart rate. The nurse should recognize that this response as which part of the general adaptation syndrome (GAS)? A. exhaustion stage B. resistant stage C. alarm stage D. recovery stage

C. alarm stage - the alarm stage of gas body functions (blood pressure and heart rate) are heightened in order to respond to stressors

a nurse is providing teaching for an older adult client who has lost 4.5 KG since the last admission six months ago which of the following instructions of the nurse include in the teaching? (SATA) A. eat 3 large meals a day B. eat your meals in front of the television C. eat foods that are easy to eat such as finger foods D. invite family members to eat meals with you E. exercise every day to increase appetite

C. eat foods that are easy to eat such as finger foods D. invite family members to eat meals with you E. exercise every day to increase appetite

When completing the nursing data on a client, to complete the admission and develop a plan of care, the nurse will need to: A. test the family unit's ability to cope. B. evaluate communication patterns. C. identify family unit form and attitudes. D. gather health data from all family members

C. identify family unit form and attitudes.

a nurse is counseling an order adult who describes having difficulty dealing with several issues. which in the following problems verbalized by the client should the nurse identify as the priority? A. I spent my whole life dreaming about retirement and now I wish I had my job back B. "It's been so stressful for me to have to depend on my child to help around the house" C. I just heard my friend Al died, That's the third one in 3 months" D. "I keep forgetting which medications I have taken during the day"

D. "I keep forgetting which medications I have taken during the day"

Carol is reviewing the psychoanalytical/psychosocial theories. Which stage of psychosocial development as defined by Freud focuses on delayed gratification? A. Oral B. Latency C. Phallic D. Anal

D. Anal

Which of the following might be a cause of stress for the middle-aged adult? A. Financial security B. Planned retirement C. Arrival of grandchildren D. Caring for children and aging parents

D. Caring for children and aging parents

The charged nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. which the following example should the nurse include as a developmental task for middle adulthood A. The client evaluates their behavior after a social interaction B. The client states that they are learning to trust others C. The client wishes to find meaningful friendships D. The client expresses concerns about the next generation

D. The client expresses concerns about the next generation - Erickson's task for a middle adult as generativity versus stagnation include showing concern for the next generation as an example for the age group

A nurse is caring for a family who is experiencing a crisis. which of the following approaches should the nurse use when working with the family using an open structure for coping with the crisis A. Prescribing tasks unilaterally B. delegating care to one member C. speaking to the primary client privately D. conveying a family meeting

D. conveying a family meeting - An open structure is loose, and conveying a family meeting would give all family members input an opportunity to express their feelings

According to Kohlberg, moral development is a component of psychosocial development. Moral development depends on the child's ability to integrate: A. modeling of others. B. faith and optimism. C. self-control and independence. D. decisions of right and wrong.

D. decisions of right and wrong.

As Wayne is talking to Mr. Sampson about his addictions, Mr. Sampson tellsWayne that he suspects he may have a sexually transmitted infection (STI) since he is experiencing discharge from his penis. Wayne informs the health care provider, who then orders an STI panel. Wayne knows that which of the following diseases will be tested for in the panel because of its high rate of incidence in men Mr. Sampson's age (22) ? A. Genital herpes B. Syphilis C. AIDS D. Gonorrhea E. Chlamydia

E. Chlamydia -Men ages 20 to 24 had a higher rate of chlamydia than any other group in2008; this was a 12.6% increase over the 2007 incidence.

gerontological nursing

Involves the provision of care that addresses mutually established goals for an older adult, the family, and health care team members

Presbycusis

a gradual loss of sensorineural hearing that occurs as the body ages -effects ability to hear high pitched

Middle adults

aged 35-64 -sandwich generation

Presbyopia

impaired vision as a result of aging -Decreased accommodation to near/far vision (decreased ability to focus on close objects)

Young adult psychosocial changes

lifestyle, career, sexuality, childbearing, parenthood, emotional health, singlehood, types of families, alternative family structures and parenting

Erik Erikson

ØTrust vs. mistrust (birth to 12 to 18 months) ØAutonomy vs. sense of shame and doubt (18 months to 3 years) ØInitiative vs. guilt (3 to 6 years) ØIndustry vs. inferiority (6 to 12 years) ØIdentity vs. role confusion (puberty) ØIntimacy vs. isolation (young adult) ØGenerativity vs. self-absorption and stagnation (middle age) ØIntegrity vs. despair (old age)

Moral development theory -Kohlberg's Theory of Moral Development

•Level I: Preconventional reasoning •Level II: Conventional reasoning •Level III: Postconventional reasoning

Cognitive developmental theory -Jean Piaget

•Period I: Sensorimotor (birth to 2 years) •Period II: Preoperational (2 to 7 Years) •Period III: Concrete Operations (7 to 11 Years) •Period IV: Formal Operations (11 Years to Adulthood)

Psychoanalytical/psychosocial theory -Sigmund Freud

•Stage 1: Oral (birth to 12 to 18 months) •Stage 2: Anal (12 to 18 months to 3 years) •Stage 3: Phallic or oedipal (3 to 6 years) •Stage 4: Latency (6 to 12 years) Stage 5: Genital (puberty through adulthood