Human Growth & Development
Which client is eligible for Medicare?
A 65-year-old client who is disabled Rationale Clients who are 65 years of age and older may qualify for Medicare. A client who is in the first stage of renal disease does not require dialysis and therefore would not qualify for Medicare.
Which statement about family violence is true?
Alcohol and substance abuse can lead to family violence. Rationale Alcohol and substance abuse are among factors that contribute to family violence. The incidence of family violence increases, not decreases, with pregnancy. Sexual abuse occurs equally across all socioeconomic classes. Although abuse may end when one leaves a particular family environment, negative long-term physical and emotional consequences often persist.
What is the most therapeutic nursing intervention to help a late-middle-aged individual cope with the emotional aspects of aging?
Assisting the individual with plans for the future Rationale Helping an individual maintain an interest in the future is therapeutic. It is forward looking and fosters a positive attitude. Focusing on the individual's past experiences is appropriate for an older adult, not a late-middle-aged adult. Lectures may or may not include emotional aspects of aging; also, the client should express an interest in this subject. Encouraging the individual to focus on his or her career does not address concerns about the future.
Which type of family involves a nuclear family plus additional family members living in the same household?
Extended family Rationale An extended family involves a nuclear family plus additional members living in the same household who share responsibilities. In grandfamilies, the biological parents may or may not take part in the child's care. A nuclear family involves a married man, woman, and their children. A blended family involves an adult who is previously married who remarries and combines children within the new household.
A 65-year-old man is admitted to the hospital with a history of depression. The client, who speaks little English and has had few outside interests since retiring, says, "I feel useless and unneeded." The nurse concludes that the client is in which of Erikson's developmental stage?
Integrity versus despair Rationale Integrity versus despair is the task of the older adult; the client has difficulty accepting what life is and was, resulting in feelings of despair and disgust. Initiative versus guilt is the task of the preschool-aged child. Intimacy versus isolation is the task of the young adult. Identity versus role confusion is the task of the adolescent.
A registered nurse is teaching a nursing student about various developmental theories. What points mentioned by the registered nurse are accurate? Select all that apply.
Moral development theory attempts to define how moral reasoning matures in an individual. Developmental theory provides a basis for nurses to assess and understand a client's responses. Cognitive development focuses on rational thinking processes that include changes in children, adolescents, and adults to perform intellectual operations. Rationale Moral development theory attempts to define how moral reasoning matures in an individual. Developmental theory provides a basis for nurses to assess and understand a client's responses. Cognitive development focuses on rational thinking processes that include the changes in children, adolescents, and adults to perform intellectual operations. Biophysical development explores theories of why individuals age from a biological standpoint as well as why development follows a predictable sequence. Psychosocial theories describe human development from the perspectives of personality, thinking, and behavior.
Which sources provide prepaid health plans? Select all that apply.
Preferred provider organizations (PPOs) Health maintenance organizations (HMOs) Rationale Preferred provider organizations (PPOs) and health maintenance organizations (HMOs) provide prepaid health plans. Medicare provides benefits to disabled clients, clients who are at the end stage of renal disease, or clients 65 years of age or older. Medicaid provides benefits to poor and low-income clients. Private pay provides reimbursement for posthospitalization as well as many more benefits; this service does not work on a contractual basis.
Which statement regarding abuse is true?
Sexual abuse is nonconsensual sexual contact with another individual. Rationale Sexual abuse is nonconsensual sexual contact with another individual, including one who is incapable of providing consent. Emotional, not physical, abuse involves inflicting anguish, emotional pain, or distress through verbal or nonverbal acts. Material abuse, not neglect, is the improper exploitation of the victim's funds, property, or assets. Not feeding an individual is an example of neglect, not emotional abuse.
Which action should the nurse perform when conducting health assessment interviews with older clients?
Spend time in several short sessions to elicit more complete information from the clients Rationale Spending time in several short sessions reduces client fatigue and compensates for a shortened attention span, which is common in the older adult. The questionnaire may never be completed if it is left for the client to complete at his or her leisure. Asking family members rather than the client to supply the necessary information is degrading to the client; the client should be asked initially and, if necessary, family can be asked to fill in details later. Constantly referring to previous questions may be overwhelming and create feelings of anger and resentment.
The nurse considers that a 70-year-old female can best limit further progression of osteoporosis by doing what?
Taking supplemental calcium and vitamin D Rationale Research demonstrates that women past menopause need at least 1500 mg of calcium a day, which is almost impossible to obtain through dietary sources because the average daily consumption of calcium is 300 to 500 mg; vitamin D promotes the deposition of calcium into the bone. Consumption of eggs and cheese does not contain adequate calcium to meet requirements to prevent osteoporosis; these do not contain vitamin D unless fortified. If large amounts of magnesium are present, calcium absorption is impeded because magnesium and calcium absorption are competitive; vitamin E is unrelated to osteoporosis. Milk and milk products may not be consumed in quantities adequate to meet requirements to prevent osteoporosis.
A nurse is caring for an adult client who immigrated to this country 5 years ago. What does the nurse know about the past experiences of clients who have immigrated to this country?
They are important in assessment of their values. Rationale Past experiences are important and must be recognized because they set the parameters for the individual's enduring values throughout life. Past experiences do not affect inherited traits. Past experiences play an important role in an individual's life. Nothing establishes how an individual responds over a lifetime; new experiences continue to influence future responses.
The nurse administers a pneumococcal vaccine to a 70-year-old client. The client asks "Will I have to get this every year like I do with the flu shot?" How should the nurse respond?
"It is unnecessary to have any follow-up injections of the pneumococcal vaccine after this dose." Rationale The Centers for Disease Control and Prevention recommend that adults be immunized with pneumococcal vaccine at age 65 or older with a single dose of the vaccine; if the pneumococcal vaccine was received before 65 years of age or if there is the highest risk of fatal pneumococcal infection, revaccination should occur five years after the initial vaccination. The pneumococcal vaccine should not be administered every two years. The pneumococcal vaccine should not be administered annually.
A client confides to the nurse that she enjoys engaging in sex with multiple male adult sex partners simultaneously. What is the most appropriate response by the nurse?
"What are you using for birth control and protection from sexually transmitted infections?" Rationale Adults may have consensual sex as desired, but the nurse should encourage the use of birth control and protection from sexually transmitted infections. The nurse is interjecting personal values by stating that the client should seek counseling for this behavior or that the client's behavior is immoral. If the sex is consensual, it is not abusive.
Which can cause family stress? Select all that apply.
Abuse Divorce Chronic illness Rationale Abuse, divorce, and chronic illness can cause family stress. Influenza and engagements do not cause family stress.
When planning discharge teaching for a young adult, the nurse should include the potential health problems common in this age group. What should the nurse include in this teaching plan?
Accidents, including their prevention Rationale Accidents are common during young adulthood because of immature judgment and impulsivity associated with this stage of development. Kidney dysfunction is not a problem specific to any one stage of growth. Cardiovascular disease is a common health problem in middle adulthood. Glaucoma is a common health problem in the older adult.
Which risk factors are associated with the future development of osteoporosis in women? Select all that apply.
Cigarette smoking Familial predisposition Inadequate intake of dietary calcium Rationale Cigarette smoking is a high-risk behavior associated with an increased incidence of osteoporosis in later life. Familial predisposition is considered a risk factor for the development of osteoporosis. Inadequate calcium intake during the premenopausal years is a risk factor for the development of osteoporosis after menopause. Moderate exercise is not considered a risk factor for the development of osteoporosis, although a sedentary life-style is. Use of street drugs is not considered a risk factor for osteoporosis.
Which characteristic change is observed during the late adolescence stage?
Develops adult relationships Rationale The characteristic change observed during the late adolescence stage is developing adult relationships. Early adolescence is characterized primarily by the changes of puberty. Middle adolescence is characterized by changes in dressing and dominant peer orientation.
Identify the populations who are eligible for the Medicare insurance program. Select all that apply.
Disabled individuals Clients receiving dialysis People older than 65 years Rationale Medicare covers disabled people, dialysis clients, and clients older than 65 years of age. Medicaid insurance programs cover low-income children and uninsured pregnant women.
Which statement regarding menopause is true?
During menopause, menstrual flow ceases and hormone levels decrease Rationale During menopause, menstruation ceases and estrogen and progesterone hormone levels decrease. The reduction in estrogen results in hot flashes. Menopause usually occurs in women between 42 and 58 years of age. Cigarette smoking, family history, and surgical intervention are all associated with early menopause.
An older adult tells the nurse, "I regret so many of the choices I've made during my life." Which of Erikson's developmental conflicts has the client probably failed to accomplish?
Ego integrity versus despair Rationale The sense of ego integrity comes from satisfaction with life and acceptance of what has been and what is. Despair reflects guilt or remorse over what might have been. During puberty adolescents attempt to find themselves and integrate their own values with those of society; an inability to solve conflict results in confusion and hinders mastery of future roles. During early and middle adulthood the individual is concerned with the ability to produce and to care for that which is produced or created; failure during this stage leads to self-absorption or stagnation. Autonomy, the ability to control the body and environment, is developed during the toddler period; doubt may result when the child is made to feel ashamed or embarrassed.
According to Erikson, a person's adjustment to the period of senescence will depend largely on the adjustment the individual made to which earlier developmental stage?
Generativity versus stagnation Rationale Erikson theorized that how well people adapt to the current stage depends on how well they adapted to the stage immediately preceding it - in this instance, adulthood. Although Erikson believed that the strengths and weaknesses of each stage are present in some form in all succeeding stages, their influence decreases with time
A middle-aged adult contributes to future generations through parenthood, teaching, and community involvement. To which stage of Erikson's theory does this relate?
Generativity versus stagnation Rationale In the generativity versus stagnation stage, the adult focuses on supporting future generations. Middle-aged adults achieve success in this stage by contributing to future generations through parenthood, teaching, and community involvement. The ego integrity versus despair stage is seen in older adults. During this stage, some older adults live their lives with a sense of satisfaction and others see themselves as failures marked by despair and regret. The intimacy versus isolation stage is seen in young adults, in which they develop a sense of identity and a capacity to love and care for others. In the identity versus role confusion stage, an individual will have a marked preoccupation with his or her appearance and body image.
Which opposing conflict does a young adult face according to Erikson's theory of psychosocial development?
Intimacy versus Isolation Rationale According to Erikson's theory of psychosocial development, a young adult is likely to face Intimacy versus Isolation. An adolescent is likely to face Identity versus Role confusion. A toddler age 1 to 3 years of age is likely to face Autonomy versus Sense of Shame and Doubt. A middle-aged adult is likely to face Generativity versus Self-Absorption and Stagnation.
According to Erikson, a young adult must accomplish the tasks associated with which stage?
Intimacy versus isolation Rationale Major tasks of young adulthood are centered on human closeness and sexual fulfillment; lack of love results in isolation. The trust versus mistrust stage is associated with infancy. The industry versus inferiority stage is associated with middle childhood. The generativity versus stagnation stage is associated with middle adulthood.
According to Erikson, a young adult must accomplish the tasks associated with which stage?
Intimacy versus isolation Rationale Major tasks of young adulthood are centered on human closeness and sexual fulfillment; lack of love results in isolation. The trust-versus-mistrust stage is associated with infancy. The industry-versus-inferiority stage is associated with middle childhood. The generativity-versus-stagnation stage is associated with middle adulthood.
What conflict associated with Erikson's psychosocial stages of development should the nurse remember when caring for a client 30 years of age?
Intimacy versus isolation Rationale The major task of the young adult is to develop close, sharing relationships that may include a sexual partnership; the person develops a sense of belonging and avoids isolation. During the integrity-versus-despair stage the adjusted older adult can look back with satisfaction and acceptance of life and resolve the inevitability of death; failure at these tasks results in despair. The middle school-aged child gains a sense of competence and self-assurance as social interactions and academic pursuits are mastered; failure in these tasks leads to feelings of inferiority. During adolescence the individual develops a sense of self, self-esteem, and emotional stability; failure to establish self-identity results in a lack of self-confidence and difficulty with occupational choices.
A nurse is evaluating a young adult for evidence of achievement of the age-related developmental stage set forth in Erikson's developmental theory. What developmental crisis is associated with this age group?
Intimacy versus isolation Rationale The major task of young adulthood is centered on human closeness and sexual fulfillment; lack of love results in isolation. The trust-versus-mistrust stage is associated with infancy. The industry-versus-inferiority stage is associated with middle childhood (school age). The generativity-versus-stagnation stage is associated with middle adulthood.
The primary health-care provider suggests that a low-income 40-year-old client with cardiovascular disease, hypertension, and cerebrovascular accident access long-term care services. Which system would financially support the client to access the services?
Medicaid Rationale Medicaid provides benefits to low-income clients. Therefore, the client can apply for Medicaid. Medicare gives reimbursement benefits to clients with terminal illnesses or clients 65 years of age or older. A third party provides post-hospitalization care services. In private pay, the individual has to pay for home health services.
A 70-year-old client is admitted to the hospital with end-stage renal disease. Which insurance program would cover the client's hospital payments?
Medicare Rationale Medicare is a federal insurance program that covers hospital payments for clients older than 65 years of age or clients who have end-stage renal disease. Medicaid is a federal insurance program that pays for the health-care costs for low-income clients of all ages and home-care services to the poor and needy. Preferred provider organizations (PPOs) and health maintenance organizations (HMOs) are prepaid health plans operated independently or through employer groups.
An individual is verbally inflicting anguish, emotional pain, and distress on an older adult. Which type of abuse is this?
Psychological Rationale Psychological or emotional abuse involves the infliction of anguish, emotional pain, or distress through verbal or nonverbal acts. Sexual abuse is nonconsensual sexual contact including with someone who is incapable of giving consent. Physical abuse involves the use of physical force that may cause bodily injury, physical pain, or impairment. Material abuse is defined as illegal or improper exploitation of an older adult's funds, property, or other assets.