Chapter 10: Developmental Processes

10. What age range defines middle adulthood? a. 45 to 65 years b. 20 to 35 years c. 65 to 75 years d. 30 to 50 years

ANS: A The term middle adulthood usually refers to the ages between 45 and 65 years. DIF: Cognitive Level: Knowledge REF: p. 132 OBJ: 2 TOP: Middle Years KEY: Nursing Process Step: N/A

27. What should be a nurse's focus when counseling a 25-year-old mother and businesswoman regarding health promotion? (Select all that apply.) a. Adhering to an exercise program b. Having a Pap stain/test performed every 3 years c. Making annual appointments for a mammogram d. Performing a self-breast examination (SBE) monthly e. Scheduling an annual physical examination

ANS: A, D Adequate exercise programs and monthly SBEs are appropriate for a 25-year-old woman. Annual physical examinations are not necessary. Mammograms are recommended after the age of 40 or 50 years. Pap stains/tests should be performed annually. DIF: Cognitive Level: Comprehension REF: p. 130-131 OBJ: 2 TOP: Health Promotion Behaviors for Young Adult KEY: Nursing Process Step: Implementation

15. What is most likely to occur during the time period of young adulthood? a. Earning most of his or her money, paying most of the taxes, and having most of the power in business b. Settling down to a career, raising a family, and taking on new responsibilities c. Experiencing personal freedom and enjoying maximum influence over others d. Focusing on many adjustments that must be made to physiologic, psychologic, and social changes

ANS: B Developmental tasks of young adults include becoming established in a vocation or profession that provides personal satisfaction, economic independence, and a feeling of making a worthwhile contribution to society. DIF: Cognitive Level: Comprehension REF: p. 129 OBJ: 1 TOP: Developmental Tasks: Young Adulthood KEY: Nursing Process Step: N/A

3. What does intimacy accomplish when developed in a relationship? a. Allows for sexual expression b. Gives priority to the well-being of another over one's own c. Guarantees a suitable setting for the selection of a partner d. Requires exclusion of all others

ANS: B Intimacy refers to a situation in which the well-being of another takes priority. Intimacy does not guarantee a suitable spouse nor require that other interpersonal relations be abandoned. DIF: Cognitive Level: Comprehension REF: p. 129 OBJ: 1 TOP: Developmental Tasks: Young Adulthood KEY: Nursing Process Step: Implementation

25. What is the term sandwich generation used to describe? a. Young adults who tend to eat on the run b. Middle-aged adults caring for both children and parents c. Single-parent households d. Older adults who are in transition from independent to assisted living

ANS: B Many people who are in their middle years belong to a group called the sandwich generation. They may have teenagers and young adults at home and, at the same time, have ailing elderly parents to care for. DIF: Cognitive Level: Knowledge REF: p. 132 OBJ: 2 TOP: Middle Years KEY: Nursing Process Step: N/A

22. What are the leading causes of death in older adults? a. Vehicular accidents and suicide b. Cardiovascular disease and diabetes mellitus c. Alcoholism and cirrhosis d. Cancer and strokes

ANS: B The major cause of death of those in the older age group is related to chronic illness, specifically cardiovascular disease, cancer, and diabetes mellitus. DIF: Cognitive Level: Knowledge REF: p. 134 OBJ: 3 TOP: Health Problems of the Older Adult KEY: Nursing Process Step: N/A

7. What is the major cause of death in young adults? a. Cervical and testicular cancer b. Overwhelming infection c. Accidents and violence d. Human immunodeficiency virus (HIV)

ANS: C Accidents and violence are the leading causes of death in the young adult age group. DIF: Cognitive Level: Knowledge REF: p. 130 OBJ: 2 TOP: Health Concerns of the Young Adult KEY: Nursing Process Step: Implementation

11. Which term best describes the functional capabilities of various organ systems in the body? a. Psychologic age b. Social age c. Biologic age d. Chronologic age

ANS: C Biologic age focuses on the functional capabilities of various organ systems in the body. DIF: Cognitive Level: Knowledge REF: p. 133 OBJ: 3 TOP: Middle Years KEY: Nursing Process Step: N/A

19. Which age group is asking patients about loneliness a particularly significant assessment? a. Young adults b. Old young adults c. Old middle-aged adults d. Older adults

ANS: D Because of changes in living conditions and the loss of a spouse or significant other, older adults may feel lonely. DIF: Cognitive Level: Comprehension REF: p. 133-134 OBJ: 1 TOP: Development Tasks: Older Adulthood KEY: Nursing Process Step: Assessment

23. A 74-year-old man asks a nurse if he needs to get revaccinated with the pneumococcal vaccine because he has not had one for 2 years. What is the most informative response by the nurse? a. "Yes. You should have the pneumonia vaccine every year." b. "No. One vaccination for pneumonia is all you need." c. "Yes. Every year they alter the vaccine to include more infectious organisms." d. "No. You only need to be revaccinated every 5 years."

ANS: D Pneumonia revaccination should be given every 5 years. DIF: Cognitive Level: Comprehension REF: p. 134 OBJ: 3 TOP: Pneumonia Vaccine KEY: Nursing Process Step: Implementation

12. To what does a person's type of dress, language, and social relationships pertain? a. Psychologic age b. Biologic age c. Chronologic age d. Social age

ANS: D Social age refers to the roles and habits of a person in relation to other members of society, including such aspects as the person's type of dress, language, and social relationships. DIF: Cognitive Level: Knowledge REF: p. 133 OBJ: 3 TOP: Middle Years KEY: Nursing Process Step: N/A

6. A 25-year-old man receives a tetanus booster. When should the nurse instruct the man to get his next booster? a. Next year b. In 2 years c. In 5 years d. In 10 years

ANS: D Tetanus boosters should be repeated every 10 years to maintain the antibody level. DIF: Cognitive Level: Knowledge REF: p. 131 OBJ: 3 TOP: Developmental Tasks: Tetanus Booster in the Young Adult KEY: Nursing Process Step: N/A

29. A nurse assesses that a 22-year-old woman who is totally committed to her career and who does not date or socialize is experiencing the Eriksonian crises of _____.

ANS: isolation If a person is not building generativity, the resulting crisis is that of isolation. DIF: Cognitive Level: Comprehension REF: p. 130 OBJ: 1 TOP: Self-Absorption KEY: Nursing Process Step: Assessment

9. What age group is balancing work and other roles as a developmental task? a. Middle adulthood b. Young adulthood c. Older adulthood d. Late adulthood

ANS: A Balancing work and other roles is a developmental task of middle adulthood. DIF: Cognitive Level: Knowledge REF: p. 132 OBJ: 1 TOP: Developmental Tasks: Middle Adulthood KEY: Nursing Process Step: N/A

14. To what are most health problems in young adults related? a. Stress b. Smoking c. Alcohol consumption d. Fatigue

ANS: A Stress in the workplace and at home is the cause of most of the health problems of young adults. DIF: Cognitive Level: Knowledge REF: p. 130 OBJ: 2 TOP: Health Concerns of the Young Adult KEY: Nursing Process Step: Assessment

28. To what is the gradual weight gain of a 25-year-old man most likely related? (Select all that apply.) a. Consuming the same amount of calories as he did as an adolescent b. Inadequate exercise c. Consuming large amount of protein in the diet d. Keeping late hours, resulting in inadequate rest e. Eating junk food

ANS: A, B, E Obesity in young adults is related to maintaining eating habits from adolescence in terms of amount and content but with inadequate exercise. DIF: Cognitive Level: Knowledge REF: p. 130-132 OBJ: 2 TOP: Weight Gain KEY: Nursing Process Step: Assessment

26. Why have many young adults today extended their adolescence and live with their parents? (Select all that apply.) a. Postgraduate educational goals b. Military obligations c. Job losses d. Chronic illnesses e. Divorces

ANS: A, C, E Education, job loss, and divorce have caused many young adults to return to their parents' homes. DIF: Cognitive Level: Comprehension REF: p. 129 OBJ: 1 TOP: Extended Adolescence KEY: Nursing Process Step: N/A

20. What is an example of an ethnic- and gender-related difference in life expectancies? a. Black men live longer than white men. b. White women live longer than black women. c. Black men live longer than black women. d. White men live longer than white women.

ANS: B Life expectancies have been extended for all middle-aged adults. White men have a life expectancy of 75.7 years, white women have a life expectancy of 80.4 years, black men have a life expectancy of 69.5 years, and black women have a life expectancy of 76.5 years. DIF: Cognitive Level: Comprehension REF: p. 132 OBJ: 1 TOP: Extended Life Expectancy KEY: Nursing Process Step: Planning

13. Older adults have the ability to remember, dream, and exercise behavioral control. To what are these factors most related? a. Biologic age b. Psychologic age c. Social age d. Chronologic age

ANS: B Psychologic age refers to the behavioral capacity of the person to adapt to changing environmental demands and the ability to remember, learn, and exercise behavioral control. DIF: Cognitive Level: Knowledge REF: p. 133 OBJ: 3 TOP: Middle Adulthood KEY: Nursing Process Step: N/A

21. A single 48-year-old woman has not had a regular menstrual period for the past 6 months. She tells the nurse she has been experiencing vaginal spotting for the past several days. What may these symptoms indicate? a. Miscarriage b. Endometrial cancer c. Severe vaginitis d. Resumption of menses

ANS: B Unexpected vaginal bleeding in menopausal women may be signs of endometrial cancer. DIF: Cognitive Level: Application REF: p. 133 OBJ: 2 TOP: Vaginal Bleeding in Menopausal Women KEY: Nursing Process Step: Implementation

1. What should a nurse take into consideration regarding developmental tasks when planning patient care? a. All of the activities performed throughout life b. Activities learned primarily in the middle years of life c. Things to be learned and accomplished in each stage of life d. All actions taken when confronted with specific problems

ANS: C Developmental processes are changes that present challenges that must be undertaken and mastered for a person to go on to the next stage successfully. DIF: Cognitive Level: Comprehension REF: p. 129 OBJ: 1 TOP: Developmental Tasks KEY: Nursing Process Step: Planning

2. An unmarried 21-year-old patient is admitted to the hospital. During his hospitalization, he has visitors from work and church who come and go continuously. What part of the developmental process of young adults does this display? a. Young adults require many superficial relationships. b. Young adults do not require much rest for recovery. c. Young adults are socially oriented. d. Young adults need to combat loneliness.

ANS: C Developmental tasks for young adults center on acceptance of self, independence, intimacy, and social interactions. DIF: Cognitive Level: Comprehension REF: p. 129 OBJ: 3 TOP: Developmental Tasks: Young Adulthood KEY: Nursing Process Step: Assessment

17. Which group of adults must accept role reversal with their parents? a. Younger adults b. Old young adults c. Middle-aged adults d. Older-aged adults

ANS: C Middle-aged persons must accept role reversal with their parents. DIF: Cognitive Level: Knowledge REF: p. 132 OBJ: 3 TOP: Middle Years KEY: Nursing Process Step: Planning

8. An 18-year-old patient reports to the nurse that she has been sexually active since the age of 15 years and uses oral contraceptives regularly. What is the priority diagnostic test for this patient? a. Mammography b. Digital rectal examination c. Papanicolaou (Pap) stain/test d. Pregnancy test

ANS: C Young women should get a Pap stain/test 3 years after becoming sexually active. DIF: Cognitive Level: Application REF: p. 130 OBJ: 2 TOP: Young Adult Years KEY: Nursing Process Step: Implementation

4. Which behavior is not characteristic of a young adult's developmental task? a. Living in his or her own apartment b. Accepting a place on the board of a community agency c. Interacting with a large group of friends d. Dating many different young women

ANS: D As young adults enter their 30s and 40s, their focus is directed mainly toward raising a family and furthering their career. A heterosexual intimate relationship is not in keeping with developmental tasks. DIF: Cognitive Level: Comprehension REF: p. 120-130 OBJ: 1 TOP: Developmental Tasks: Young Adulthood KEY: Nursing Process Step: Assessment

16. Which statement made by a resident in a long-term care facility should lead the nurse to conclude a positive resolution of the developmental task of old age? a. "I love my children. I could have done more for them." b. "I am too young to be in a place like this." c. "I miss my friends and wife. I'm ready to go." d. "I've enjoyed the ride!"

ANS: D Developmental tasks of older adults include maintaining emotional satisfaction in relation to their past lives. DIF: Cognitive Level: Application REF: p. 134 OBJ: 3 TOP: Developmental Tasks: Older Adulthood KEY: Nursing Process Step: Assessment

5. What should young adults be thinking about by the age of 35 years? a. Leaving home and establishing their own lives b. Establishing career goals c. New career paths d. Health promotion for the prevention of chronic disease

ANS: D In the years between 30 and 45 years, especially after age 35 years, young adults should begin to think about the prevention of chronic illness, particularly cancer and heart disease. DIF: Cognitive Level: Comprehension REF: p. 131 OBJ: 3 TOP: Developmental Tasks: Young Adulthood KEY: Nursing Process Step: N/A

18. All of the following behaviors have been assessed by the nurse in a 52-year-old man. Which behavior is considered incongruent with middle-aged developmental tasks? a. Refusal to work more than 50 hours a week b. Refusal to give up time with his grandchildren c. Refusal to stop his semiweekly golf game d. Refusal to make preparations for retirement

ANS: D The developmental tasks of middle adulthood include preparation for retirement. DIF: Cognitive Level: Comprehension REF: p. 132 OBJ: 1 TOP: Developmental Tasks: Middle Adulthood KEY: Nursing Process Step: Implementation

24. Which intervention is directed toward reducing the most common cause of death among young adults? a. Teaching early warning signs of cancer b. Encouraging cardiovascular fitness c. Teaching principles of safe sex d. Promoting safe driving practices

ANS: D The four major causes of death in the young adult age group are vehicular accidents, other accidents, suicide, and homicide. DIF: Cognitive Level: Application REF: p. 130 OBJ: 3 TOP: Health Problems KEY: Nursing Process Step: Implementation