Chapter 23: Middle-Aged Adult

A 45-year-old client who has experienced a ten pound weight gain during the past year asks the nurse if she thinks iron supplements would help increase her energy. Which of the following would be the most appropriate action for the nurse to take? a. Ask the client to describe her daily activity and diet b. Leave a note requesting an iron supplement on the clients chart for the doctor c. Provide the client with information related to aerobic exercise classes d. Ask the client if she is still menstruating

A

A nurse has received a grant to provide a community-based education series for middle-age adults. Which of the following topics would allow the nurse to have the greatest impact on the health of members of this age group? a. Diet and exercise b. Seat belt use c. Depression screening d. Cancer prevention

A

The occupational health nurse is asked to develop a plan to reduce work-related injuries. Which of the following recommendations would the nurse stress as the most effective way to reduce work-related injuries? a. Make the work environment smoke-free. b. Reduce environmental noise levels. c. Conduct regular walk-through assessments at the worksite. d. Increase paid personal days from one to three.

A

Which of the following medications is generally recommended to help preserve cardiovascular health in middle-age women? a. Aspirin b. Folic acid c. Estrogen d. Estrogen receptor modulator

A

Which of the following middle-age adults has successfully transitioned to Eriksons generativity-versus-stagnation stage of development? a. A 60-year-old woman who retired last year and volunteers at a homeless shelter 2 days a week b. A 63-year-old man who regrets his career choice and feels he cannot change careers c. A 45-year-old woman who resents having to care for her aging mother-in-law d. A 50-year-old man who has not saved for retirement but spends his discretionary income on vacations he takes by himself

A

Which of the following statements about alcohol intake is correct? a. Women have a higher death rate related to alcoholism than men. b. A woman who drinks two glasses of wine per day with her evening meal is considered a moderate drinker. c. More women than men are considered problem drinkers. d. Women who experience fewer cognitive effects from drinking are less likely to drink heavily than do women who get a buzz from drinking.

A

A 62-year-old person states to the nurse, I have trouble with my peripheral vision. Sometimes, I do not notice objects unless they are in front of me. Which of the following disorders is the client likely experiencing? a. Presbyopia b. Glaucoma c. Cataracts d. Diabetic retinopathy

B

A nurse conducted a 5-week education series about health maintenance. Which of the following statements by a participant indicates the analysis stage of cognition as defined by Blooms taxonomy? a. If I eat too much food and do not exercise, I will gain weight. b. Fat is more calorie-dense than is protein. If I eat calorie-dense foods and do not do moderate exercise at least 5 days a week, I will gain weight. c. I will walk briskly at least a mile a day, 6 days a week, to maintain a healthy weight. d. I can eat more if I exercise more.

B

A nurse has been asked to develop a visit plan for a mobile mammogram van. Which of the following considerations would be made by the nurse when deciding which neighborhoods to visit? a. Hispanic women have the highest rate of breast cancer of all minority groups in the United States. b. The death rate from breast cancer is higher in Hispanic women than for women in other ethnic groups. c. The death rate from breast cancer in Hispanic women has risen in the past 10 years. d. Breast cancer in Hispanic women is usually diagnosed at an early stage.

B

A nurse is conducting a community education program. Which of the following should be stressed as the leading cause of death in middle-age adults? a. Automobile accidents b. Malignant disease c. Homicide d. Suicide

B

An occupational health nurse is planning injury-prevention educational sessions. Which of the following considerations should be made by the nurse? a. Education should be focused on workers with the least experience. b. All workers need continued education related to safety issues. c. OSHA rules apply to all companies with more than 25 employees. d. Middle-age workers have the lowest rate of injury of any age group.

B

The nurse collects the following assessment data from a woman: Hispanic ethnicity, BMI 29 kg/m2, age 41. Which of the following actions should be taken by the nurse? a. Encourage the client to continue her dietary and exercise patterns. b. Discuss her current dietary and exercise lifestyle habits. c. Counsel the client that she will face chronic health problems because of her weight. d. Encourage the client to adopt a low-calorie diet to help control her weight.

B

A 35-year-old person asks the nurse working in a dermatology clinic what causes skin to wrinkle. Which of the following statements would be most appropriate way for the nurse to reply? a. There is really nothing you can do to prevent a lot of wrinkles. It is part of aging. b. As we age, we lose fat beneath the skin so wrinkles appear. There is nothing we can do to prevent it. c. Wrinkles appear for a number of reasons, including loss of fat beneath your skin and too much sun exposure. d. Wrinkles are caused by genetic factors.

C

A 52-year-old woman going through menopause tells the nurse working in the womens health center that she is interested in slowing down the aging process and asks if she should take estrogen. Which of the following statements would be the best response by the nurse? a. The latest research has shown that estrogen is safe to take and will help keep you healthy. Ill tell the nurse practitioner that you are interested in estrogen therapy. b. Estrogen is safe to take for about 10 years. Ill get you some information on estrogen therapy that you can take home and read. c. The safety of long-term estrogen therapy is inconclusive. It is primarily used short-term to relieve hot flashes. d. You can get the same effects from natural products in a health food store, and each product is backed up by research showing that it is effective.

C

A 63-year-old woman complains to the nurse that she has insomnia and sleeps only 6 hours a night. Which of the following responses should be made by the nurse? a. Do you want a sleeping pill? b. Make sure that you do not nap during the day even if you are tired. c. Do you feel excessively tired during the day? d. The nurse practitioner may want to run some simple tests to find out why you are having trouble sleeping.

C

A nurse formed a political action committee to advocate for health insurance for the uninsured. On which of the following populations would the nurse focus the groups efforts? a. Asian Americans b. Blacks c. Hispanic Americans d. Working-poor White Americans

C

A nurse working in a rural location is interested in starting a weight management group for clients in the area. Which of the following interventions is most likely to ensure success? a. Using a pre-set list of topics for discussion b. Relying on printed material to relay information to the group c. Asking for a list of topics that interest the group d. Beginning each session with a 2-mile walk

C

Which of the following effects of divorce on middle-age adults and children has been documented by research? a. Children adapt to divorce more rapidly than do adults. b. Emotional healing after a divorce takes approximately 24 months in adults. c. Children of divorced parents may have life-long difficulty forming relationships. d. Children of divorced parents undergo similar emotional turmoil as their parents.

C

Which of the following is a normal physiological change that occurs during middle age? a. Increase in gastric emptying resulting in acid reflux b. Reduction in height caused by kyphosis c. Reduction of glomerular filtration by 50% d. Increase in the amount of estrogen produced in both genders

C

A 52-year-old postmenopausal woman tells the nurse that she is afraid she will develop osteoporosis like her mother did. Which of the following statements is the most appropriate response by the nurse? a. The American diet is much better now than when your mother was your age, so you have enough calcium in your diet to keep your bones strong. b. You have a strong genetic risk factor. There is not much we can do to stop the process. c. You need about 1000 mg of calcium a day to keep your bones strong. Lets talk about your diet. d. Tell me about your diet, how much walking you do each day, and what medications you take.

D

A nurse is discussing sexuality with middle-age men and women. Which of the following information should be stressed by the nurse? a. Contraception usage should be decreased as a woman nears menopause. b. Difficulty with sexual performance among men happens near age 60. c. HIV infection after age 50 is rare. d. The majority of new HIV/AIDS cases occur among middle-age adults.

D

Taking into account all of the agents that affect middle-age adults, the nurse plans a health education workshop focused on developing an individualized lifestyle change program for each participant. Which of the following actions should the nurse stress that individuals take first? a. Limiting unprotected exposure to sun b. Starting a smoking cessation program c. Exercising at least three times a week d. Scheduling a complete physical and dental exam

D

The occupational health nurse is planning a health fair for employees. Which of the following information about dental health should be included? a. Drinking bottled water helps prevent tooth decay. b. Gingivitis results in bone destruction and can be eliminated by flossing daily. c. Preventive dental care requires a visit to the dentist every 4 months. d. In addition to screening for tooth decay, dentists screen for mouth cancer.

D

Which of the following people has exceeded the recommended guidelines for activity? a. A 36-year-old man who engages in bike riding and has a pulse rate of 137 during activity b. A 45-year-old woman who swims and has a pulse rate of 145 during activity c. A 50-year-old man who jogs and has a pulse rate of 120 during activity d. A 60-year-old woman who walks briskly and has a pulse rate of 125 during activity

D