Adaptive Quizzing, Chapter 13 Young and Middle Adult

The nurse assesses a group of young adults who have been identified as at risk by their school. Some have been in trouble for fighting at school or performing other acts of violence. Which questions should the nurse ask to determine their susceptibility to engage in violence? Select all that apply. 1 "Does your family have a steady income?" 2 "Do you have access to guns?" 3 "Have you had any changes in diet recently?" 4 "Have you experienced abuse in the past?" 5 "Do you sit for long periods of time, or are you physically active after school?"

1 "Does your family have a steady income?" 2 "Do you have access to guns?" 4 "Have you experienced abuse in the past?" The factors that predispose young adults to engage in violent activity are poverty, access to guns, and a history of child abuse. Changes in diet and sedentary lifestyle are not considered risk factors for an individual to engage in violence.

During an assessment, the nurse suspects a patient is the victim of intimate partner violence (IPV). Which patient statements led the nurse to this conclusion? Select all that apply. 1 "My partner has a drug habit." 2 "My partner was recently laid off at work." 3 "My partner smokes two packs of cigarettes a day." 4 "My partner doesn't always let me see my friends when I want to." 5 "My partner and I always use a condom when having sexual intercourse."

1 "My partner has a drug habit." 2 "My partner was recently laid off at work." 4 "My partner doesn't always let me see my friends when I want to." If the partner has a drug abuse problem, was recently laid off (which causes financial strain), and controls the patient by not allowing him or her to see his or her friends, these are indications that the patient may be a victim of IPV. While drug and alcohol abuse are correlated with IPV, cigarette smoking isn't. The decision to use a condom during sexual intercourse is a healthy one and doesn't indicate IPV.

A pregnant woman in her first trimester approaches the nurse for a regular checkup. The patient expresses concern about her husband, because his sexual needs are not fulfilled. Which information should the nurse provide to this patient to overcome this psychosocial stress? Select all that apply. 1 Advise cuddling and holding. 2 Explain that a woman's sexual activity is influenced by body image. 3 Convince the patient to abstain from sexual intercourse. 4 Explain that sexual intercourse may result in premature labor. 5 Reassure the couple that sexual activity does not harm the fetus.

1 Advise cuddling and holding. 2 Explain that a woman's sexual activity is influenced by body image. 5 Reassure the couple that sexual activity does not harm the fetus. The correct concepts of sexuality in pregnancy should be explained to the couple. A pregnant woman may desire to be cuddled rather than having intercourse, but intercourse during pregnancy will not harm the fetus. A woman's activity is influenced by her body image, which changes during pregnancy. Sexual abstinence is not required, and sexual intercourse does not result in premature labor.

Which factors have been linked to intimate partner violence (IPV)? Select all that apply. 1 Alcohol abuse 2 Pregnancy 3 Unemployment 4 Drug use 5 Religion

1 Alcohol abuse 2 Pregnancy 3 Unemployment 4 Drug use Intimate partner violence (IPV) has been linked to alcohol abuse, especially heavy drinking; stress from unemployment of the perpetrator; drug use; and pregnancy. The greatest risk of IPV occurs during the reproductive years, with a pregnant woman having a 35.6% greater risk of being a victim of IPV than a nonpregnant woman.

The nurse teaches a group of young adults in a community center about the pathophysiological changes related to obesity. Which conditions should the nurse mention as being linked to obesity? Select all that apply. 1 Asthma 2 Hypotension 3 Type 1 diabetes 4 Psoriatic arthritis 5 Hypercholesterolemia

1 Asthma 4 Psoriatic arthritis 5 Hypercholesterolemia Obesity is linked to conditions such as asthma, joint conditions such as psoriatic arthritis, and high cholesterol. Obesity does not cause hypotension, but rather hypertension. Obesity is linked to type 2 diabetes. The link to type 1 diabetes is not known.

The nurse prepares to teach good health practices to a patient who is planning to conceive. Which topics should the nurse include in the teaching for this patient? Select all that apply. 1 Balanced diet 2 Benefits of breastfeeding 3 Avoidance of alcohol 4 Methods of postpartum contraception 5 Dental care

1 Balanced diet 3 Avoidance of alcohol 5 Dental care The nurse is responsible for teaching good health practices to women who plan to conceive. The nurse should educate the patient about balanced diet, alcohol use, smoking cessation, and dental checkups. The patient is planning to conceive but is not pregnant as yet. It is not necessary for the nurse to discuss the benefits of breastfeeding at this time. Because the patient is planning to get pregnant, teaching about contraceptive methods would be inappropriate.

The nurse delivers a lecture to a group of people on the benefits of regular exercise. Which statements regarding the long-term effects of exercise are correct? Select all that apply. 1 Exercise decreases insomnia. 2 Exercise decreases fatigue. 3 Exercise helps increase blood pressure. 4 Exercise decreases the size of the muscles. 5 Exercise helps decrease the resting heart rate.

1 Exercise decreases insomnia. 2 Exercise decreases fatigue. 5 Exercise helps decrease the resting heart rate. The long-term benefits of exercise include improved sleep, thereby decreasing insomnia, lowering fatigue, and decreasing the basal heart rate. The immediate effect of exercise is an increase in blood pressure, but the long-term effect reduces the blood pressure at rest. Exercise causes muscle hypertrophy over a period of time. Decrease in muscle size indicates muscle atrophy.

The nurse assesses a couple and finds that the wife has many cuts and bruises on her neck, arms, and legs. After assessing the couple, the nurse suspects that the wife may be a victim of intimate partner violence. Which findings in the husband may have led the nurse to suspect that he abuses his wife? Select all that apply. 1 He is a drug addict. 2 He is unemployed. 3 He is stressed at his job. 4 He is suffering from chronic illness. 5 He has borderline personality traits.

1 He is a drug addict. 2 He is unemployed. 5 He has borderline personality traits. Intimate partner violence (IPV) is a global issue. The risk factors for engaging in IPV include chronic alcoholism, drug abuse, unemployment, and having antisocial or borderline personality traits. Stress due to job and chronic illness are unlikely causes of IPV.

The nurse assesses a group of pregnant women to determine whether they are at risk for developing postpartum mood disorder. Which factors should the nurse assess? Select all that apply. 1 Social support 2 Blood pressure 3 Age of the women 4 Relationship with husband 5 Presence of co-morbid conditions

1 Social support 3 Age of the women 4 Relationship with husband Women at risk for developing postpartum mood disorder include women who have an ineffective social support system, are young, or have poor marital relationships. Blood pressure may increase the risk of cardiac disorders but is not associated with postpartum mood disorder. Presence of co-morbid conditions may increase the risk of postpartum complications but is also not known to be associated with postpartum mood disorder.

Chronic illness (e.g., diabetes mellitus, hypertension, rheumatoid arthritis) may affect a person's roles and responsibilities during middle adulthood. What should the assessment include when assessing the knowledge base of both the middle-aged patient with a chronic illness and the patient's family? Select all that apply. 1 The medical course of the illness 2 The prognosis for the patient 3 Coping mechanisms of the patient and family 4 The need for community and social services 5 The family's nutritional needs

1 The medical course of the illness 2 The prognosis for the patient 3 Coping mechanisms of the patient and family 4 The need for community and social services When assessing a patient with a chronic illness, the nurse should determine how much the patient and the family know about how the illness has progressed and the long-term prognosis for the patient. This includes understanding the patient's and family's ability and readiness to accept the illness and the outlook for the patient. Understanding the coping mechanisms used by the patient and family helps the nurse to determine how to teach and counsel them about the treatment regimen and whether or not community or social services are needed and will be accepted to help the patient and family.

A 45-year-old obese patient wants to lose weight, and the nurse conducts a thorough assessment. Which factors may be contributing to the patient's obesity? Select all that apply. 1 The patient works in an executive position that is very demanding. 2 The patient works out at the corporate gym at 5:00 two mornings per week 3 The patient has little time to prepare meals at home and eats out at least four nights a week. 4 The patient tries to eat low-cholesterol foods to help lose weight. 5 The patient gets plenty of sleep each night

1 The patient works in an executive position that is very demanding. 3 The patient has little time to prepare meals at home and eats out at least four nights a week. Demanding and stressful work environments can lead to frequent stress eating of nonnutritious foods. Frequently eating away from home and eating fast food have been identified as contributing factors to obesity.

The nurse works at a family counseling center. The nurse finds that most patients who come to the center are couples in which both the husband and wife work. Which are possible causes of stress in two-career families? Select all that apply. 1 Transferring to a new city 2 Inability to increase the financial base of the family 3 Inability to spend time with and pay attention to their child 4 Inability to make friends and engage in leisure activities 5 Inability to spend time fulfilling household needs

1 Transferring to a new city 3 Inability to spend time with and pay attention to their child 5 Inability to spend time fulfilling household needs Two-career families are common, and they have advantages and disadvantages. Possible causes of stress in two-career families can include transferring to a new city for work, because the other partner may not want to move. Other sources of stress are the inability to fulfill child needs and household needs. When both parents work, they do not have as much time to spend with their children. The household work may also be neglected. The advantage of having a two-career family is that it increases the financial base of the family and provides a wider network of people with whom to connect and socialize.

The nurse assesses a pregnant woman who is a victim of intimate partner violence. Which adverse health outcomes would the nurse expect the patient to have? Select all that apply. 1 Vaginal bleeding 2 Low blood pressure 3 Preterm delivery of baby 4 Low-birth-weight infant 5 High maternal weight gain

1 Vaginal bleeding 3 Preterm delivery of baby 4 Low-birth-weight infant Pregnant women are at increased risk of being victims of intimate partner violence (IPV). Women who experience IPV are likely to delay prenatal care. The adverse health outcomes related to IPV for pregnant women are vaginal bleeding, preterm delivery of the baby, and delivering a low-birth-weight infant. Pregnant women who experience IPV are likely to have pregnancy-induced hypertension and have low maternal weight gain.

A patient with a history of substance abuse who has developed fluid-filled vesicles on the penis has been admitted to a hospital. Which questions should the nurse include in the initial investigation? Select all that apply. 1 "Do you sleep well at night?" 2 "Are you suffering from urinary incontinence?" 3 "How many times have you been hospitalized?" 4 "Have you had unprotected sexual intercourse?" 5 "Have you undergone a blood transfusion recently?"

2 "Are you suffering from urinary incontinence?" 4 "Have you had unprotected sexual intercourse?" The fluid-filled vesicles on the patient's penis may be due to an infection. Urinary incontinence may be a symptom of infection. Unprotected sexual intercourse can result in sexually transmitted diseases such as syphilis and chlamydia. Getting proper sleep at night is not generally related to infection but may be related to the patient's history of substance abuse. Queries about the patient's prior hospitalizations and blood transfusions are general health concerns and are not related specifically to the infection and its causes.

The nurse performs a job assessment of a patient who is extremely stressed. Which questions should the nurse ask while doing the assessment? Select all that apply. 1 "Do you have pets at home?" 2 "Do you get irritated frequently?" 3 "Could you please describe your work?" 4 "How much time do you spend for exercise?" 5 "Has there been any change in sleep pattern recently?"

2 "Do you get irritated frequently?" 3 "Could you please describe your work?" 5 "Has there been any change in sleep pattern recently?" During the job assessment, the nurse should ask about the patient's increase in irritability or nervousness. Such behavior may be a sign of stress at the workplace. The nurse should be aware of the nature of work of the patient. Stress at the workplace can interfere with sleeping and eating patterns. The nurse should gather information about this as well while doing the job assessment. Asking about pets and exercise duration is irrelevant while doing job assessment. These questions are related to assessment of lifestyle.

Which factors affect a young adult's adherence to decisions about smoking cessation? Select all that apply. 1 Workplace 2 Desire to learn 3 Family history 4 Education level 5 Socioeconomic status

2 Desire to learn 4 Education level 5 Socioeconomic status Factors that could affect a young adult's adherence to decisions include the desire to learn or acquire new skills, self-motivation, educational level, and socioeconomic status of the patient. A workplace is not responsible for a young adult's adherence to smoking cessation. Family history has no role with the young adult's adherence to lifestyle modification such as smoking cessation.

The nurse has explained the self-care and drug regimen to an adult patient with diabetes. Which factors may influence how well the patient adheres to the therapy? Select all that apply. 1 Family of the patient 2 Educational level of the patient 3 Socioeconomic status of the patient 4 Physical status of the patient 5 Motivational level of the patient

2 Educational level of the patient 3 Socioeconomic status of the patient 5 Motivational level of the patient Factors such as the educational level of the patient, socioeconomic status of the patient, and the motivational level of the patient determine how well the patient adheres to a particular therapy. The patient's family and the physical status of the patient do not affect adherence to a particular regimen.

The nurse observes factors that cause stress across various ages. The nurse assesses a group of 30-year-old adults. Which factor is most likely to cause stress in this age group? 1 Physical appearance 2 Failure in career 3 Inability to set goals in life 4 Inability to have an intimate relationship

2 Failure in career At 30 years of age, a person likely focuses on achieving success in career and/or family life. A person's failure to achieve career success may cause stress within this age group. Physical appearance and the inability to have an intimate relationship are the most likely stressors for adults 23 to 28 years of age. Inability to set any goals in life is the most likely cause of stress in adults 35 to 43 years of age.

Which information should the nurse find in the personal lifestyle assessment section of the medical history of a patient? Select all that apply. 1 Educational level 2 Hobbies 3 General life satisfaction 4 Home condition and pets 5 Diet, sleep, and sexual habits

2 Hobbies 3 General life satisfaction 4 Home condition and pets 5 Diet, sleep, and sexual habits The nurse performs a personal lifestyle assessment in order to identify a patient's habits that increase the risk of illnesses. The assessment components include general life satisfaction, hobbies, and interests; home condition and pets; and diet, sleep, exercise, and sexual habits. This assessment helps to identify the interventions that the patient needs to reduce unhealthy lifestyle behaviors. Educational level is not included in the personal lifestyle assessment.

A pregnant woman has come for her first prenatal care session. The nurse practitioner is teaching the woman about changes that occur during the first trimester. Which physical changes should the nurse include in the teaching? Select all that apply. 1 Urinary frequency 2 Morning sickness 3 Increased fatigue 4 Enlargement of breasts 5 Braxton Hicks contractions

2 Morning sickness 3 Increased fatigue 4 Enlargement of breasts The nurse should explain the understanding the patient's and family's ability and readiness to accept the illness, which include morning sickness, increased fatigue, and breast enlargement and tenderness. Increase in the frequency of urination and Braxton Hicks contractions occur during the third trimester.

The nurse performs psychosocial assessments in young adults. Which findings would indicate that a patient is mature for the developmental age? Select all that apply. 1 Ability to internalize anger 2 Not sensitive to criticism 3 Very calm temperament 4 Satisfied with friends and family 5 Satisfied with personal growth and development

2 Not sensitive to criticism 4 Satisfied with friends and family 5 Satisfied with personal growth and development Young adults should have the physical and emotional capacity and support systems to tackle the challenges, tasks, and responsibilities they face. Not being sensitive to criticism, being satisfied with family and friends, and being satisfied with personal growth and development indicate successful emotional maturation in young adults. Internalizing anger and having a calm temperament does not indicate that the young adult is emotionally mature.

The nurse delivers a lecture on smoking and its harmful effects to a group of young adults. Which pathophysiological changes due to smoking would increase the risk of cardiac disease in young adults? Select all that apply. 1 Obstruction of airways 2 Peripheral vasoconstriction 3 Coronary vasoconstriction 4 Deposition of fats in coronary arteries 5 Vasodilation of coronary arteries

2 Peripheral vasoconstriction 3 Coronary vasoconstriction 4 Deposition of fats in coronary arteries Smoking causes peripheral vasoconstriction, which raises blood pressure and increases the risk for cardiac disease. Coronary vasoconstriction and deposition of cholesterol and fats in the coronary arteries are also pathophysiological changes associated with smoking and cause cardiac conditions such as angina, myocardial infarction, and coronary artery disease. Obstruction of airways due to the pollutants that are inhaled while smoking causes pulmonary conditions, including lung cancer, emphysema, and bronchitis.

The nurse assesses a patient who delivered a child 2 days ago. The patient is irritable, has mood swings, and overall emotional instability. Which condition do these signs indicate? 1 Schizophrenia 2 Postpartum depression 3 Postpartum psychosis 4 Bipolar mood disorder

2 Postpartum depression Dramatic physical and psychological changes occur following childbirth, causing some women to experience postpartum depression. The signs of this condition include mild irritability, mood swings, and emotional instability. Postpartum women are unlikely to have schizophrenia. Clinical manifestations of postpartum psychosis are very severe; the patient may have delusions, hallucinations, thoughts of harming the baby, unwillingness to eat or sleep, risk of suicide, and severe depression. The mood swings in postpartum depression are not as severe as seen in a bipolar mood disorder.

The nurse is conducting a physical assessment of a 50-year-old patient. Which assessment findings are considered abnormal? Select all that apply. 1 Graying of hair 2 Very thin skin 3 Wrinkling of skin 4 Patchy hair loss 5 Enlarged scrotal sac

2 Very thin skin 4 Patchy hair loss 5 Enlarged scrotal sac Many physiological changes occur during middle age. Thin skin, patchy hair loss, and enlarged scrotal sac are abnormal findings and need further investigation. Graying of hair and wrinkling of skin are common in this age group.

The nurse teaches a group of nursing students about perimenopause and menopause. Which statement about perimenopause is true? 1 Women no longer have menstruation cycles. 2 Women experience irregularities in their menstrual cycles. 3 Women no longer produce estrogen or progesterone. 4 Women's neurohormonal system fails to stimulate the endocrine system.

2 Women experience irregularities in their menstrual cycles. Perimenopause is the period before menopause when the ovarian function starts declining. Ova production decreases and menstrual cycles become irregular. The cessation of menses, the cessation of the production of estrogen and progesterone, and failure of the neurohormonal system to stimulate the endocrine system are characteristics of menopause.

Which patient statement during the history assessment most indicates that the nurse needs to investigate the possibility of drug abuse carefully? 1 "I have been having trouble sleeping lately." 2 "I drink lots of coffee when I have to work late." 3 "I was arrested earlier this year for drunk driving." 4 "I smoked marijuana in college, but I haven't in years."

3 "I was arrested earlier this year for drunk driving." A recent drunk driving arrest is cause for the nurse to ask further questions to determine if a patient has begun abusing drugs. Although changes in sleep patterns may be due to drug abuse, sleep disturbances have a wide array of causes. Although caffeine is a legal stimulant, it is widely used and not associated with drug abuse. Although marijuana is considered a gateway drug, the patient's assertion that he or she hasn't smoked in years implies he or she is not necessarily likely to have developed a drug abuse problem.

A student nurse is listing the nursing interventions for caring for a patient with postpartum psychosis to prevent clinical manifestations such as delusions, hallucinations, and thoughts of harming or killing the baby. Which intervention listed indicates a need for further education? 1 "Identify sources of social support for new mothers after they are discharged from the hospital with their babies." 2 "Provide information to new mothers on community resources that can be used during the postpartum period." 3 "Prepare a primary prevention strategy for stressors that new mothers may encounter regardless of their ethnic backgrounds." 4 "Evaluate for possible postpartum stressors such as fatigue, first-time mother stress, previous postpartum stress, or feelings of social isolation."

3 "Prepare a primary prevention strategy for stressors that new mothers may encounter regardless of their ethnic backgrounds." When dealing with postpartum psychosis of new mothers, the nurse should prepare a culturally appropriate primary prevention strategy for stressors that new mothers may encounter since the cultures and beliefs of each individual differ. The nurse should find sources of social support for new mothers after they are discharged from the hospital with their babies, such as new mother visits. The nurse should provide information to new mothers on health care and community resources that can be used during the postpartum period; this helps in preventing postpartum psychosis. The nurse should evaluate for possible postpartum stressors such as fatigue, first-time mother stress, previous postpartum stress, or feelings of social isolation to help prevent postpartum psychosis.

The nurse assesses a patient who delivered a baby 3 days ago. After the assessment, the nurse concludes that the patient has postpartum psychosis. Which signs would have led the nurse to this conclusion? Select all that apply. 1 Severe pain 2 Mild irritability 3 Hallucinations 4 Occasional emotional instability 5 Suicidal thoughts

3 Hallucinations 5 Suicidal thoughts Postpartum psychosis is an extremely serious and rare mood disorder. This condition is considered a medical emergency. Signs of this condition include hallucinations, suicidal ideation, severe depression, and thoughts of harming or killing the baby. Pain is not associated with postpartum psychosis. Mild irritability and occasional emotional instability are symptoms associated with postpartum depression, which is a relatively common condition in postpartum women.

In what way should the nurse expect menopause to affect a female patient? 1 The patient will have a decreased level of androgen hormones. 2 The patient will no longer be producing thyroid-stimulating hormone (TSH). 3 The patient's ovaries will no longer produce any estrogen and progesterone. 4 The patient will experience increased levels of estrogen and progesterone hormones.

3 The patient's ovaries will no longer produce any estrogen and progesterone. In menopause, ovarian production of estrogen and progesterone stops. Men in their late 40s or early 50s may have decreased levels of androgen hormones. Menopause does not stop the production of TSH. In menopause, estrogen and progesterone levels decrease.

Which nursing student statement regarding intimate partner violence (IPV) is true? 1 "Women are the only victims of IPV in the United States." 2 "IPV includes connectedness with an abusive acquaintance." 3 "A non-pregnant woman has a greater risk of being a victim of IPV than a pregnant woman." 4 "IPV begins with mental or emotional abuse and may advance to physical or sexual assault."

4 "IPV begins with mental or emotional abuse and may advance to physical or sexual assault." IPV begins with mental or emotional abuse and may advance to physical or sexual assault. Men and women are both victims of IPV in the United States. IPV includes physical, psychological, emotional, and sexual harm committed by someone the victim knows well, not an acquaintance. A pregnant woman has a greater risk of being a victim of IPV than does a non-pregnant woman.

A middle-aged patient who has been smoking for the past 10 years finds it hard to quit this habit. The patient smokes more when stressed. What should the nurse tell this patient about the health hazards of smoking? Select all that apply. 1 Nicotine increases the risk of hepatitis. 2 Nicotine causes peripheral vasodilation. 3 Smoking increases the risk of appendicitis. 4 Cigarette smoke increases the risk of emphysema. 5 Tobacco increases the risk of coronary artery disease.

4 Cigarette smoke increases the risk of emphysema. 5 Tobacco increases the risk of coronary artery disease. The ingredients of cigarette smoke increase the risk of chronic lung disorders such as emphysema and chronic bronchitis. Tobacco causes constriction of coronary blood vessels and increases the risk of coronary artery disease. Nicotine does not cause hepatitis. Nicotine causes peripheral vasoconstriction, not vasodilation. Smoking is not associated with risk of appendicitis.

The nurse assesses a young patient in a gynecological clinic. The nurse has been asked to assess for signs related to sexually transmitted diseases. Which sign would indicate that the patient might have a sexually transmitted disease? 1 Nausea 2 Muscle tremors 3 Redness of eyes 4 Excessive vaginal discharge

4 Excessive vaginal discharge Sexually transmitted diseases are common among young adults. Immediate signs of sexually transmitted disease include genital discharge, discomfort, and infection. Nausea, muscle tremors, and redness of eyes are not signs of a sexually transmitted disease. Nausea is a nonspecific symptom and may indicate a gastrointestinal problem. Muscle tremors are associated with conditions of the nervous and musculoskeletal systems. Redness of the eye may indicate infection of the eye.

A nursing student is listing factors linked to intimate partner violence (IPV) perpetrators. Which indicates a need for further teaching? 1 Unemployment 2 Substance abuse 3 Antisocial personality traits 4 Never having been a victim of abuse

4 Never having been a victim of abuse Perpetrators of IPV are frequently victims of previous abuse themselves. Unemployment, substance abuse, and antisocial personality traits are also linked to IPV.