exam 11-16 208
A terminally ill person has elected to stop receiving curative treatment and has requested no cardiopulmonary resuscitation. The family is very upset by this decision and wants to override the patient's decision. The best response to the family is: a. "I will discuss your concerns with the doctor and ask her to reinstitute treatment." b. "I will discuss your concerns with your family member and try to get him to change his mind." c. "According to the dying person's bill of rights, your relative has the right to make this decision." d. "I will get the chaplain to help you accept this decision."
"According to the dying person's bill of rights, your relative has the right to make this decision."
At a routine yearly physical, an 18-year-old woman states, "I never check my breasts. I think I am too young to worry about that." The most helpful response would be: a. "There is no need to check your breasts at your age." b. "Most women would be interested in their own health." c. "You should practice checking your breasts the first day of your monthly period." d. "All women should check their breasts every month."
"All women should check their breasts every month."
A young adult man says that his 3-year-old son wants to do many things the parent thinks is dangerous. The most helpful suggesting the health-care worker could give about this toddler's behavior is: a. "Let him do what he wants. He won't break." b. "Allow him his independence, but keep an eye out for safety." c. "Your child should be limited in his explorations as his judgment is immature." d. "Parents of toddlers need to continue to do things for their children."
"Allow him his independence, but keep an eye out for safety."
An occupational health-care worker is teaching a class of health-promoting behaviors to a group of young adults when a member of the group asks why this class is necessary, since they are all healthy young adults. The health-care worker's best response is: a. "Major health changes occur from young adulthood to middle age, so it is necessary to learn health behaviors to cope with these changes." b. "Because you all will face chronic illness as older adults, you need to learn coping strategies now." c. "Good health habits formed as young adults show striking effects on the prevention of illness and disease as you grow older." d. "In order to maintain your company health insurance, it is necessary for you to attend this class."
"Good health habits formed as young adults show striking effects on the prevention of illness and disease as you grow older."
As a Native American elder is dying, a young health-care worker complains to her supervisor that the eldest son is not at his father's bedside and is nowhere to be found. The culturally competent health-care worker responds: a. "He is probably making arrangements with the funeral home." b. "Because he believes it is dishonorable to watch a person die, he is not here." c. "He has gone to get the ceremonial robes for his father to wear after death." d. "He is observing his own private grieving away from his dying father."
"He is observing his own private grieving away from his dying father."
Teaching to increase self care is effective when the adult learner makes which statement? a. "I'll do whatever you say; you're the professional." b. "I don't think I can quit smoking." c. "I exercise for 30 minutes 5 times a week." d. "What do you think I should do?"
"I exercise for 30 minutes 5 times a week."
The health-care worker identifies age-related memory impairment in the older adult who says: a. "I just can't remember my telephone number." b. "I forgot I went to the store this morning and didn't realize it until I went again this afternoon." c. "I forget the names of movie stars more often now, but I can remember them later." d. "I simply cannot remember how to set my alarm clock anymore."
"I forget the names of movie stars more often now, but I can remember them later."
A health-care worker passing an open door sees a nursing home resident having sexual intercourse with another resident. The most appropriate response is to say: a. "What are you doing? Please remember where you are!" b. "Let me shut the door to give you more privacy." c. "I need to notify your physician. Remember your heart condition." d. "You should wait until all the other residents are in their rooms."
"Let me shut the door to give you more privacy."
A new mother tells the home health-care worker that she feels "really stupid" about caring for her newborn, as her mother-in-law does everything for the baby. The best approach to facilitate instruction would be: a. "Let's talk about what you already know about infant care, then we can plan from there." b. "Tell your mother-in-law that she has to teach you everything she knows." c. "You and your husband should sign up for child-care classes at the YMCA." d. "You and your husband should read up on infant care."
"Let's talk about what you already know about infant care, then we can plan from there."
When the shocked father of a 17-year-old who committed suicide says, "We should have seen this coming. I feel so guilty." The most therapeutic response would be: a. "This must be awful for you. Tell me about your son." b. "I know how you must feel." c. "Don't feel guilty. It was his decision." d. "Tell me what happened."
"This must be awful for you. Tell me about your son."
A health-care worker is preparing the body of an Arab American patient who just died for transfer to the morgue. Family members insist on washing and cleansing the body before it is taken away. The health-care worker's best response is: a. "No, I'm sorry, only hospital personnel are allowed to do this." b. "I think it would be better if you left the room while I make him ready." c. "Yes, of course you may. Do you need any special cloths or towels?" d. "I'm afraid it will just make you more distressed if you touch him again."
"Yes, of course you may. Do you need any special cloths or towels?"
Persons experiencing bereavement should postpone making drastic changes in their lives for at least: a. 1 month. b. 6 months. c. 1 year. d. 2 years.
1 year.
The baseline goal for moderate to vigorous physical activity is ______ hours a week.
2 1/2
The health-care worker plans to use the CAGE alcohol use assessment tool to assess the older adult. This tool is a questionnaire consisting of _____ questions. a. 4 b. 5 c. 8 d. 10
4
14. Young adulthood, or early adulthood, is most often defined as the time of age 20 years to _____ years. a. 25 b. 30 c. 35 d. 40
40
According to the _______ theory, a recently retired person who finds satisfaction in hobbies, travel, or volunteering is adjusting to life after retirement.
Activity
The health-care worker recommends the services of _____________, a community health-care organization specializing in the care of dying patients and their families.
Hospice
Saying goodbye to the pain of loss, the feeling of isolation, and the nearness of the loved one is known as _________ ____.
Letting go
_________________ is the outward expression of grief.
Mourning
The _________________ ___________________ Act of 1990 is a federal law stating that acute care or long-term care facilities must provide written information to patients concerning their rights to accept or refuse treatment and make advance directives.
Omnibus Reconciliation
The health-care worker reminds a group of middle-aged men that they should take preventative measures to reduce the risk of cardiovascular disorders resultant from their lifestyle, which includes which factor(s)? (Select all that apply.) a. Sandwich generation stress b. Lack of intimacy c. Smoking d. Inadequate exercise e. Hormonal changes
Sandwich generation stress Smoking Inadequate exercise Hormonal changes
At the time of a child's death, a "memory kit" is made for the parents. The most appropriate items in such a kit would be: a. the hospital identification bracelet. b. a curl of the baby's hair. c. the pacifier used to quiet the baby. d. the small hospital blanket used to cover the baby.
a curl of the baby's hair.
The best practice in promoting quality of life for a terminally ill 10-year-old child would be: a. focused on the child's chronological age. b. allowing the child to return to his or her regular classroom. c. having the child cared for only by health-care providers, who are more objective than families. d. placing the child in a health-care facility for treatment and care.
allowing the child to return to his or her regular classroom.
When a 65-year-old woman comes to the health clinic with postmenopausal symptoms, the health-care worker will encourage a high dietary intake of: a. potassium. b. sodium. c. calcium. d. vitamin C.
calcium.
The primary goal of end-of-life care is: a. comfort and care to promote death with dignity. b. protecting the dying person from needless grieving. c. implementing measures to maintain physiological functioning. d. facilitating the patient's progress through all stages of grieving.
comfort and care to promote death with dignity.
When designing a plan of care for the older adult, the health-care worker should consider the older adult's: (Select all that apply.) a. income. b. previous employment. c. educational level. d. date of retirement. e. living arrangements.
income. educational level.
The health-care worker is planning a discussion about sexual responses in the aging population. The health-care worker would make a point to include information relative to that fact that: a. menopause decreases the sexual response in females. b. erotic response of the nipple and clitoris decrease. c. sperm motility is not affected by reduced testosterone. d. males retain their fertility into the eighth decade of life
males retain their fertility into the eighth decade of life
Interventions to promote health in the geriatric elder that follow the goals of Healthy People 2020 are primarily focused on: a. providing a sense of mastery over health problems. b. managing disease and disability. c. teaching positive health behaviors. d. controlling symptoms of illness.
teaching positive health behaviors.
A common anxiety about suicide is reflected when the twin brother of a suicide victim asks: a. "Although he is dead, am I still a twin?" b. "Do you think I will be tempted to commit suicide like he did?" c. "Do you think my parents will ever get over this?" d. "Have you ever had suicidal thoughts?"
"Do you think I will be tempted to commit suicide like he did?"
A middle-aged man says that he is taking up a strenuous exercise program to increase his testosterone level and his libido. The best response to this information would be: a. "That is great! You will begin to feel better and enjoy an increased libido." b. "While exercising, you should wear tight fitting underwear and an athletic support." c. "To get the result you want, you will have to exercise every day." d. "Excessive exercise may actually decrease your testosterone level."
"Excessive exercise may actually decrease your testosterone level."
The statement that would be least therapeutic to say to the bereaved mother at the death of her infant son would be: a. "I have called your husband. He will be here soon." b. "You can stay with him and hold him if you wish." c. "He was a very special little boy to me." d. "Fortunately he is not suffering anymore."
"Fortunately he is not suffering anymore."
After the death of their child in the emergency room following a hit-and-run automobile accident, the mother says, "God is dead for me. God is as dead as my child. I will not worship a dead god!" The most helpful response would be: a. "I am sorry for your loss." b. "Let me get the hospital chaplain for you!" c. "God feels your pain and he is still there for you. d. "I can understand why you feel angry with God and everyone else right now."
"I can understand why you feel angry with God and everyone else right now."
The health-care worker enters the room of a patient who has just been diagnosed with a terminal illness. The son is highly agitated and tearfully screams, "I am taking my dad out of this place and take him somewhere where people actually care what happens to him!" The most helpful response would be: a. "Why don't you tell me what is really wrong?" b. "I can understand your angry feelings." c. "I'll be back when you calm down." d. "Yelling at me will not change the diagnosis."
"I can understand your angry feelings."
After giving birth to a stillborn baby, the woman says, "I just painted the baby's room. Do you think that had an influence on my baby's death?" The best response to this woman is: a. "No, that's an old wives' tale." b. "Maybe. The excessive exertion may have caused the loss of the baby." c. "Looking for answers to questions like that will prolong your grief." d. "I can understand your need to find an answer to what caused this."
"I can understand your need to find an answer to what caused this."
The statement that best depicts the preschooler's understanding of death is: a. "My brother is in a better place now and isn't sick now." b. "It will seem funny not to play with my brother anymore." c. "My mom and dad won't have two children since my brother died." d. "I know that my brother got taken because I had a fight with him."
"I know that my brother got taken because I had a fight with him."
The family of a terminally ill Hindu patient requests that all life support equipment be removed, as per the wishes of the patient, and the loved one discharged to their care at home. The health-care worker points out that: a. "This is an unrealistic request. Your family member is in no shape to go home." b. "I'm sorry, that request is against hospital policy." c. "The grief counselor can speak to you about this decision." d. "I know that you and your loved one will be more comfortable at home; I will do what I can to expedite the process."
"I know that you and your loved one will be more comfortable at home; I will do what I can to expedite the process."
The health-care worker assesses a normal response in a dying 8-year-old boy who says: a. "I am too young to die. God is being cruel to make me die!" b. "I cry because my mom cries a lot." c. "I will miss my mom and dad, but my grandmother in heaven will take care of me." d. "After I am dead, I can come back and be with my mom and dad again."
"I will miss my mom and dad, but my grandmother in heaven will take care of me."
When a terminally ill patient says, "I feel that death is just around the corner," the most appropriate response would be: a. "Don't talk like that. You sound as if you are giving up hope." b. "We are all going to die. No one knows when." c. "Is this feeling something you would like to talk about?" d. "Let's not talk about dying. Let's talk about living. "
"Is this feeling something you would like to talk about?"
An elder who lives alone at home says to the home health care worker, "My children haven't visited me in weeks, and I've had no phone calls either. I don't even have any news about my new granddaughter. I think they have forgotten me." Which response would be most helpful at this time? a. "I'm sure they didn't forget you. They must be very busy with your new granddaughter." b. "Why don't you give them a call and find out what's happening?" c. "It sounds as if you are feeling a little neglected at this time." d. "Well, let's see what your blood pressure is doing. I bet it is low."
"It sounds as if you are feeling a little neglected at this time."
A woman in the third trimester of pregnancy expresses fear about her impending labor and how she will manage. The best response would be: a. "Don't worry about it, you'll do fine." b. "Labor is scary to think about, but the actual experience isn't." c. "You can have an epidural. You won't feel anything." d. "It's normal to be anxious. Let's go over what happens after you are admitted."
"It's normal to be anxious. Let's go over what happens after you are admitted."
The grieving mother whose adolescent son died last week tells the home health-care worker that her 5-year-old has begun to wet the bed. The health-care worker's most helpful response would be: a. "Your preschooler should probably be evaluated by a urologist." b. "Your son is showing a rather severe grief reaction." c. "Regression to less mature forms of behavior are not unusual after a death." d. "Don't worry about it. Bedwetting is no big deal."
"Regression to less mature forms of behavior are not unusual after a death."
According to Sanderson (2008), gerontologists list old age as when the prospects of living another ____ years is not realistic.
15
The health-care worker reminds the 55-year-old executive that, although he is busy, he should find time to engage in the recommended _____ hours of moderate exercise a week.
2.5
Using Erikson's developmental stages as a guide, the home health-care worker identifies the person at risk for delayed development as the: a. 22-year-old man finishing his degree at night school so he can work in the daytime to support his wife and child. b. 23-year-old divorced woman in a committed lesbian relationship who works as a medical assistant in a busy physician's office. c. 24-year-old woman who is still living at home and spends most of her time involved in computer social media. d. 25-year-old man living in the garage apartment behind his parent's house as he and his wife work and go to school to finish their advanced degrees.
24-year-old woman who is still living at home and spends most of her time involved in computer social media.
Middle adulthood is considered the period of development after young adulthood but before retirement and is categorized as age 40 to _____ years. a. 50 b. 55 c. 60 d. 65
60
The death rituals observed by the East Indian community include which aspect(s)? (Select all that apply.) a. Family members wash and prepare the body. b. Family allows only the heart to be donated. c. The naked body is wrapped in a white sheet. d. Official mourning will last for 40 days. e. The body is buried within 24 hours of death.
Family members wash and prepare the body. Official mourning will last for 40 days.
The parents of a 7-year-old are concerned because their child, upon being informed about the death of his grandmother, said, "Nana is mean. I don't love her anymore!" This behavior is: a. maladaptive. b. an inability to have a concept of death. c. anxiety about their own death. d. a normal reaction.
a normal reaction.
The health-care worker recommends the utilization of a senior center for a 79-year-old widow because in addition to a meal, a senior center can provide: a. transportation to and from the center. b. prescription drugs. c. a venue for socialization. d. a nurse counselor.
a venue for socialization.
Seven months ago, a 30-year-old man lost his wife in an automobile accident. His coworkers have become concerned about his mood swings from rage to uncontrolled crying. The health-care worker recognizes that this is: a. normal grief due to the unexpectedness of his loss. b. abnormal grief that may require psychological counseling. c. a manifestation of a personality disorder. d. outward expressions of grief that are considered normal.
abnormal grief that may require psychological counseling.
The health-care worker suspecting a woman who comes to the clinic is in an abusive relationship teaches the woman about partner abuse because the health-care worker knows that all women should be informed: a. about the health-care worker's ethical responsibility to protect women. b. that women's legal rights cannot be controlled by men. c. about the submissive nature of women who stay in abusive relationships. d. about the cycle of violence that indicates once violence begins, it continues and escalates over time.
about the cycle of violence that indicates once violence begins, it continues and escalates over time.
A terminally ill man tells the health-care worker, "I have never believed in God or in an afterlife, but now it really doesn't seem so bad." The health-care worker assesses that this man has reached the dying state of: a. denial. b. bargaining. c. depression. d. acceptance.
acceptance.
The most therapeutic communication to use with a bereaved family should reflect: a. reassurance of reduction of grief. b. acknowledgment of the loss. c. interpretation of depth of grief. d. cheerfulness.
acknowledgment of the loss.
Columbia University developed an assessment tool for persons with Alzheimer's that: a. aids in the planning of care for the person with Alzheimer's disease. b. sets a drug protocol for the treatment of Alzheimer's. c. lists specific effective interventions for care of a person with Alzheimer's. d. measures the deterioration of the cerebral cortex.
aids in the planning of care for the person with Alzheimer's disease.
The health-care worker can support grieving families at the time of death by: a. allowing the family time to stay with the loved one after the death. b. calling the funeral home to collect the body. c. uttering consoling phrases such as "I know how you feel." d. emphasizing that the painful grieving should last less than a year.
allowing the family time to stay with the loved one after the death.
A woman tells the health-care worker that her 85-year-old father is frequently confused about medication doses and frequently forgets to take his medicines. He usually eats crackers for dinner and sweet snacks for lunch. The daughter lives in a two-bedroom apartment with her two children and works full time. The health-care worker suggests that the most appropriate placement for him would be in: a. the daughter's home. b. a nursing home. c. an assisted-living home. d. a retirement center.
an assisted-living home.
The goal of intimacy for the young adult means that the young adult has achieved: a. a satisfying sexual relationship. b. an open and trusting relationship with another person. c. a casual relationship with several close friends. d. a clear sense of identity.
an open and trusting relationship with another person.
The impending signs of death include: (Select all that apply.) a. thirst. b. anorexia. c. pulmonary congestion. d. flushed face. e. mottled extremities.
anorexia. pulmonary congestion. mottled extremities.
Several health-care workers have requested to attend the funeral of a patient for whom they felt especially close. The supervisor recognizes that attending the funeral is: a. appropriate, because families always expect this expression of concern. b. appropriate, because it can assist in the resolution of personal grief. c. inappropriate, because it is unprofessional. d. inappropriate, because it increases the potential for burnout.
appropriate, because it can assist in the resolution of personal grief.
Regarding cataracts, the most important point is that they: a. are rare and are symptoms of other medical conditions. b. block some of the light to the eye but do not cause blindness. c. are a normal part of aging; most older people have cataracts in both eyes. d. occur in both eyes and vision deteriorates at the same rate.
are a normal part of aging; most older people have cataracts in both eyes.
An appropriate strategy when teaching geriatric adults is to: a. ask them to repeat what they heard because of possible hearing deficits. b. use many videos and charts to keep their interest. c. present all the material in one long session rather than two short ones. d. speed up the presentation because of the short attention span.
ask them to repeat what they heard because of possible hearing deficits.
When a 66-year-old woman comes into the health clinic complaining of dyspareunia, the sensitive health-care worker would: a. say, "I believe you can get relief from the use of lubricating creams." b. ask, "Has this affected your sexual activity?" c. ask, "Have you considered hormone replacement therapy?" d. inform her, "There are many CAM therapies that can help."
ask, "Has this affected your sexual activity?"
When assessing a middle-aged person, the health-care worker should be sensitive to the fact that these persons are uniquely challenged by: a. metabolic changes in their aging bodies. b. attempting to meet the needs of both their children and their parents. c. inadequate income and job insecurity in an unstable economy. d. the need to find their place in their community.
attempting to meet the needs of both their children and their parents.
In cultures where ageism prevails, the elderly are: a. respected and are valued for their contribution to society. b. used as role models for the younger generation. c. avoided and made to feel useless. d. disallowed to take part in community and civic organizations.
avoided and made to feel useless.
The health-care worker can provide the best support to a family experiencing anticipatory grief related to the imminent death of a loved one by: a. discouraging premature expressions of grief. b. suggesting activities to cheer up the family. c. attempting to "lighten the mood." d. being available to the family.
being available to the family.
The term geriatrics refers to the study of: a. the elderly. b. care of aging persons. c. human adaptation to aging. d. biological, psychological, physiological, and sociological aspects of aging.
biological, psychological, physiological, and sociological aspects of aging.
When discussing the basic needs for the older adult, the health-care worker uses the term ___________ to indicate effective interactions. a. autonomy b. disengagement c. competence d. relatedness
competence
The home health care worker suggests a lifestyle change that would be supportive to memory retention such as: a. completing a crossword puzzle. b. listening to "oldies" music. c. subscribing to a travel magazine. d. working on a jigsaw puzzle.
completing a crossword puzzle.
The health-care worker clarifies that the concept of generativity means that the middle adult: a. provides care for elderly parents. b. has generated the next generation. c. contributes positively to family and community. d. expresses total concern for his well-being.
contributes positively to family and community.
The health-care worker encourages the 84-year-old to engage in some physical activity for at least 30 minutes a day. Such natural activities appropriate for the able geriatric person include: (Select all that apply.) a. weight training. b. dancing. c. swimming. d. walking. e. jogging.
dancing. swimming. walking. jogging.
The health-care worker is taking the health history of an older adult with the assistance of the patient's daughter, who is the caregiver. The assessment that would suggest that the patient may be abused is the: a. patient is disoriented. b. daughter has little knowledge of the patient's medical condition. c. daughter handles the patient's finances. d. daughter is involved in many community activities.
daughter has little knowledge of the patient's medical condition.
The event most likely to make a grief reaction complicated and pathological would be: a. identification with the lost person. b. death by suicide. c. fantasizing about one's own death. d. intense anticipatory grieving.
death by suicide.
A middle-aged man is considering testosterone replacement therapy to increase his strength and sense of well-being. A deficit of testosterone therapy is that the therapy: a. is very expensive. b. does not correct erectile dysfunction. c. increases accumulation of body fat. d. may cause hypertension.
does not correct erectile dysfunction
The document naming the person or persons who should make health-care decisions if a patient cannot make informed decisions for him- or herself is the: a. personal will. b. living will. c. durable power of attorney. d. do not resuscitate (DNR) order.
durable power of attorney.
A grief reaction that interferes with life's functions is: a. mourning. b. anticipatory grief. c. bereavement. d. dysfunctional grief.
dysfunctional grief.
In cultures in which respect and inclusion of the older adult in family life is the norm, the older adult demonstrates greater: a. authoritarian dominance. b. fiscal responsibility. c. emotional competency. d. life expectancy.
emotional competency.
An appropriate nursing action helpful to older adults with insulin-dependent diabetes mellitus is to: a. avoid discussing future lifestyle changes. b. assure the elder that the condition is stable. c. encourage confidence in the elder as a competent manager of the disease. d. assign the responsibility for insulin injections and blood testing to a home health-care worker.
encourage confidence in the elder as a competent manager of the disease.
Women's health care should include safe-sex practices. The purpose of this is to: a. make sure no unwanted pregnancies occur. b. identify persons who are not using safe-sex practices. c. encourage healthy lifestyles to prevent sexually transmitted diseases (STDs). d. reduce teen pregnancies.
encourage healthy lifestyles to prevent sexually transmitted diseases (STDs).
Most young adults have ceased to grow when the __________ of the long bones fuse.
epiphyses
Signs of intimate partner violence include: (Select all that apply.) a. absolute financial control by partner. b. erratic prenatal care. c. self-blame for marital problems. d. cycle of violence in partner. e. substance abuse in partner.
erratic prenatal care. self-blame for marital problems. cycle of violence in partner. substance abuse in partner.
When the treatment for a 12-year-old child with terminal cancer needs to shift from cure to palliation, the health-care worker reminds the family it is important that they should: a. tell the child that he will not have to take any more treatments. b. explain this new approach in age-appropriate terms. c. the family must understand that palliative care takes place at home. d. withhold this information from the child as it will contribute to a sense of hopelessness.
explain this new approach in age-appropriate terms.
A dying patient becomes withdrawn and verbally uncommunicative. Relatives try to cheer him up, which is most indicative of: a. hopefulness. b. anticipatory grief. c. very strong support toward the patient's feelings. d. failure to recognize the patient's need to openly express his grief.
failure to recognize the patient's need to openly express his grief.
When developing a teaching plan for elders, the health-care worker may include family members and significant others because: a. family support affects the elder's sense of well-being. b. family members are responsible for care of the elder. c. the family members may have conflicting views regarding health teaching topics. d. families need to know how to foster dependence in the elder to prevent serious injury.
family support affects the elder's sense of well-being.
The health-care worker cautions the 30-year-old woman that at her age there is an increased risk for injuries due to muscle mass being replaced by_________.
fat
The health-care worker assessing an 85-year-old man for his ability to manage the activities of daily living (ADLs) would assess his ability to: (Select all that apply.) a. feed himself. b. manage his own finances. c. cook a simple meal. d. shop for himself. e. manage some form of transportation.
feed himself. cook a simple meal. shop for himself.
The theory of aging that attributes the age-related cellular changes to an unpaired ion is the theory of: a. wear and tear. b. free radical. c. immune. d. apoptosis.
free radical
According to Erikson, the primary task of middle adulthood is contributing positively to family and community, also known as _________________. Failure to achieve this task may result in stagnation. a. intimacy b. integrated c. generativity d. ego integrity
generativity
Patients and families progress through various stages of reactions when a diagnosis of a terminal illness is made. After the helplessness phase, a period of adjustment usually follows. This phase is characterized by: a. social reintegration. b. denial. c. guilt. d. acceptance.
guilt.
The health-care worker recommends cardiovascular screening for the 60-year-old man who: a. smokes a cigar after Sunday dinner. b. has a high low-density lipid level. c. has a blood pressure of 136/78. d. exercises strenuously every day.
has a high low-density lipid level.
The home health-care worker recognizes that memory loss related to depression as compared to normal age-related memory loss is that depression-related memory loss: a. progresses slowly. b. has a rapid onset. c. affects all areas of memory. d. usually becomes permanent.
has a rapid onset.
The home health care worker will make a point to make frequent blood pressure assessments on a 67-year-old man who has been put on a new hypertensive drug because the older adult: a. will be curious about the effectiveness of the drug. b. has sudden changes in blood pressure. c. may reject a medication change. d. has decreased liver and kidney function.
has decreased liver and kidney function.
A middle-aged woman says that her husband does not seem to want to make love to her anymore. She says he makes excuses every night and she is afraid he no longer loves her. The health-care worker recognizes that most likely: a. he may be having an affair and is too tired for his wife. b. the physiological changes occurring in his wife's body have made her unattractive to him. c. he is working too hard and is too tired at night for anything but sleep. d. he is concerned about his sexual performance and is afraid to try for fear of failure.
he is concerned about his sexual performance and is afraid to try for fear of failure.
High schools and junior high schools are now offering classes in money management and parenting for the purpose of: a. keeping adolescents interested in school. b. giving minority populations increased insight to finances. c. helping adolescents transition more easily to adulthood. d. discouraging teen pregnancy.
helping adolescents transition more easily to adulthood.
A health-care worker preparing a class on nutrition for a group of young adults explains that MyPlate is a nutritional guide that: a. spells out food exchanges. b. recommends that 30% of a plate be fruits and vegetables. c. directs nutritional intake to be 50% protein. d. helps limit portion size.
helps limit portion size.
A newborn in the neonatal intensive care unit is dying, and the neonatologist has shared with the parents their baby's prognosis. When the father sees his son, he says, "He looks just fine to me. I can't understand what all this is about." The health-care worker recognizes that the father is: a. in denial or disbelief. b. attempting to shield the truth from his wife. c. in the shock and numbness phase of mourning. d. beginning anticipatory grieving.
in denial or disbelief.
A 70-year-old woman has been newly diagnosed with cancer. She says that if the treatment is not successful, she has had a productive life and will have no regrets. This is: a. denial of the severity of her disease. b. an example of repression. c. lack of faith in the effectiveness of treatment. d. indication of a satisfactory and fulfilling life.
indication of a satisfactory and fulfilling life.
The family of a young girl killed in an automobile accident arrives at the hospital shortly after her death and requests to see her body. Since she is disfigured from the accident, the most appropriate action is to: a. explain that their daughter is disfigured and that it would be too upsetting for them to see her. b. contact a grief counselor to discuss this problem with them. c. encourage them to wait to see her until the funeral home has prepared her body. d. inform them of what to expect and then let them see the body.
inform them of what to expect and then let them see the body.
When teaching an older adult, the health-care worker promotes learning by providing: a. detailed verbal explanations. b. information that relates to the person's actual experiences. c. a review of basic concepts, because long-term memory is impaired. d. numerous repetitive presentations to promote memory retention.
information that relates to the person's actual experiences.
The school-age siblings of a dying child should be: a. involved in the plan of care for their sibling. b. allowed to remember the dying child as he or she was before death. c. allowed to contact their sibling only by phone. d. protected from death rituals and end-of-life care.
involved in the plan of care for their sibling.
Denial is a common reaction to the diagnosis of a terminal illness, because the use of this defense mechanism: a. is a maladaptive response. b. is helpful to adaptation. c. prevents a sense of hope. d. prevents the development of problem-solving behavior.
is helpful to adaptation.
Many middle-aged adults desire to return to school to continue an education interrupted by career, family, and childrearing. When counseling these adults, an important factor to consider is that: a. intelligence declines after age 30, so it may be too difficult to resume schooling at this age. b. it may take more time to learn and assimilate new material, but once learned, the content is remembered with greater accuracy. c. without family responsibilities or pressures, learning capability will quickly return to young adult levels. d. there should be no difficulty in keeping up with the younger students in the class.
it may take more time to learn and assimilate new material, but once learned, the content is remembered with greater accuracy.
When a dying 90-year-old woman gives her rosary to her granddaughter, this gift should be viewed as a: a. religious ceremony. b. legacy. c. sign of favoritism. d. directive for greater spiritualism.
legacy.
A 65-year-old woman who recently lost her husband comes to the clinic for her first examination in 5 years. To facilitate a positive health-care experience, the health-care worker should: a. remind the woman that she is long overdue for an examination. b. reassure this woman that her examination should be normal as she has no symptoms. c. listen carefully and allow for extra time for her health history interview. d. encourage the woman to talk about the death of her husband.
listen carefully and allow for extra time for her health history interview.
The college health-care worker cautions the 20-year-old male about an adverse effect of overtraining, which is: a. excessive secretion of testosterone. b. loss of strength. c. uncontrolled rise in blood glucose. d. reduced libido.
loss of strength.
In addition to the Eriksonian crisis, middle-aged persons have other developmental tasks, which include: (Select all that apply.) a. managing finances. b. nurturing their marriage. c. maintaining social relationships. d. managing the household. e. developing an ego ideal.
managing finances. nurturing their marriage. maintaining social relationships. managing the household.
During an assessment, an 80-year-old man says that his wife died a year ago, his only child moved to another city, and he recently moved into an apartment in a new neighborhood so he stays indoors most of the time and watches TV. This man: a. has an opportunity for new social contacts. b. may be at risk for suicide. c. should go live with his child. d. needs the services of Meals on Wheels.
may be at risk for suicide.
The term climacteric refers to a time in life in which: a. women have erratic menstrual cycles. b. men have a decrease in libido. c. women have completed menopause. d. men become permanently impotent.
men have a decrease in libido.
A 50-year-old woman visits the women's health clinic stating her last menstrual period was 6 months ago. Since that time, she has been experiencing palpitations and hot flashes. The health-care worker should suspect that her symptoms are related to: a. pregnancy. b. menopause. c. a cardiac disorder. d. neurosis.
menopause.
A 55-year-old man has recently purchased a sports car, had a hair transplant, and taken up skydiving as a hobby. The term for this behavior as an attempt to challenge the inevitability of the future is known as: a. generativity. b. identity accommodation. c. male climacteric. d. midlife crisis.
midlife crisis.
The health-care worker recommends that the young adult take up weight training for fitness and counsels that such activity should be: (Select all that apply.) a. moderate to high intensity. b. performed 2 or more days a week. c. intense enough to involve all major muscle groups. d. supervised and directed by a trainer. e. prescribed by a physician.
moderate to high intensity. performed 2 or more days a week. intense enough to involve all major muscle groups.
A 90-year-old West Indian man is dying, and 20 family members fill the hall as they try to crowd into the room. The culturally competent health-care worker will: a. inform the family that only 3 or 4 at a time should try to be at the bedside. b. move out unnecessary furniture to make room for the family. c. direct the family to the waiting room so they will have more space. d. call the chaplain to pray with the family.
move out unnecessary furniture to make room for the family.
The health-care worker recommends the practice of Tai Chi to an older adult to enhance ___________ strength.
muscle
After the death of an 80-year-old Jewish man, the health-care worker is aware that while the family is waiting for the funeral home to come for the body, the deceased is: a. covered by a ceremonial cloth. b. prepared for burial on the next Saturday. c. blessed by placing a basil leaf on his tongue. d. never left alone.
never left alone.
The college health-care worker planning a health promotion class plans to support the goals of Health People 2020 and focus on: a. nutrition, family planning, and physical fitness. b. vaccine-preventable disease and osteoporosis prevention. c. periodontal disease and chronic lung disease. d. breastfeeding and sudden infant death syndrome (SIDS) prevention.
nutrition, family planning, and physical fitness.
When caring for a terminally ill patient, health-care workers are permitted to provide interventions that: a. present the family with the means to end the dying person's life. b. actively aim to end a suffering person's life. c. relieve symptoms only if there is low risk for hastening death. d. offer pain relief to the dying person even if there is a risk death will occur.
offer pain relief to the dying person even if there is a risk death will occur.
A bereaved person is in special need of condolence and support: a. on the deceased's birthday. b. at the first of the year. c. on the anniversary date of the death. d. on the weekends.
on the anniversary date of the death.
The White House Conference of 2005 stimulated the: a. broadening of the definition of elder abuse. b. increase in the number of assisted living facilities. c. development of training programs for caregivers. d. passing of the Older American Act, which supported long-term care strategies.
passing of the Older American Act, which supported long-term care strategies.
The health-care worker clarifies to the family of a dying patient that palliative care includes: (Select all that apply.) a. patient-centered care b. analgesics c. oxygen therapy d. curative therapy e. laxatives
patient-centered care analgesics oxygen therapy laxatives
An important consideration in the rehabilitation of a geriatric patient to prevent loss of function from inactivity and immobility is: a. using assistive devices such as walkers and canes. b. teaching good nutrition to prevent loss of muscle mass. c. performing active exercises daily. d. assessing for safe environment.
performing active exercises daily.
To prevent or decrease age-related postmenopausal osteoporosis, the health-care worker recommends that the 66-year-old woman include in her lifestyle: a. taking vitamins E and B-complex supplements. b. increasing intake foods rich in iron. c. maintaining annual health assessments. d. performing regular aerobic, weight-bearing exercise.
performing regular aerobic, weight-bearing exercise.
A psychological death occurs begins when the: a. dying person begins to discuss end-of-life rituals. b. person is informed of a terminal illness. c. terminally ill person gives up hope. d. person loses confidence in his curative protocols.
person is informed of a terminal illness
According to Piaget, the stage of development that is necessary for effective problem-solving skills in adulthood is the _______________ stage. a. integrative b. preoperational c. concrete operational d. post-formal operational
post-formal operational
A young woman pregnant with her first child is in the second trimester. The health-care worker will direct instruction toward: a. detailed information about the birth process. b. possible abnormalities of the fetus. c. preparations about the physical environment for the expected infant. d. birth-control measures after delivery.
preparations about the physical environment for the expected infant.
An 8-year-old child with a terminal illness is returning to school after having received treatment that has caused hair and weight loss. The most appropriate action by the school nurse would be to: a. recommend that the child's parents attend school at first to prevent teasing. b. refer the child to a home school program. c. discuss with the child and the parents that the child's classmates will not accept him or her as before. d. prepare the child's classmates and teachers for changes they can expect.
prepare the child's classmates and teachers for changes they can expect.
When access to health care is blocked, the major negative impact is that: a. communities will not develop broader health services. b. minorities will be the most neglected. c. insurance payments will be impacted. d. preventative health-care measures are neglected.
preventative health-care measures are neglected.
Among the goals for the aged from Healthy People 2020 is an increased access for the elderly to acquire: a. comprehensive dental care. b. preventative health-care services. c. spiritual counseling. d. legal assistance.
preventative health-care services.
Health maintenance instruction during young adulthood should be directed toward: a. preparing for the inevitable physical decline. b. halting age-related physiological changes. c. teaching how to cope with chronic illness. d.preventing illnesses caused by lifestyle choices.
preventing illnesses caused by lifestyle choices.
Health maintenance during middle adulthood should be directed toward: a. preventing illnesses due to lifestyle and physiological changes. b. stopping the physiological aging process. c. preparing for inevitable physical decline. d. maintaining strength and endurance at the young adult level.
preventing illnesses due to lifestyle and physiological changes.
The health-care worker caring for a dying 78-year-old Hispanic woman understands that in Hispanic families when death is near, the family will: a. seek the spouse's advice on medical decisions. b. confirm the DNR order. c. call for the shaman to perform religious rites. d. prohibit pregnant women and children from the bedside.
prohibit pregnant women and children from the bedside.
When parents ask if their school-age child should attend the funeral of their grandmother, the health-care worker would base a response on the understanding that attendance will: a. provide an closure for the child. b. be a frightening experience. c. be a deeply religious experience. d. be parents' responsibility is to protect the child from distressing events.
provide an closure for the child.
To enhance success for health teaching to middle-aged adults, the health-care worker should: a. provide information related to health concerns and stressors common to the age-group. b. begin with concepts about teaching and learning techniques. c. incorporate structured learning activities that keep all group members learning at the same rate. d. direct members to seek independent learning without formal instruction.
provide information related to health concerns and stressors common to the age-group.
A provision of the controversial Health Care Affordability Act of 2010 was to: a. ration health care to the elderly. b. provide wider health-care coverage. c. limit hospital stays. d. set up more community health clinics.
provide wider health-care coverage.
The best description of therapeutic communication related to terminally ill patients and their families would be that it is a(n): a. goal-directed interaction that brings about the patient's insight. b. purposeful interaction that is highly structured. c. interaction guided by the needs of the patient and the health-care worker. d. interaction that involves accepting the patient's emotional responses.
purposeful interaction that is highly structured.
The manner in which persons adjust to losses in their life will determine: a. family relationships. b. depth of religious views. c. quality of life. d. maturity.
quality of life.
The process of bereavement includes the survivors': (Select all that apply.) a. reaction to the loss. b. refusal to integrate the loss. c. portrayal of the deceased as perfect. d. adjustment to the loss. e. reorganization of the fabric of life.
reaction to the loss. adjustment to the loss. reorganization of the fabric of life.
The health-care worker assesses for the physiological changes in the middle-aged person, which include: (Select all that apply.) a. redistribution of fat. b. increased muscle tone. c. loss of skin elasticity. d. thinning hair. e. increasing energy.
redistribution of fat. loss of skin elasticity. thinning hair.
Health goals established for older adults by Healthy People 2020 include: (Select all that apply.) a. eradication of dementia. b. reduction of morbidity from flu and pneumonia. c. disease prevention. d. reduction of occurrence of hip fractures. e. food banks for the needy.
reduction of morbidity from flu and pneumonia. disease prevention. reduction of occurrence of hip fractures.
The sensitive health-care worker can demonstrate therapeutic presence by: a. keeping family informed about patient's condition every hour. b. remaining near the patient and family. c. calling the chaplain to administer to the family. d. giving pain medication every 4 hours.
remaining near the patient and family.
An 83-year-old senior in a nursing home spends a great deal of time telling stories about past accomplishments and life experiences. The health-care worker recognizes that: a. reminiscing about positive life experiences is therapeutic and helps bring a feeling of achievement and satisfaction to the elder adult. b. this may be early senility, as the elder cannot remember from one time to the next what stories have been told. c. this story-telling needs to be curtailed to allow others to participate. d. the reminiscences should not be encouraged, to prevent feelings of bitterness or anxiety.
reminiscing about positive life experiences is therapeutic and helps bring a feeling of achievement and satisfaction to the elder adult.
When planning health-promotion classes for geriatric adults, the health-care worker should include information pertinent to: a. vitamin supplements, folic acid. b. hormone replacement therapy, contraception. c. homicide, motor vehicle accidents. d. safe home environment, immunizations.
safe home environment, immunizations.
While discussing health promotion and maintenance to a group of middle-aged men, the health-care worker advises that men should make as a priority to have an annual: a. screen for prostate cancer. b. sperm count for infertility. c. skin assessment for cancer. d. assessment for testosterone level.
screen for prostate cancer.
The school nurse plans a class in men's health needs in order to: a. balance the amount of information about female health needs. b. encourage the organization of gender-specific health-care providers. c. interest insurance carriers in supporting preventative health measures for men. d. sensitize males to health concerns.
sensitize males to health concerns.
______________ is a part of every phase of life and involves beliefs and behaviors that surround physiological responses, emotions, and cultural values.
sexuality
While doing final preparations for a Hindu woman to be picked up by the funeral home, the health-care worker observes a thread tied around the corpse's wrist and a basil leaf in her mouth. These items: a. are to be removed only by the next of kin. b. may be removed by the sadhu, the Hindu holy man. c. should be left in place. d. should be collected and given to the eldest son.
should be left in place.
A 70-year-old man retired 6 months ago after a long career as a newsman. His wife tells the health-care worker that she is concerned because her husband has stopped going to church, turned over the bill-paying duties to her, and spends most of the time listening to the radio. The health-care worker recognizes this as: a. normal in the newly retired. b. necessary for adjustment to retirement. c. signs of disengagement and possible early depression. d. preparation for transition to advanced old age.
signs of disengagement and possible early depression.
When planning health promotion classes for people in late adulthood, the health-care worker should include information about: a. motor vehicle accidents. b. stress management. c. sexually transmitted diseases. d. vitamin supplements.
stress management.
Because of changes in the blood vessels, which become narrow with fatty deposits, the geriatric elder is at risk for: a. hypotension. b. stroke. c. increased heart muscle tone. d. rapid response to anxiety.
stroke
A terminally ill patient is unresponsive and having periods of apnea. The patient's family is arguing at the bedside about where the funeral should be held. The health-care worker should: a. remind the family that this should be the patient's decision. b. ask the family members to leave the room. c. take the family members aside and explain that the patient may be able to hear them. d. tell the family members that such decisions are premature.
take the family members aside and explain that the patient may be able to hear them.
According to Kohlberg, young adults should develop moral reasoning as they mature; this moral reasoning is characterized by: a. conforming to rules to gain recognition or reward. b. taking responsibility for care of others. c. obeying rules to avoid punishment. d. maintaining a sense of life achievement.
taking responsibility for care of others.
The most effective nursing intervention for health promotion in the older adult is primarily focused on: a. managing disease. b. providing a sense of control over health problems. c. controlling symptoms of illness. d. teaching positive health behaviors.
teaching positive health behaviors.
6. The health-care worker planning a men's health clinic at a local college plans to give a priority focus on a booth that will provide information about: a. career counseling. b. family planning. c. immunizations. d. testicular self-examination.
testicular self-examination.
A 52-year-old woman who is recently divorced and has just sent her last child to college says she just does not understand why she is feeling so "low and alone." She states she is not sleeping well and has no energy for anything. These most likely are symptoms of: a. worsening depression related to early menopause. b. pathologic depression related to the divorce. c. the "empty nest" syndrome related to the children being gone from home and stress from the recent divorce. d. indicative of her need to go out and get a job.
the "empty nest" syndrome related to the children being gone from home and stress from the recent divorce.
The immune theory of aging proposes that: a. the aging body becomes immune to the restorative properties of nutritious food, adequate sleep, and exercise. b. as body parts begin to age and become dysfunctional, they become immune to the body's attempt to repair them. c. the aging person's immune system cannot differentiate between healthy and defective cells and destroys both kinds. d. the geriatric elder becomes immune to many therapeutic remedies and can receive no protection from infection from them.
the aging person's immune system cannot differentiate between healthy and defective cells and destroys both kinds.
A widow of 10 months says that she has started sleeping better, is going out more with friends, and can talk about her husband without feeling so lost and angry. The health-care worker recognizes that this represents: a. the beginning of the "letting-go" process. b. an inability to accept the reality of her husband's death. c. her true feelings of relief that her husband has died. d. recognition that she is now ready to make changes in her life, such as selling her house or moving to a new city.
the beginning of the "letting-go" process.
A man whose wife died 6 months ago says that he sometimes still "hears" his wife's voice and has trouble sleeping and does not feel like socializing. The health-care worker recognizes that: a. these complaints are part of a normal grief response. b. the pain of the loss should be less by this time. c. these responses are more typical immediately after the death. d. this grieving is excessive and should be evaluated.
these complaints are part of a normal grief response.
The signs of a mid-life crisis" in a 39-year-old man suggest that he may be experiencing the negative influence of Levinson's stage of: a. structure period. b. concrete period. c. operational phase. d. transitional phase.
transitional phase.
To help the older adult maintain independence, Healthy People 2020 advocates the promotion of services that provide: a. prescription drug delivery. b. food banks for the older adult. c. transportation. d. day care for persons suffering from dementia.
transportation.
A school-age child is diagnosed with a terminal illness. The parents want to protect their child from knowing the seriousness of the illness. The health-care worker should explain that: a. denial will help the child cope more effectively. b. this attitude is helpful in order to give the parents more time to cope. c. terminally ill children usually do not wish to discuss the seriousness of their illness. d. truthfulness in understandable terms is the most supportive approach.
truthfulness in understandable terms is the most supportive approach.
As adults move from middle adulthood into older and late adulthood, a productive level of functioning is more likely to be maintained if the person feels: a. useful and loved. b. dependent and closely watched. c. wanted and dependent. d. financially secure and physically active.
useful and loved.
In the United States, at age 18, young adults are able to: (Select all that apply.) a. vote. b. purchase a license for a shotgun. c. marry without parental consent. d. purchase alcohol. e. be drafted into military.
vote. purchase a license for a shotgun. marry without parental consent. be drafted into military.
A young Cambodian man has just arrived at the hospital from the airport to find that his father has already died. His family members are all praying at the bedside. The culturally competent health-care worker would offer the young man a(n): a. white hospital gown to wear. b. small basin with soap so that he may wash his hands before praying. c. surgical cap so he may cover his head. d. opportunity to pray with the hospital chaplain.
white hospital gown to wear.
A terminally ill patient in hospice care says that she plans to attend her grandson's college graduation 5 months from now. This patient: a. is in denial about her condition. b. has unrealistic expectations about the length of time she has left. c. will probably live to attend the graduation. d. is only offering her family false hope and should stop planning an event so far in the future.
will probably live to attend the graduation.
