HGD Ch 12/13: Adulthood, Family, Older Adulthood

During a routine health examination, to obtain effective information relating to common health problems, the question the nurse could ask a 24-year-old patient that can introduce further assessments is: A) "Are you sexually active?" B) "Have you noticed a change in your vision or hearing?" C) "Do you experience chest pain when exercising?" D) "Have you ever had the flu or pneumonia immunizations?"

ANS: A A common health problem of young adults is risk for unhealthy behaviors, among which is irresponsible sexual behavior that can result in unwanted pregnancy, sexually transmitted infections, and, in particular, HIV infection.

The nurse warns that infection after exposure to respiratory illness in the older adult: A) is more likely to result in serious lower respiratory infection related to weakened respiratory muscles and fewer cilia. B) is likely to be fatal due to the older person's low resistance. C) results in rates of infection similar to those in the younger adult. D) can be easily prevented with the use of antibiotics when the adult is exposed.

ANS: A Changes in the older adult respiratory system make older adults more susceptible to infections that can be very serious. Although some infections are life threatening, most are not.

The nurse reviews the medications of a 52-year-old woman in the outpatient clinic to confirm that her calcium dose has been: A) increased to 1200 mg/day. B) reduced to 1000 mg/day. C) replaced by a daily dose of vitamin D) augmented with glucosamine.

ANS: A Women over the age of 51 should increase their calcium to 1200 mg a day. Vitamin D is also important to help utilize the calcium.

A 78-year-old man is admitted to the hospital after a fall from his bed at home that resultedin a fractured hip and several fractured ribs. He states, "I don't know how I broke so many bones. I only fell out of bed." The nurse can explain that: A) loss of calcium from bone occurs in older adults and can result in fractures from minor trauma. B) it is likely that an underlying disease made him more susceptible to fractures. C) the bedside table near the bed added to his injuries. D) the height of the bed will need to be lowered when he goes home to prevent further injuries.

ANS: A A physiological change of aging is loss of calcium from bone, resulting in osteoporosis and greater likelihood of fractures.

The nurse takes into consideration that divorce affects more than just the parents; adolescents who come from a divorced family may experience: A) lack of trust in their own heterosexual relationships. B) a distancing from the family unit. C) hostile feeling that is acted out in activities such as vandalism and drug use. D) being rushed into adulthood.

ANS: A Divorce frequently leads adolescents to lack trust in their own heterosexual relationships.

A 48-year-old married father of two teens is involved with his children's sports teams as a coach and referee. He manages a large fast-food franchise, which employs a number of teenagers whom he trains. The nurse recognizes that this lifestyle is conducive to: A) generativity from contact with young persons. B) self-absorption because he focuses on his recreational and business activities. C) isolation because of limited contact with people close to his age. D) stagnation based on repetitiveness of his work and recreation.

ANS: A Generativity is the positive psychosocial outcome in adulthood that comes from educating and guiding the younger generation. Isolation occurs when people fail to develop intimaterelationships; stagnation results from not being involved in the younger generation's life.

The nurse suggests that one option for people in middle adulthood to reduce stress is to: A) begin planning for retirement by developing leisure time activities or hobbies that they will be able to continue into their later years. B) focus their time and energy on succeeding in their work environment with the knowledge that hard work will guarantee a secure position until retirement. C) change employment frequently to increase their skills and employability in a rapidly changing job market. D) find employment that pays very well, even if the work is not enjoyable, because that is the way to accumulate enough funds for eventual retirement.

ANS: A Leisure activities and early planning for retirement are excellent stress reducers for the middle adult.

A young adult patient is admitted to the hospital with asthma. He is considered a millennial. Millennials: A) were born between 1978 and 2004. B) make up over one half of the population. C) are less ethnically diverse than previous generations. D) outnumber the baby boomers.

ANS: A Millennials (people born between 1982 and 2000) now outnumber the baby boomers. There are now over 83 million millennials, making up over one quarter of the US population (US Census Bureau, 2015). Millennials are also more ethnically diverse than previous generations.

A 76-year-old neighbor confides to the nurse that she is having to get up in the middle of the night to void and often wets herself before she can get to the bathroom during the day. Thenurse's best explanation would be: A) "As you get older, your bladder muscle loses tone and you can hold less urine." B) "You are probably drinking too much during the day and especially before bedtime." C) "You probably have a bladder infection that should be treated with antibiotics." D) "With age, the urine becomes very concentrated and causes the bladder to empty spontaneously."

ANS: A Physiological changes of aging include decreased bladder and sphincter tone, resulting in stress incontinence and more frequent voiding.

When the nurse in a long-term facility observes a resident bringing his reading material very close to his face, the nurse assesses that the patient is experiencing: a. presbyopia. b. myopia. c. presbycusis. d. cataracts.

ANS: A Presbyopia is caused by decreased flexibility of the eye lens. This makes near vision more difficult and leads to the need for reading glasses.

The nurse clarifies that the immune system failure theory states that: A) older adults lose their ability to effectively respond to infections and are more likely to die from them. B) the body no longer recognizes itself and begins to attack itself, causing illness. C) toxins and harmful chemicals (free radicals) in the environment cause damage to body cells. D) the diminished activity of older adults make them susceptible to illness.

ANS: A With advancing age, the immune system of older adults has less ability to fight infections.

When planning a community health fair, which of the following topics are most appropriate for the nurse to include to target the young adult? (Select all that apply.) A) Sexually transmitted infections, including HIV B) Alcohol and drug abuse C) Development of proper diet and exercise regimen D) Foot care E) Screening for presbyopia F) Osteoporosis

ANS: A, B, C Young adults typically are in good health but may develop unhealthy behaviors including chemical abuse; sedentary lifestyle, overeating, and sexual promiscuity, which can lead to sexually transmitted infections, including HIV.

When planning a community health program that is directed at young adults, the nurse will prepare the material to: (Select all that apply.) A) build on previous knowledge. B) design clear goals for the program. C) indicate how the new knowledge can be of benefit. D) use straight lecture method to get points across quickly. E) relate material to common concerns of young people.

ANS: A, B, C, E Building on previous knowledge, designing clear goals based on common concerns, and stressing how the material can be of benefit should be part of the plan. The straight lecture method is not the most effective way of communicating with young adults.

To promote cognitive health for a 79-year-old, the nursing student should encourage the patient to do which of the following? (Select all that apply.) A) Read the newspaper. B) Put together puzzles. C) Take naps when tired. D) Write letters. E) Toilet independently.

ANS: A, B, D Mental stimulation such as these activities maintains active and healthy neural connections, which promotes cognitive health.

Susan, a 21-year-old, has just graduated from college and will begin teaching at the local elementary school in the fall. Her parents have been supportive and have assisted with her tuition throughout college and consoled her when she became overwhelmed at school. They are also helping Susan find an apartment close to the school where she will teach. At this point in her life, Susan will be faced with which of the following developmental tasks? (Select all that apply.) A) Marriage B) Parenting C) Planning for retirement D) Caring for parents E) Developing a social group

ANS: A, B, E The decision to marry and become a parent, as well as developing a network of friends, are developmental tasks for the young adult.

A nurse talking to a group of women about the signs and symptoms occurring with menopause would explain that expected symptom include all of the following except: A) frequent insomnia. B) increased vaginal lubrication. C) increased emotional lability. D) increased fatigue.

ANS: B Signs and symptoms occurring with menopause include decreased vaginal lubrication, emotional lability, fatigue, flushing and hot flashes with heavy sweating, headache, heart palpitations, and insomnia.

Marriages may improve after the children are grown and gone if the partners: A) are of the same age. B) have developed mutual interests. C) have adequate income. D) are busy with community activities.

ANS: B The development of mutual interests and having more time for each other often improve marriages after the children are grown.

A 70-year-old widower continues to work part time in a demanding business, while traveling in his free time with a 68-year-old widow to visit longtime friends and relatives. He remains an active member of several community organizations. His life is an example of a person who: A) is acting like a younger person to prove to himself that he is not "old." B) is adjusting well to the changes of benign senescence. C) should slow down and enjoy retirement while he is still healthy. D) is avoiding the psychosocial tasks of aging such as retirement and slowing down.

ANS: B Benign senescence is the normal changes of aging, and many healthy people at 70 years of age do not fit the stereotype of "old" but are more like older adults of 45 to 70 years.

A patient states that she uses the supplement black cohosh. The nurse recognizes black cohosh is used: A) for reduction of blood pressure and cholesterol. B) to lessen signs and symptoms of menopause C) to help maintain cartilage and decrease arthritis D) to improve blood flow to the brain and decrease forgetfulness.

ANS: B Black cohosh is used to lessen signs and symptoms of menopause.

The nurse appropriately advises a 28-year-old woman that to detect breast cancer in early stages she should: A) schedule annual breast mammograms for early detection. B) perform monthly breast self-examinations and begin mammograms at age 40. C) arrange for annual examinations by her primary care provider and mammograms as indicated from the physical examination. D) schedule a complete physical examination every 5 years until age 50, then annual examinations that include a mammogram.

ANS: B Breast self-examination should be taught and emphasized as a monthly early detection technique to all women. Mammograms are usually begun after age 40 unless there is a family history of breast cancer.

The nurse seeks out residents with whom they reminisce in an interview regarding the resident's life story. The value of this activity is that: A) it gives the staff more time to care for other residents and perform routine care. B) it can affirm the positives of the resident's life and lead to ego integrity for the resident. C) nursing home residents have long days to pass, and any activity helps the time pass more quickly. D) students learn about the "good old days" and better appreciate the modern conveniences available today.

ANS: B Erikson's psychosocial task for older adults is ego integrity, which can be assisted by life review and reminiscence.

When caring for a child from another culture, the nurse takes into consideration the child'sfamily because families: A) are disruptive to the child's therapy. B) shape how the child reacts to other people. C) may create a break in confidentiality. D) bring inappropriate foods to the child.

ANS: B Families from all cultures shape cultural values and how the child interacts with others.

The home health aide who visits an older adult reports to the nurse that the patient has manynew bruises on her arms and face. The patient states that her daughter "has a temper and got mad" when she visited the day before. The nurse should: A) call the daughter for clarification. B) notify her nursing supervisor to report the incident to the authorities. C) tell the aide to report it to the nursing supervisor. D) plan to visit the patient when the daughter will be present.

ANS: B It is a legal requirement for licensed health care personnel to report suspected elder abuse to protect the public (patient). An LPN should report to the RN supervisor first. The aide issupervised by the nurse and thus the nurse is responsible. It is not the nurse's responsibilityto determine whether the daughter is abusing the patient but only to report it so that it can be investigated by the proper agency.

A nurse caring for an older adult suspects that he is experiencing depression. Which of the following are true for the older adult and depression? A) More than three million older adults experience depression. B) If experiencing suicidal thoughts, the older adult more likely to act on them successfully. C) Depression is a risk factor for diabetes. D) Difficult to treat with medications and counseling.

ANS: B It is estimated that more than one million older adults experience depression, and older adults who have suicidal thoughts are more likely to act on them successfully than younger people with similar thoughts (Aziz and Steffans, 2013). Signs and symptoms of depression in the older adults are listed in Box 13-2. Depression can often be treated successfully with medications and counseling. Depression is a risk factor and possibly an early sign ofdementia (degeneration of brain tissue).

The nurse understands that the best explanation of why a particular person lives into his 90s in relatively good health is that the person: A) had healthy parents who passed on to him "good" genes and no hereditary diseases. B) has lived a healthful lifestyle, which has included preventative care, good nutrition, exercise, and a positive outlook. C) has treated illness with "old-fashioned" home remedies while avoiding the use of many prescription drugs. D) reads a lot about the newest advances in health care and tries these approaches as soon as they are publicized.

ANS: B Lifestyle and personality together probably contribute to longevity more than genetics, new medical approaches, or old-fashioned home remedies, although those may contribute in important ways. A healthy lifestyle decreases the risk of disease and its sequelae.

A 48-year-old woman asks the clinic nurse about symptoms she has experienced, such as trouble sleeping, because she wakes up feeling hot and sweaty. She has also felt tired and depressed about aging. The most helpful nursing response would be: A) "You may have an illness that the doctor should evaluate." B) "It sounds to me as though you might have symptoms of menopause." C) "You're too young to be going through menopause. Are you worried about anything?" D) "Those symptoms are all related to aging, and there's not much to do about it."

ANS: B Symptoms of menopause often occur before the cessation of menses and are treatable. They are not a disease or illness but part of normal development.

The nurse points out elements in our culture that support longevity in older people, which include: (Select all that apply.) A) reducing stress from regular exercise on the body in younger years. B) being actively involved in their own health care. C) taking of antibiotics through their lifetime. D) increasing education about health matters. E) avoiding the eating of red meat.

ANS: B, D Active participation in one's own health care, being better educated about illness, and illness prevention are elements in attaining a longer life span.

A 76-year-old recently lost her spouse. They lived in a large house with a yard that theymanaged well until her spouse's sudden death. She is in good health and stays active but isbecoming concerned about her ability to maintain the large house by herself. The nurse'smost helpful suggestion would be to: (Select all that apply.) A) recommend living with her daughter who lives 2 hours away. B) encourage her to investigate apartment rentals. C) encourage her to check herself into a skilled nursing facility. D) hire a gardener and a housekeeper to maintain the property. E) encourage her to involve family in any decisions related to her living arrangements.

ANS: B, E Many older adults choose to rent an apartment when they cannot maintain a house and yard. Including family members in important decisions keeps communication lines open. Family members can offer support and recommendations to their parent(s), easing the decision-making process.

A 24-year-old mother of two has just become divorced from her husband of 4 years. She is living with her parents again until she is able to get her finances in order to find her own apartment. This is an example of ____________ children.

ANS: boomerang

A 55-year-old is married with two children, ages 15 and 17. He is a supervisor for the local utility company, where he has been employed for 25 years. He is active in his communityand serves on the town council. According to Schaie's theory of cognitive development, heis in the ______________ stage, which occurs in the _______________ stage of adulthood.

ANS: responsibility; middle

A nurse making a home visit to a 75-year-old woman discovers that the patient stays in bed or on the couch most of the time because she is afraid of falling. The nurse should arrange for: A) a sitter to stay with the woman during the day. B) a wheelchair to increase mobility. C) a physical therapist to teach resistance training. D) a special cushion for the chair and bed to reduce the risk of decubiti.

ANS: C A physical therapist can teach resistance and balance training to help prevent falls.

The nurse is aware that according to Schaie's theory of development, the most significant event in the life of a 26-year-old single woman who is graduating from graduate school would be: A) marriage and starting a family. B) academic recognition for her high grades. C) employment in a prestigious business. D) a long-term relationship with a significant other.

ANS: C According to Schaie, the achievement stage is satisfied by young adults being able to apply what they have learned to increase their competence and increase their career choices.

A nurse is instructing a patient about the prevention of automobile accidents and reminds the 65-year-old patient that he may be prone to an accident because of: A) increasing speed of traffic. B) his tendency to be distracted. C) a slower reaction time. D) reduced strength.

ANS: C Among the changes associated with age is the slowed reaction time.

An 84-year-old patient who is hospitalized for pneumonia says to the nurse, "I don't know why I've lived so long. All my friends are gone, my children and grandchildren are allindependent and successful—nobody needs me anymore." An appropriate response by the nurse is: A) "You have a lot to live for. Your children and grandchildren really love you." B) "You must have inherited good genes. You should be thankful you're still alive." C) "Tell me about your children and what it was like when you were raising them." D) "The pneumonia has made you feel morbid. Things will look up!"

ANS: C Encouraging reminiscing helps the older adult put her life in perspective and acquire a sense of ego.

When the 75-year-old patient tells the nurse that he has had a good and rewarding life and has enjoyed every minute of it, the nurse is aware that the patient has attained the Eriksonian stage of: a. generativity. b. autonomy. c. integrity. d. intimacy.

ANS: C Erik Erikson's psychosocial development theory includes the stage of ego integrity vs.despair, which is characterized by reflection on one's life and one's achievements. A senseof pride or despair is developed regarding the accomplishments in life that have been made or were lost.

When the nurse is conducting a class for senior citizens at a local assisted living facility, to enhance physical health, he encourages the older residents to engage in some form of exercise for at least: A) 1 hour every other day. B) 10 minutes at a time several times a day. C) 30 minutes a day, five times a week. D) 1 hour every morning.

ANS: C Exercise for as little as 30 minutes a day 5 days a week is beneficial.

A nurse cautions that stress-related illnesses such as headaches and hypertension in young adults most likely will: A) diminish as the person ages. B) require no long-term treatment. C) increase in intensity over the years. D) post no threat to health.

ANS: C Headaches and hypertension are often stress related and should be treated because these disorders may intensify as the person ages and pose a threat to health.

The nurse points out that there are many myths about older adults that are not true. The statement that reflects the most accuracy about older adults is: A) most old people live in nursing homes. B) genetics is the main factor in longevity. C) the optimistic, happy person generally lives longer. D) most old people are isolated from their families.

ANS: C Myths about old people include: most old people live in nursing homes, genetics is the main factor in longevity, and most old people are isolated from their families. It is true that a major contributor to longer life is that the optimistic, happy person generally lives longer.

An 85-year-old has been increasingly confused and disoriented to place and time over the last several months. He also has difficulty remembering what he ate, who visited, and where the recreation room is. This behavior is indicative of ________________.

ANS: dementia Confusion, memory loss, and disordered thinking are early signs of dementia. Causes of dementia include malnutrition, medications, mini strokes, and Alzheimer disease.

A middle aged adult has been diagnosed with stage 1 hypertension. The nurse prepares patient teaching that would include which of the following? A) Diet with increased savory, rich foods. B) Regular social drinking with friends and family. C) Regular aerobic exercise. D) Keep blood pressure below 120/80 mm Hg.

ANS: C Pressure control in middle adults. Adults should keep their blood pressure—below 120/80 mm Hg; adults with prehypertension 120-139/80-89; adults for stage 1 hypertension 140-159/90-99—by• Decreasing sodium intake• Drinking minimal alcohol• Participating in regular aerobic exercise• Promoting an overall healthy lifestyleSource: Mayo Clinic (2015)

When a 68-year-old recent retiree confides in the health clinic nurse that he has felt depressed and withdrawn since retirement, the nurse suggests that he: A) talk with the primary care provider about anti-depression medication. B) arrange his day so that he is able to take a nap in the afternoon. C) set a small goal for himself to be met every day. D) eat three regular meals as he did when he was employed.

ANS: C Setting a small goal to be met allows for direction in the day. Many recent retirees miss the regulation of employment.

A nurse is preparing a patient education brochure for a class she is teaching at a local community outreach center on pregnancy. Which of the following facts would she include in the brochure? A) Age of first-time mothers is 30. B) Birth rates are increasing for teenagers aged 15 to 19. C) Birth rates are declining for women in their 20s. D) Birth rates are decreasing for women in their 30s and late 40s.

ANS: C The National Center for Health Statistics reports that the average age of first-time mothers is 26 (Family Facts, 2011). The birth rates are declining for teenagers aged 15 to 19, as well as for women in their 20s. In contrast, rates are increasing for women in their 30s and late 40s (National Vital Statistics Report, 2015).

An 82-year-old man is alert and oriented and in good physical health except for somearthritic pain that "slows me down, but I just keep moving." He lives alone in an apartmentin a senior citizen complex but enjoys the company of other residents and takes part in the social activities there. His lifestyle is an example of: A) an exception to the expected norm. B) the disengagement theory. C) the activity theory. D) the biological theory.

ANS: C The activity theory states that persons who remain active and interested in outside activities live longer.

The nurse is aware that when the children of middle adults have grown and left home, the middle adults may: A) enjoy being part of a "sandwich generation" that has no responsibilities to either children or older parents. B) suddenly show marked changes in their personalities and habits that have characterized them since young adulthood. C) experience the "empty nest syndrome" characterized by depression and a sense of loss or sadness. D) look forward to their children becoming "boomerang children" who visit briefly with their expanding families and quickly return to their own homes.

ANS: C The empty nest syndrome, with its sense of depression and loss, occurs for some adults, especially those whose lives had revolved around their children, when their children leave home.

A recently divorced young mother tells the nurse in the well child clinic that her 5-year-oldhas become very withdrawn since the divorce. The nurse's best response to this concernwould be: A) "He probably misses his dad. Young children adjust quickly though." B) "He may be acting out his resentment toward you for the breaking up of the family unit." C) "Young children frequently feel they are to blame for the family breakup." D) "You should explain to him why the marriage was no longer sustainable."

ANS: C Young children frequently feel that they are to blame for the family breakup and experience guilt feelings. The other three items are subjective.

An 82-year-old patient expresses concern of always being cold. Based on knowledge of the physical changes associated with aging, the nurse could appropriately respond: (Select all that apply.) A) "Wrap up warmly, because the cold feeling is a result of decreased bone calcium that occurs with aging." B) "Chronic constipation can lead to a sense of cold because of the reduced peristalsis." C) "Subcutaneous fat is reduced as part of aging. This fat helps to keep you warm decreases." D) "A low level of thyroid hormone causes you to feel cold." E) "Eat more protein foods to help your body generate heat."

ANS: C, D Decreased subcutaneous fat and slowed thyroid production contribute to older people feeling cold.

The home health nurse assesses an 80-year-old who has fallen twice in the last 10 days. The nurse discovers that the patient uses a cane for ambulation stability, drinks up to 6 cups of coffee a day, has altered depth perception because of cataracts, and has recently carpeted her home with a smooth tight weave carpet. The nurse suspects the cause of her recent falls to be: A) the use of the cane. B) the new carpet. C) the large intake of caffeine. D) the altered depth perception.

ANS: D Altered depth perception, changes in gait, and slow reaction times may cause falls in older adults. The cane helps with stability, and the smooth tight weave carpet should not cause falls.

The home health nurse assesses the older patients in her case load for signs of abuse. The nurse is aware that the primary incidence of abuse is ______________.

ANS: neglect In patients over the age of 80 who suffer abuse, the primary type of abuse is neglect.

A nurse is educating a female patient about bone health in middle adults. The nurse would recognize the need for further education if the patient states: A) "Since I have a family history of osteoporosis, I will begin regular bone density screening at age 45." B) "Since I have experienced a loss of 2 inches in height since I was 20, I will seek screening for osteoporosis." C) "I will obtain sufficient vitamin D from sunlight or take a vitamin D supplement as recommended by my primary care provider." D) "I will take 1500 mg/day of calcium until menopause and then decrease my calcium intake to 1200 mg/day after menopause."

ANS: D Calcium intake should be 1000 mg/day prior to menopause and should be increased to 1200 mg/day after menopause. Obtaining sufficient vitamin D from sunlight or supplementation is also important.

An 80-year-old man has no chronic diseases and is alert, oriented, and physically active. Which of the following nursing diagnoses is likely to be present as a result of the normal aging process? A) Poisoning, risk for, related to the many medications an older person must take. B) Suffocation, risk for, related to declining respiratory function. C) Hopelessness, related to recognition of the end of life drawing near. D) Constipation, related to slowed peristalsis.

ANS: D Constipation is a common nursing diagnosis for older adults in otherwise good health. In addition to peristalsis slowing, most older adults experience decreased taste and smell resulting in decreased appetite and food intake, as well as decreased physical mobility.

The nurse caring for a 42-year-old patient is satisfied that Erik Erikson's psychosocialdevelopment phase of generativity has been satisfied by the fact that this patient is: A) reflecting on one's life and one's achievements. B) investigating and identifying alternatives regarding vocation. C) attaining new intellectual skills and developing his career. D) fulfilling parenting and civic responsibilities.

ANS: D Erik Erikson's psychosocial development theory includes the stage of generativity vs. stagnation in which parenting, nurturing others, and fulfilling civic responsibilities are the tasks. The adult finds ways to be productive and of help to others in order to grow personally.

A nurse is concerned about a 21-year-old who does not seem to have any intimate relationships. The nurse is aware that according to the Eriksonian theory, a lack of intimacy in this person's life can result in: A) mistrust. B) guilt. C) role confusion. D) isolation.

ANS: D Erik Erikson's psychosocial development theory includes the stage of intimacy vs. isolation. This stage is where love relationships are developed, and fear of intimate relationships will lead to a sense of isolation.

A nurse working for an assisted living facility is reviewing the Healthy People Objectives for Older Adults. Which of the following would she incorporate into the environment to promote health for the older adult population? A) Encourage staff management of chronic health conditions. B) Discourage participation in sessions for "Welcome to Medicare" benefit. C) Decrease opportunities for light, moderate, or vigorous physical activities. D) Develop and implement strategies to prevent pressure ulcer formation.

ANS: D Healthy People Objectives: Older Adult• Increase the proportion of older adults who use the "Welcome to Medicare" benefit.• Increase the proportion of older adults who are up to date on a core set of clinical preventive services.• Increase the proportion of older adults with one or more chronic health conditions who report confidence in managing their conditions.• Increase the proportion of older adults who receive Diabetes Self-Management Benefits.• Reduce the proportion of older adults who have moderate to severe functional limitations.• Increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous physical activities.• Increase the proportion of the health care workforce with geriatric certification.• Reduce the proportion of noninstitutionalized older adults with disabilities who have an unmet need for long-term services and supports.• Reduce the proportion of unpaid caregivers of older adults who report an unmet need for caregiver support services.• Reduce the rate of pressure ulcer-related hospitalizations among older adults.• Reduce the rate of emergency department (ED) visits due to falls among older adults.• Increase the number of states and the District of Columbia that collect and make publicly available information on the characteristics of victims, perpetrators, and cases of elder abuse, neglect, and exploitation. (Source: https://www.healthypeople.gov/2020/topics-objectives/topic/older-adults)

A primary care provider has ordered a Mantoux test. The patient asks the purpose of this test. The nurse tells the patient this test is done to screen for: A) Lyme disease. B) lung cancer. C) valley fever. D) tuberculosis.

ANS: D Periodic Mantoux tests are advised to screen for tuberculosis.

The nurse assesses a 36-year-old clinic patient as having slightly elevated blood pressure and being overweight by approximately 20 pounds. The most motivating suggestion the nurse could make would be: A) "If you could lose that extra weight in the next month, your blood pressure would probably be back to normal." B) "The chances of you having a stroke or heart attack will increase if you don't lose some weight and bring your blood pressure down." C) "You'll need to take lifelong medications if diet and exercise don't reduce your blood pressure." D) "Exercise and diet modification started now, even in small amounts, can improve your overall health and delay the onset of aging."

ANS: D Research has established that healthy exercise and eating patterns delay the onset of aging and help control blood pressure.

The school nurse speaking to a group of college sophomores reminds them that in the modern world of work, it is normal to have as many as _____ different jobs throughout their work life. a. four b. five c. six d. seven

ANS: D The myth of the ideal job has given way to a person's being employed in as many as seven jobs in their work life.

An 85-year-old widow who lives alone has fallen several times in the last month and hasbeen noted by her children to be confused about her medications and to frequently "forget"what is cooking on the stove until it is burned. These observations indicate that: A) she needs to be hospitalized to determine the cause of her confusion and falls. B) home delivery of a hot meal every day would solve her cooking risk. C) nursing home placement would be the best solution to her problems of aging. D) further assessment is needed to evaluate an increased level of assistance.

ANS: D The widow is showing signs of needing additional assistance. It might include home delivered meals or nursing home placement, but further assessment needs to be performed. Acute care hospitalization is not indicated in this situation.

A 35-year-old mother of three children, ages 8, 10, and 13, has decided to return to school to become a nurse. Her husband and parents have been very supportive of her decision and will help with child care while she is in school. According to Schaie's theory for cognitivedevelopment, she is in the _____________ stage, which occurs in the ____________ stage of adulthood.

ANS: achievement; young

A 67-year-old submitted a job application at a local gas station. The station manager said,"Aren't you retired? I can't hire you. You're too old to be working!" This is an example of__________________.

ANS: ageism Ageism is defined as any discrimination related to age, including job discrimination.