Exam 05: Middle-Aged Adult NCLEX Questions

A community health nurse is caring for a variety of different people in the community. Which of the following individuals would the nurse recognize as being at risk to experience increased stress related to family dynamics? (Select all that apply.) A. A 54-year-old couple whose young adult daughter and grandson move back into their home. B. A 44-year-old single mother raising three adolescent children without child support. C. A 60-year-old couple whose children have established successful careers in another state. D. A 36-year-old couple whose child plays competitive tennis.

A. A 54-year-old couple whose young adult daughter and grandson move back into their home. B. A 44-year-old single mother raising three adolescent children without child support. D. A 36-year-old couple whose child plays competitive tennis. • Stressors of middle age include adult children moving back home, heading a single parent household, and parents whose child plays competitive sports with the emphasis on winning. The couple who has children living out of state who have established successful careers are at the least risk to have stress related to family dynamic.

Which of the following individuals is at risk for developing osteoporosis? (Select all that apply.) A. A 55-year-old man who is on a low dose of oral prednisone every day because of rheumatoid arthritis. B. A 40-year-old woman who works as a secretary. C. A 60-year-old woman who walks three miles a day. D. A 50-year-old man who works as a mason.

A. A 55-year-old man who is on a low dose of oral prednisone every day because of rheumatoid arthritis. B. A 40-year-old woman who works as a secretary. • Osteoporosis occurs most frequently in postmenopausal women who have fair complexions and are small, sedentary individuals, and people on long term-steroid use. Increases with age.

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

A. A 60-year-old woman who retired last year and volunteers at a homeless shelter 2 days a week. • Generativity according to Erikson's theory involves a sense of productivity, creativity, and the desire to help others, whereas stagnation involves a sense of isolation and focus on oneself.

The nurse, teaching a class on smoking cessation to a group of middle-age adults, presents the adverse effects of smoking, which that nicotine: A. Acts to stimulate the heart. B. Calms the central nervous system. C. Assists in decreasing blood pressure. D. Causes a decrease in carbon monoxide.

A. Acts to stimulate the heart. • Nicotine acts in two divisions of the nervous system to affect the central part of th brain and the spinal cord, and the peripheral portion that controls the arms and legs. Nicotine stimulates the heart, leading to an increased pulse and elevated blood pressure. Although smokers frequently believe that cigarettes have a calming effect, this notion is misleading. Nicotine stimulates the body, whereas increasing levels of carbon monoxide causes lethargy. Smokers may feel calm, although they are actually having their sensations dulled by the elevated level of carbon monoxide.

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

A. Ask the client to describe her daily activity and diet. • A lack of routine exercise and activity plus a diet high in calories contributes to weight gain and a lack of energy. The priority action by the nurse is assessment, which will reveal the reason for a lack of energy.

Which of the following medications is generally recommended to help preserve cardiovascular health in middle-age women? A. Aspirin B. Folic acid C. Estrogen D. Estrogen receptor modulator

A. Aspirin • Only aspirin is recommended to help maintain cardiovascular health by lowering the risk of clot formation.

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

A. Diet and exercise • Obesity is a major risk factor for heart disease, metabolic syndrome, and Type 2 diabetes mellitus. An educational series devoted to discussing a diet and exercise will have the greatest impact on health.

A nurse is preparing a health promotion course for a group of middle adults. Which of the following strategies should the nurse recommend? (Select all that apply.) A. Eye examination every 1 to 3 years. B. Decrease intake of calcium supplements. C. DXA screening for osteoporosis. D. Increase intake of carbohydrate in the diet. E. Screening for depressive Disorders.

A. Eye examinations every 1 to 3 years C. DXA screening for osteoporosis. D. Increase intake of carbohydrate in the diet. E. Screening for depressive Disorders • The nurse should recommend middle adult clients have an eye examination every 1 to 3 years to screen for glaucoma and other disorders. • The nurse should recommend middle adult client have DXA scan to screen for osteoporosis. • The nurse should recommend middle adult clients obtain adequate protein, and consume more fresh fruits, vegetables, and whole grains. • The nurse should recommend screening for anxiety and depression during middle adulthood.

The leading cause of death in middle adulthood, in both White and Black populations, are the same and include: A. Heart disease B. Kidney disease C. Respiratory disease D. Gastrointestinal disease

A. Heart disease • The tree leading causes on both White and Black populations are the same: Heart disease, cancer, and cerebrovascular accident. Reducing disabilities and deaths from these chronic conditions are national health-promotion objectives. Most of the diseases and by professional nurses, is effective with adults who want or must change their lifestyle behaviors.

The nurse provides anticipatory guidance to people during middle age to meet developmental tasks of: (select all that apply.) A. Helping children become responsible, happy adults. B. Rediscovering new satisfaction in the relationship with one's spouse. C. Developing an affectionate but independent relationship with aging parents. D. Reaching the peak of one's career. E. Passing on traditions and skills to grandchildren. F. Developing leisure-time activities.

A. Helping children become responsible, happy adults. B. Rediscovering new satisfaction in the relationship with one's spouse. C. Developing an affectionate but independent relationship with aging parents. D. Reaching the peak of one's career. F. Developing leisure-time activities.

A 48-year-old woman complains to her nurse that she is experiencing frequent episodes of insomnia. What are some measure the nurse should educate her about? (select all that apply.) A. Insomnia is common for this age group. B. Engage in activity 1 to 2 hours before bed to encourage sleep. C. Avoid or reduce the amount of caffeinated beverages that are consumed. D. Occasional napping should be avoided. E. Have a regular schedule for waking and sleep.

A. Insomnia is common for this age group. C. Avoid or reduce the amount of caffeinated beverages that are consumed. E. Have a regular scheduled for waking and sleep. • Insomnia is a common finding in this age category. This condition may be the result of overstimulation resulting from drinking too much caffeinated beverages, strenuous exercise within two hours of bedtime, not having a regular schedule for waking and sleep inf a 24-hour period. Frequently-occurring insomnia can lead to distractibility and irritability and fatigue during the daytime hours. Rest is essential to allow restorative function of the body to occur. The effects of insomnia can be counteracted by regularly scheduled, high-quality sleep and occasional napping when fatigued.

Blacks are more likely than non-Hispanic White Americans to be diagnosed with cancer at a later stage and have a less optimal outcome after the diagnosis is made. Which of the following reasons help explain this difference? (Select all that apply.) A. Lack of access to, or utilization of, cancer screening. B. Lack of health insurance. C. Genetic variations D. Lack of resiliency against disease.

A. Lack of access to, or utilization of, cancer screening. B. Lack of health insurance. C. Genetic variations. • Although poverty and lack of access may account for lack of screening and early diagnosis, genetic variations in tumor growth and response to medication along with other major health problems.

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

A. Make the work environment smoke-free. • Accidents are twice as high among smokers than nonsmokers. Possible explanations include the loss of attention, the use of one hand for smoking, and irritation of the eyes. Because smoking has such an impact on accident rates, this would have the largest effect on reduction of work- related injuries.

A nurse is collecting history and physical examination data from a middle adult. The nurse should expect to find decreases in which of the following physiologic functions? (Select all that apply.) A. Metabolism B. Ability to hear low-pitched sounds C. Gastric secretions D. Far vision E. Glomerular filtration

A. Metabolism C. Gastric secretions E. Glomerular filtration • The nurse should expect metabolism to decline, causing weight gain during middle adulthood. • In middle adulthood, decreases in secretions of bicarbonate and gastric mucus begin and persist into older age. This increases the risk of peptic ulcer disease. • Middle adults begin to lose nephron units, which results in a decline in glomerular filtration rates.

The occupational health nurse working for a large corporation is a member of a task force to improve the work environment. Which of the following suggestions by the nurse would help to improve work conditions? (Select all that apply.) A. On-site walking paths. B. On-site food vendors C. On-site counseling services D. On-site meeting of support groups such as Alcoholics Anonymous

A. On-site walking paths. C. On-site counseling services. D. On-site meeting of support groups such as Alcoholics Anonymous.

Common visual conditions which my occur in middle-aged adults include which of the following? (Select all that apply.) A. Presbyopia B. Glaucoma C. Cataracts D. Macular Degeneration E. Presbycusis

A. Presbyopia B. Glaucoma C. Cataracts D. Macular degeneration • Presbyopia (farsightedness) is common in middle-aged adults, even in individuals who have had no previous problems with their vision. Glaucoma occurs and as a result of increased intraocular pressure, which can damage the optic nerve. Cataracts, an opacity of the lens, can develop and cloud the vision in later years of middle age. Macular degeneration is a progressive deterioration of the maculae of the retina and choroid structures of the eye. Presbycusis is an impairment in auditor acuity.

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

A. Women have a higher death rate related to alcoholism than men. • The death rate for female alcoholics is 50% to 100% higher than for male alcoholics. More men than women are considered problem drinkers. Moderate drinking for women is defined as one alcohol-containing drink a day. Women who are able to hold their liquor are more likely to drink excessively than those who cannot hold their liquor.

A nurse is counseling a middle adult client who describes having difficulty dealing with several issues. Which of the following client statements should the nurse identify as the priority to assess further? A. "I am struggling to accept that my parents are aging and need so much help." B. "It's been so stressful for me to think about having intimate relationships." C. "I know I should volunteer my time to a good cause, but maybe I'm just selfish." D. "I love my grandchildren, but my son expects me to relive my parenting days."

B. "It's been so stressful for me to think about having intimate relationships." • When using the urgent vs. nonurgent approach to client care, the counseling priority is the problem that reflects a lack of completion of the previous stage and progression to the current stage of development. According to Erikson, developing intimacy vs. isolation is a task of young adulthood. This middle adult I still struggling with this task and needs assistance in working through searching for and developing intimate relationships with others

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

B. All workers need continued education related to safety issues. The role of the occupational health nurse is focused on keeping the worksite safe for employees. Experienced workers may not know how to prevent injury. OSHA applies to all companies. There are no data to support that middle-aged workers have the lowest rate on injury. Physical and cognitive changes, which are part of middle age, may predispose workers to injury (i.e, decline in vision/hearing).

The nurse initiates an exercise program with the middle-aged adults by: A. Planning physical activity for a minimum of 45 minutes. B. Considering activities that have the least potential for injury. C. Counseling the adult that exercise should be rigorous to produce results. D. Advising that the heart rate should double during exercise for cardiovascular benefits to be achieved.

B. Considering activities that have the least potential for injury. • Moderation is the key, along with increased caution as the adult approaches age 65. The exercise program should be realistic, and the activities selected should be activities that the individual enjoyed in the past. Activates should be selected with the consideration of the potential for injury. Physical exercise should involve as many muscles as possible, performed on a regular basis, preferably 3 to 4 times a week, for a minimum of 30 minutes each time. The appropriate level of performance for aerobic exercise is determined by achieving a pulse rate that I established for the individual: taking the number 220, subtracting the person's age, then computing 75% of that number.

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

B. Discuss her current dietary and exercise lifestyle habits. • Obesity is defined as a BMI of 30 kg/m2. The client is at risk for obesity. Further data should be gathered related to her dietary and exercise patterns so as to plan appropriate interventions. Adoption of a low-calorie dietary not be an appropriate intervention depending on what additional data collection reveals. Also, dietary changes should be accompanied by regular aerobic exercise.

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

B. Fat is more calorie-dense than is protein. If I eat calorie-dense foods and do not do moderate exercise at least 5 days a week, I will gain weight. • During the analysis stage of cognition, all aspects of learning come together in thought and the individual is cognizant of the relationships and interactions of all the parts. If I eat too much food and do not exercise, I will gain weigh indicates knowledge (recall of facts.) I will walk briskly at least a mile a day, 6 days a week, to maintain a healthy weight indicated application. I can eat more if I exercise more indicated comprehension.

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

B. Glaucoma • Glaucoma occurs as a result of increased intraocular pressure, which can damage the optic nerve. Damage to the optic nerve is irreversible, but visual loss can be prevented if damage is identified early and treatment is initiated. Peripheral vision is affected in glaucoma, Presbyopia is farsightedness. Cataracts caused cloudy vision.

A nurse is conduction a community education program. Which of the following should be stressed as the leading cause of death in middle-aged adults? A. Automobile accidents B. Malignant disease C. Homicide D. Suicide

B. Malignant disease • The leading causes of death during middle adulthood are heart disease, cancer, and accidents. Accidents are the major cause for death in children and young adults. Homicide and suicide are major causes of death for young adults.

A 50-year old man is initiating an exercise program to help improve cardiovascular health. What are some of the recommended guidelines that the nurse should instruct him on? (Select all that apply) A. Every adult over the age of 50 should start with a daily running program. B. Overexertion should be avoided. C. Increase fluid intake during periods of strenuous exercise in hot weather. D. Adults over the age of 50 benefit from intense strength training. E. Suggested actives include walking, jogging, swimming and bicycling.

B. Overexertion should be avoided. C. Increase fluid intake during periods of strenuous exercise in hot weather. E. Suggested activities include walking, jogging, swimming, and bicycling. • Some suggested activities for the middle-aged adults include brisk walking, jogging, swimming, and skipping rope as well as walking or biking to work. Activites that focus on skill and coordination should be attempted by the adult over age 40 rather than activites necessitation speed and strength. Moderation is important for all groups of individuals. Caution is recommended for adults nearing age 65 to prevent muscle strains and/or fails, etc. Overexertion as evidenced by dizziness, chest pressure or chest pain, and unresolved shortness of breath should be avoided. Also, in hot weather, strenuous exercise should be balanced with rest periods and increased intake of fluids to prevent heat stroke.

The nurse is collecting data to evaluate a middle adult's psychosocial development. The nurse should expect middle adults to demonstrate which of the following developmental tasks? (Select all that apply.) A. Develop an acceptance of diminished strength and increased dependence on others. B. Spend time focusing on improving job performance. C. Welcome opportunities to be creative and productive. D. Commit to finding friendship and companionship. E. Become involved with community issues and activities.

B. Spent time focusing on improving job performance. C. Welcome opportunities to be creative and productive. E. Become involved with community issues and activities. • Psychosocially healthy middle adults strive to do well in their environment as part of achieving Erikson's stage of generativity vs. stagnation. • Psychosocially healthy middle adults accept life's opportunities for creativity and productivity and use these opportunities for achieving Erikson's stage of generality vs. stagnation. • Psychosocially healthy middle adults work to contribute to future generations through community involvement and parenting as part of achieving Erikson's stage of generativity vs. stagnation.

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

B. The death rate from breast cancer is higher in Hispanic women than for women in other ethnic groups. • Even though Hispanic women have a breast cancer rate approximately 40% lower than non-Hispanic White women, their death rate is higher, and the cancer is diagnosed at a later stage.

Bloom (1984) has developed a hierarchy of cognitive levels in the adult learner. The analysis cognitive level for the adult learner would be: A. Recalling specific facts. B. Grasping the meaning of the communicated message. C. Breaking down material into its constituent parts while noting their relationship. D. Applying knowledge in the form of abstractions and ideas to concrete situation.

C. Breaking down material into its constituent parts while noting their relationship. • Bloom (1984) developed a hierarchy of cognitive levels in the adult learner. The first level is knowledge, which is the recall of specifics. The second level is comprehension. The learner grasps the meaning of communicated messages and relates it to other material. The third level is application. The learner applies knowledge in the form of abstraction and ideas to concrete situations. Analysis is the fourth level, wherein the adult breaks down the material into its constituent parts while noting their relationship. The final and fifth level I synthesis, wherein the person is able to combine various elements to form a plan and then judge the extent of the ideas and materials satisfy the established criteria.

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

C. Children of divorced parents may have life-long difficulty forming relationships. • Although research is continuing, longitudinal studies by Wallerstein and her colleagues beginning in the early 1970s indicate that children bear the emotional scars of a divorce for a lifetime. The emotional response to divorce is different for children and parents, with most parents adjusting to the divorce within 3 years after the event.

A 63-year-old woman complains to the nurse that she has insomnia and sleeps only 6 hours a night. Which of the following response should be made by the nurse? A. Do you want a sleeping pill? B. Make sure that you no not nap during the a even if you are tired. C. Do you feel excessively tired during the day? D. The nurse practitioner may want to run some simple tests to find out why you are having trouble sleeping.

C. Do you feel excessively tired during the day? • It is important to assess the quality of sleep as well as the effects that the limited sleep has on individuals' daily activities. Mediation should not be the first intervention used to help someone attain restful sleep. People should nap when tired, if they are able to do so, rather than forcing themselves to stay awake.

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

C. Hispanic Americans • Hispanic Americans are the largest minority group in the United States and have the highest uninsured rate.

A condition of the bone that is the result of bone lysis exceeding the rate of bone matrix synthesis is called: A. Osteoarthritis B. Kyphosis C. Osteopenia D. Osteoporosis

C. Osteopenia • Osteopenia is a condition of subnormally mineralized bone, usually as a result of a bone lysis that exceeds the rate of bone matrix synthesis. Thoracic kyphosis is an angulation of the posterior spine that is sometimes referred to as "hunchback." Osteoporosis is a disorder characterized by abnormal loss of bone density and deterioration of bone tissue, with an increased fracture risk. It occurs most frequently in postmenopausal women who have fair complexions and are small, sedentary individuals, and people on long-term steroid use.

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

C. Reduction of glomerular filtration by 50%. • Gastric emptying is decreased, kyphosis is not an expected part of aging, and estrogen levels decrease in women and increase in men as male testosterone levels decrease.

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

C. The safety of long-term estrogen therapy is inconclusive. It is primarily sed short-term to relieve hot flashes. • Research about the safety of estrogen therapy is mixed, therefore it is only recommended for short-term use (1 to 3 years) and only to relieve hot flashes. Natural products do not need research to back up their claims of safety or efficacy.

During middle adulthood, physiological changes affect most bodily systems. These changes include: A. Increased cardiac output B. Increased glomerular filtration rate C. Thinning of the intervertebral disks D. Decreased bone density and mass

C. Thinning of the intervertebral disks. • Physiological changes that occur during the middle adulthood include: o Hair of the adult begins to thin and turn grey. o The skin's moisture and turgor decreases and with the loss of subcutaneous tissue, wrinkles appear. o Fat deposits increase during these years with the increases in weight gain. o Cardiac output decreases. o Bone density and mass progressively decrease. o Thinning of the intervertebral disks accounts for approximately a loss of 1 inch in height. o Acid indigestion and belching increases due to decreased gastrointestinal motility. o Stools become harder and dry due to decreased gastrointestinal motility. o As blood supply to the kidneys decrease, the glomerular filtration rate is decreased. o Blood vessels lose elasticity and become thicker.

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

C. When participants plan the topics of a discussion, interest is maintained. A pre-set list of topics may not meet the learning needs of this particular group. A 2-mile walk may not be realistic for participants.

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

C. Wrinkles appear for a number of reasons, including loss of fat beneath your skin and too much sun exposure.

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

D. A 60-year-old woman who walks briskly and has a pulse rate of 125 during activity. • During activity, the persons pulse rate should not exceed 220 minus the age time 0.75. This the woman who is 60 years old would subtract (220-60=180); then multiply 180 by 0.75 to give 120 for optimal heart rate for this client. A pulse rate of 125 exceeds the recommended optimal rate of 120.

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

D. In addition to screening for tooth decay, dentists screen for mouth cancer. • Dental health is essential to overall health. Dental professionals may be the first to detect a symptom or irregularity that points to a potentially dangerous condition, such as cancer of the mouth and esophageal cancer. Bottled water does not contain fluoride. Periodontitis is oral bone destruction. An annual dental check-up is recemented for the average person, not a check-up every 4 months.

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

D. Scheduling a complete physical and dental exam. • Although limited unprotected exposure to the sun, starting a smoking cessation program, and regular exercise are important to overall health, assessment data must first be collected to create an effective lifestyle change program. Health care needs and issues vary according to race and ethnicity, socioeconomic status, marital status, and so on. Approaches to health care/education must be individualized.

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

D. Tell me about your diet, how much walking do you do each day, and what medications you take. • The postmenopausal woman needs 1500 mg of calcium a day if she is not taking estrogen. Dietary calcium and vitamin D intake, and waking, can help prevent osteoporosis.

A nursing instructor is explaining the various stages of the lifespan to a group of nursing students. Which of the following examples should the nurse include as a developmental task for middle adulthood? A. The client evaluates his behavior after a social interaction. B. The client states he is learning to trust others. C. The client wishes to find meaningful friendships. D. The client expresses concern about the next generation.

D. The client expresses concern about the next generation. • Erikson's task for middle adult as generality vs. stagnation. The nurse should include showing concern for the next generation as an example for this age group.

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

D. The majority of new HIV/AIDS cases occur among middle-aged adults. • Adults in middle age represent 71% of all new cases of HIV/AIDS. Unintended pregnancy occurs most often in middle-age women. Male sexual performance issues begin between the ages of 40 and 50. HIV infection is not rare among middle-age adults.