NUR 208 EXAM 3
The health-care worker assesses a normal response in a dying 8-year-old boy who says:
"I will miss my mom and dad, but my grandmother in heaven will take care of me."
An older client states, I've lived a good life. I don't want to die
Integrity
A 68-year-old client with a new ileostomy remarks to the nurse, It will be difficult for my wife to care for a helpless old man. Which conflict according to Erikson does this comment exhibit?
Integrity versus despair
An older retired client tells the nurse about the great life he has lived and the activities that he enjoys at the senior center. According to Erikson's psychosocial stages of development, which developmental conflict has the client resolved?
Integrity versus despair
According to the video, in 1965 one-third of the jobs in the U.S. were manufacturing jobs. What percent of U.S. jobs today are manufacturing jobs?
Under 13%
According to the video, why did the world's largest refrigerator manufacturer, the Swedish-based company Electrolux, close its plants in Greenville, MI and Vastervik, Sweden at the end of 2006?
Economic strategy to increase profits for shareholders
An older adult says, I regret so many of the choices I've made during my life. According to Erikson's psychosocial stages of development, which developmental conflict has the client failed to accomplish?
Ego integrity versus despair
An older adult was admitted to a long-term care facility for difficulties with activities of daily living. Based on Erikson's psychosocial stages of development, which intervention would the nurse use to assist the client to fulfill her or his developmental task?
Engage the client in reminiscence about past achievements.
What is the relationship between stress and glucose levels?
Excess stress can stimulate the release of hormones, which increase blood glucose levels
Which period of Piaget's theory marks the end of cognitive development?
Formal operations.
According to Erikson's psychosocial stages of development, which earlier developmental stage most strongly affects a person's adjustment to the period of senescence?
Generativity versus stagnation
The manner in which persons adjust to losses in their life will determine:
quality of life.
The sensitive health-care worker can demonstrate therapeutic presence by:
remaining near the patient and family.
When planning health-promotion classes for geriatric adults, the health-care worker should include information pertinent to:
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:
screen for prostate cancer.
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:
should be left in place.
Because of changes in the blood vessels, which become narrow with fatty deposits, the geriatric elder is at risk for:
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:
take the family members aside and explain that the patient may be able to hear them.
The most effective nursing intervention for health promotion in the older adult is primarily focused on:
teaching positive health behaviors.
A sign of dysfunctional grief may include:
temporary social withdrawal
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:
the "empty nest" syndrome related to the children being gone from home and stress from the recent divorce.
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:
the beginning of the "letting-go" process.
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:
transitional phase.
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:
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:
useful and loved.
A terminally ill patient in hospice care says that she plans to attend her grandson's college graduation 5 months from now. This patient:
will probably live to attend the graduation.
The statement that best depicts the preschooler's understanding of death is:
"I know that my brother got taken because I had a fight with him."
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:
"According to the dying person's bill of rights, your relative has the right to make this decision."
A common anxiety about suicide is reflected when the twin brother of a suicide victim asks:
"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:
"Excessive exercise may actually decrease your testosterone level."
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:
"I can understand why you feel angry with God and everyone else right now."
Teaching to increase self care is effective when the adult learner makes which statement?
"I exercise for 30 minutes 5 times a week."
A registered nurse is teaching a nursing student about Lawrence Kohlberg's Theory of Moral Development. Which information provided by the registered nurse regarding Postconventional Reasoning needs correction?
"In this level, emphasis is given on social rules and a community-centered approach."
The registered nurse is teaching a nursing student about Lawrence Kohlberg's Theory of Moral Development. Which information provided by the registered nurse regarding 'Preconventional Reasoning' needs correction?
"In this level, the client sees moral reasoning based on his or her own personal internalization of societal and others' expectations."
When a terminally ill patient says, "I feel that death is just around the corner," the most appropriate response would be:
"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?
"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:
"It's normal to be anxious. Let's go over what happens after you are admitted."
A health-care worker passing an open door sees a nursing home resident having consensual sexual intercourse with another resident. The most appropriate response is to say:
"Let me shut the door to give you more privacy."
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:
"Regression to less mature forms of behavior are not unusual after a death."
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:
"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:
"Yes, of course you may. Do you need any special cloths or towels?"
An 85-year-old client is alert and able to participate in care. According to Erikson, which developmental stage will the client need to adjust to?
Generativity versus stagnation
Persons experiencing bereavement should postpone making drastic changes in their lives for at least:
1 year.
According to the video, how many "excess deaths" does economist Harvey Brenner predict Greenville will see in the next 10 years due to the Electrolux shutdown and increase in unemployment?
134
Using Erikson's developmental stages as a guide, the home health-care worker identifies the person at risk for delayed development as the:
24-year-old woman who is still living at home and spends most of her time involved in computer social media.
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.
4
Middle adulthood is considered the period of development after young adulthood but before retirement and is categorized as age 40 to _____ years.
60
According to Kohlberg's theory of moral development, which statement about conventional reasoning is true?
A person wants to fulfill family expectations.
What association is there between income levels and risk factors for diabetes?
Americans in the lowest income brackets are twice as likely to develop diabetes due to increased stress levels associated with poverty
A client who retired a year ago says, I don't have any hobbies or interests
Ask the client to identify past achievements.
Which groups tend to have higher rates of type 2 diabetes? A. Pacific Islanders B. Aboriginal Australians C. African Americans D. All of the above
D. All of the above
A 70-year-old man with a history of depression has few interests since retirement. He says, I feel useless and unneeded. Based on Erikson's psychosocial stages of development, which outcome is occurring?
Despair
Which statement of a client confirms that he or she has reached the intimacy versus isolation stage according to Erikson's theory of psychosocial development?
I did so much for my partner.
According to the video, how did the caseload at the local hospital in Greenville, MI change in the year following the Electrolux plant closure?
In 2004 there were 80 cases of depression, attempted suicide, and domestic abuse cases; this rate almost tripled after the plant closed
Which opposing conflict does a young adult face according to Erikson's theory of psychosocial development?
Intimacy versus isolation
According to the Erikson's theory, which stage in a young adult describes the development of the sense of caring for others?
Intimacy versus isolation.
Based on Erikson's psychosocial stages of development, which task must a 30-year-old client work through?
Intimacy versus isolation.
What might be a risk factor for the development of diabetes for the Pima and Tohono O'Odham tribes?
More than half live below the poverty line
According to Erikson, which need would nurses focus care on for the middle-aged adult?
Productive
According to Erikson's psychosocial stages of development, which activity would the nurse encourage for a 75-year-old adult?
Reflecting on past achievements with a sense of satisfaction
Which basic human needs belongs to the fourth level as per Maslow's hierarchy of needs? Select all that apply. One, some, or all responses may be correct.
Self-worth Achievement
Which stage of Kohlberg's theory explains the influence of moral values on an individual's thought?
Society-maintaining orientation.
Which stage of Kohlberg's theory of moral development does the nurse anticipate in a client who exhibits absolute obedience to authority and rules?
Stage II.
According to the video, why is unemployment in the U.S. associated with higher rates of stroke, heart and kidney disease, alcohol abuse, suicide, and homicide?
Stress has a negative effect on a person's health.
According to Erikson's theory of psychosocial development, which would the nurse include in the plan of care for a young adult client who is hospitalized?
The importance of having support from the client's significant other.
Which description by a student of the formal operations stage of Piaget's theory of cognitive development indicates a need for further teaching? Select all that apply. One, some, or all responses may be correct.
There is an absence of egocentric thought. Reversibility in thought is the primary characteristic.
A client says, I feel frustrated because I do not spend enough time with my partner because of my job. According to Maslow's hierarchy of needs, which level of need does the given scenario refer?
Third level, which includes love and belonging needs
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 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 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:
abnormal grief that may require psychological counseling.
The most therapeutic communication to use with a bereaved family should reflect:
acknowledgment of the loss.
The health-care worker can support grieving families at the time of death by:
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:
an assisted-living home.
The goal of intimacy for the young adult means that the young adult has achieved:
an open and trusting relationship with another person.
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:
appropriate, because it can assist in the resolution of personal grief.
An appropriate strategy when teaching geriatric adults is to:
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:
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:
attempting to meet the needs of both their children and their parents.
The term geriatrics refers to the study of:
biological, psychological, physiological, and sociological aspects of aging.
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:
calcium
When discussing the basic needs for the older adult, the health-care worker uses the term ___________ to indicate effective interactions.
competence
The health-care worker clarifies that the concept of generativity means that the middle adult:
contributes positively to family and community.
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:
daughter has little knowledge of the patient's medical condition.
The event most likely to make a grief reaction complicated and pathological would be:
death by suicide.
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:
durable power of attorney.
A grief reaction that interferes with life's functions is:
dysfunctional grief.
In cultures in which respect and inclusion of the older adult in family life is the norm, the older adult demonstrates greater:
emotional competency.
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:
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:
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:
family support affects the elder's sense of well-being.
The theory of aging that attributes the age-related cellular changes to an unpaired ion is the theory of:
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.
generativity
Anticipatory grief is:
grief that occurs before a loss
The health-care worker recommends cardiovascular screening for the 60-year-old man who:
has a high low-density lipid level.
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:
has decreased liver and kidney function.
A middle-aged woman says that her husband does not seem to want to make have intercourse 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:
he is concerned about his sexual performance and is afraid to try for fear of failure.
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:
help provide closure for the child.
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:
in denial or disbelief.
Normal grief responses may include
inability to concentrate
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:
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:
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:
information that relates to the person's actual experiences.
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:
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:
legacy
The college health-care worker cautions the 20-year-old male about an adverse effect of overtraining, which is:
loss of strength.
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:
males retain their fertility into the eighth decade of life.
The term climacteric refers to a time in life in which:
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:
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:
midlife crisis.
The home health-care worker recognizes that memory loss related to depression as compared to normal age-related memory loss is:
more likely to be temporary.
The college health-care worker planning a health promotion class plans to support the goals of Health People 2020 and focus on:
nutrition, family planning, and physical fitness.
When caring for a terminally ill patient, health-care workers are permitted to provide interventions that:
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:
on the anniversary date of the death.
An important consideration in the rehabilitation of a geriatric patient to prevent loss of function from inactivity and immobility is:
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:
performing regular aerobic, weight-bearing exercise.
The role of the nurse or health-care worker after the patient's death involves:
preparing the family for the grieving process
When access to health care is blocked, the major negative impact is that:
preventative health-care measures are neglected.
Among the goals for the aged from Healthy People 2030 is an increased access for the elderly to acquire:
preventative health-care services.
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:
prohibit pregnant women and children from the bedside.
A provision of the controversial Health Care Affordability Act of 2010 was to:
provide wider health-care coverage.
