NURS EXAM 2

During an educational session regarding physical changes of the middle-aged adult, a participant asks about typical weight changes. How should the nurse respond? 1. "Weight loss is no different during this time than at any other time of your life." 2. "Metabolism slows during middle age, which may result in weight gain." 3. "As long as you exercise appropriately, weight loss will be ensured." 4. "Weight loss is always a good idea, regardless of your age."

"Metabolism slows during middle age, which may result in weight gain." : Rationale 1: The nurse should educate clients regarding physical changes occurring in their bodies. Statements that generalize weight loss with all other age groups are neither accurate nor helpful to the person asking the question. Rationale 2: The nurse should educate clients regarding physical changes occurring in their bodies. Age does make a difference in how the body responds to diet and exercise, and it is important for nurses to be well informed and educated regarding age-related changes. Rationale 3: There are other factors in addition to exercise that can affect weight in this age group. Rationale 4: Statements that generalize weight loss with all other age groups are neither accurate nor helpful to the person asking the question.

The nurse working in a community health office that is often frequented by young adults is assessing clients for suicide. Which factors should the nurse identify as indicating a problem in this area? 1. Decreased interest in work 2. Weight loss 3. Depression 4. Brain dysfunction, including tumors 5. Sleep disturbances

1. Decreased interest in work 2. Weight loss 3. Depression 5. Sleep disturbances: Rationale 1: The nurse's role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including decreased interest in work roles. Rationale 2: The nurse's role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including weight loss. Rationale 3: The nurse's role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including depression. Rationale 4: Brain tumors are not an indicator for suicide. Rationale 5: The nurse's role in the prevention of suicide includes identifying behaviors that may indicate potential problems, including sleep disturbances.

The nurse is confident that a young adult has successfully achieved psychosocial development. What observations about the client did the nurse make to come to this conclusion? Standard Text: Select all that apply. 1. Discusses plans to expand his exercise routine to include running 2. Is optimistic about finding a new job 3. Volunteers weekly at the local senior center 4. Recognizes that professional sports may be enjoyed but does not aspire to participating 5. May be "too bald" to play Santa Claus

1. Discusses plans to expand his exercise routine to include running 2. Is optimistic about finding a new job 4. Recognizes that professional sports may be enjoyed but does not aspire to participating : Rationale 1: The psychosocial development of a young adult would include keeping good health habits. Rationale 2: The psychosocial development of a young adult would include the ability to cope with stressors appropriately. Rationale 3: The psychosocial development of a middle-aged adult would include pursuing charitable and altruistic activities. Rationale 4: The psychosocial development of a young adult would include having a realistic self-concept. Rationale 5: The psychosocial development of a middle-aged adult would include accepting his aging body.

The nurse is preparing a teaching session for a group of parents with newborn children. What should the nurse include about Bowlby's attachment theory during this presentation? Standard Text: Select all that apply. 1. Use the attachment figure as security 2. Desire to be near the attachment figure 3. Plan to separate from the attachment figure 4. Return to the attachment figure when threatened 5. Express anxiety when the attachment figure is absent

1. Use the attachment figure as security 2. Desire to be near the attachment figure 4. Return to the attachment figure when threatened 5. Express anxiety when the attachment figure is absent Rationale 1: Bowlby believed that attachment served as a protective or survival mechanism for the infant. Characteristics of Bowlby's attachment theory include using the attachment figure as a security base. Rationale 2: Bowlby believed that attachment served as a protective or survival mechanism for the infant. Characteristics of Bowlby's attachment theory include the desire to be near the attachment figure. Rationale 4: Bowlby believed that attachment served as a protective or survival mechanism for the infant. Characteristics of Bowlby's attachment theory include returning to the attachment figure when threatened. Rationale 5: Bowlby believed that attachment served as a protective or survival mechanism for the infant. Characteristics of Bowlby's attachment theory include expressing anxiety (separation anxiety) when the attachment figure is absent.

An occupational health nurse is providing a hypertension screening at a local manufacturing plant. Among the employees, the nurse should focus on which population? 1. Males and females, equally 2. African American males 3. Asian American females 4. White females

African American males: Rationale 1: Hypertension is a problem for males and females equally. Rationale 2: Hypertension is a major problem for young African American adults, particularly men. The causes for this are unknown. Rationale 3: Hypertension is not a major problem for Asian American females. Rationale 4: Hypertension is not a major problem for White females.

A nurse is working with the residents of an assisted living complex. When planning care for the old-old stage, the nurse realizes that what action will be important? 1. Provide as much care to the residents as possible. 2. Allow as much independence for the residents as possible. 3. Make sure to provide safety measures as needed. 4. Make sure the residents maintain peer interactions and social groups.

Allow as much independence for the residents as possible. Rationale 2: The old-old stage, age 85 and older, is characterized by increasing physical problems. The nursing implication for this age group is to assist with self-care as required, but maintain as much independence as possible.

Two nursing students, both single parents, have decided to move into a larger house. Part of their rationale includes providing support for studying and sharing the responsibilities of parenting. Which type of living arrangement are these students implementing?

Cohabiting family

A client is asked during and admission interview to describe her family. She proceeds to list her parents, siblings, grandparents, aunts, uncles, and cousins. Which type of family should the nurse document for this client?

Extended

During a family assessment, the nurse asks, "How as a family, do you deal with disappointments or stressful changes that occur and affect the members of your family? What is the nurse attempting to identify?

Family coping mechanism

A father of a family was killed in a motor vehicle crash. What should the nurse consider a normal reaction to this event?

Family disorganization may occur

During a previous family assessment, the nurse realized that the mother did most of the talking and was quick to make decisions, which appeared to be acceptable to the father. When one of their children is hospitalized what should the nurse do?

Include both parents in the decision making, but be accepting if the mother retains control

A nurse educator is working with students and assisting them in addressing their clients' spiritual needs. The educator understands that most traditional, second-year college students are aware of their own spiritual development or working to develop their own system of spirituality. The educator realizes that the students are in which stage of Fowler's developmental theory? 1. Mythic-lyrical 2. Intuitive-projective 3. Universalizing 4. Individuating-reflexive

Individuating-reflexive Rationale 4: Fowler describes this as a stage in which the person is constructing his or her own explicit system with a high degree of self-consciousness.

The nurse is preparing information for a community health education seminar. Which statement should the nurse include regarding disease for the middle-aged adult? 1. Cancer is the leading cause of death in the age group from 25 to 64 years. 2. Coronary heart disease is the leading cause of death. 3. Leading causes of death include suicide and motor vehicle crashes. 4. Injuries and chronic disease are the leading causes of death in this age group.

Injuries and chronic disease are the leading causes of death in this age group.: Rationale 1: Cancer is the second leading cause of death among people between the ages of 25 and 64 years. Rationale 2: Coronary heart disease is the leading cause of death among all age groups in the United States. Rationale 3: There is no evidence to support this statement regarding suicide. Rationale 4: Motor vehicle crashes as well as occupational injuries along with chronic disease such as cancer and cardiovascular disease combined make up the leading causes of death in the middle-aged adult group.

A child is starting school and is being screened for certain developmental milestones. What is the nurse assessing when determining how the child interacts with other children? 1. Temperament 2. Physical characteristics 3. Environment 4. Culture

Temperament Rationale 1: Temperament is the way individuals respond to their external and internal environment and sets the stage for the interactive dynamics of growth and development.

A parent brings her baby in for a well-child checkup. Which action of the child should the nurse identify as an indicator of positive resolution of the central task of this age? 1. The child does not cry when the parent allows the nurse to hold the child. 2. The child shows mistrust when strangers approach. 3. The child becomes willful when disciplined. 4. The child does not play with other children.

The child does not cry when the parent allows the nurse to hold the child. Rationale 1: In the infancy years (birth to 18 months), the child's central task is to form trust or mistrust with people. Positive resolution would indicate a safe feeling when the parents leave the child with someone they are familiar with and can trust.

A 30-year-old client who plans to travel extensively within the United States asks the nurse about appropriate immunizations. What should the nurse recommend to this client? 1. The client should have a tetanus booster if the client has not had one within the last 5 years. 2. The client should have the hepatitis B immunization series. 3. The client should receive a meningococcal vaccine if the client did not receive one as a teen. 4. The client should not worry about immunizations, as they are not recommended for this age group.

The client should receive a meningococcal vaccine if the client did not receive one as a teen.: Rationale 1: Recommended immunizations for this age group include tetanus-diphtheria booster every 10 years. Rationale 2: The hepatitis B series would not be recommended for travel within the United States. Rationale 3: Recommended immunizations for this age group include the meningococcal vaccine if not given in early adolescence. Rationale 4: There are recommended immunizations for this age group.

A community health nurse is doing a screening for cervical cancer at a women's health fair. Which client should the nurse identify as having the highest risk factor for cervical cancer? 1. The client who had a difficult vaginal delivery 2 years ago 2. The client who has a history of genital herpes 3. The client who was married at age 27 4. The client who has a sister with breast cancer

The client who has a history of genital herpes: Rationale 1: There is not current evidence to support this option. Rationale 2: High risk factors for cervical cancer include sexual activity at an early age, multiple sexual partners, and a history of syphilis, herpes genitalis, or trichomonas vaginitis. Rationale 3: There is not current evidence to support this option. Rationale 4: There is not current evidence to support this option.

The nurse is performing a family risk assessment . Which factor should the nurse identify that indicates this family is at risk of developing health problems?

The family belongs to the local synagogue and has family members still living in Germany

adaption

ability to handle demands made by the environment

What does the blended family consist of?

consist of an existing family unit joined together to form new families, also known as step families

superego

contains the conscience

The nurse is providing education regarding early detection of breast cancer to a group of women between the ages of 30 and 40. According to recommendations from the American Cancer Society, the nurse should explain that it is important for these women to 1. do monthly breast self-exams. 2. have a yearly mammogram. 3. see a physician if there is a strong family history of breast cancer. 4. have an annual breast exam performed by a health care provider.

have an annual breast exam performed by a health care provider.: Rationale 1: Breast self-exam is no longer recommended for all women. Rationale 2: Yearly mammography for all women over the age of 40 is encouraged, as it decreases mortality from breast cancer. Rationale 3: Although a family history of breast cancer is a risk factor, it is not the sole reason to monitor for breast cancer. Rationale 4: The American Cancer Society recommends that a health care practitioner perform a breast examination at a yearly physical exam.

attachment

lasting, strong emotional bond

What does an extended family consist of?

parents and offsprings along with relatives such as grandparents, aunts and uncles

morality

refers to the requirements necessary for people to live together in society

moral

relating to right and wrong

Id

resides in the unconscious, and seeks immediate pleasure and gratification

cognitive development

the manner in which people learn to think

personality

the outward expression of the inner self

unconscious mind

the part of a person's mental life of which the person is unaware

moral development

the pattern of change in moral behavior with age

ego

the realistic part of the person

adaptive mechanisms

the result of conflicts between the ID's impulses and the anxiety created by the conflicts due to social and environmental restrictions

moral behavior

the way a person perceives the requirements of living in society and responds to them

temperament

the way in which individuals respond to their external and internal environments

developmental stages

theory proposes that life is a series of levels of achievement

A young female client comes into the emergency department with vague physical symptoms and does not make eye contact with the nurse during the interview. In order to best assess the client, what should the nurse ask the client? 1. "Can you tell me what's been going on in your life lately?" 2. "What kind of problems are you having?" 3. "Is someone hurting you?" 4. "Can you explain what your family life is like?"

"Is someone hurting you?": Rationale 1: Generalized questions about life do not adequately address the client's needs during this assessment. Rationale 2: Generalized questions about life problems do not adequately address the client's needs during this assessment. Rationale 3: A nurse who works with women should explicitly ask if the young adult is frightened or hurt by someone she knows. It is essential that nurses make assessment for domestic violence part of their routine. Rationale 4: Generalized questions about family life do not adequately address the client's needs during this assessment.

A middle-aged client is struggling with life changes, including menopause. What is the best response by the nurse to this client? 1. "Don't worry—menopause can't last forever." 2. "There are some very good antidepressants you can take." 3. "What did your mother do to get through menopause?" 4. "There is a menopause support group that meets every 2 weeks."

"There is a menopause support group that meets every 2 weeks.": Rationale 1: Telling a client who is struggling not to worry is not therapeutic and does not address the problem. Rationale 2: Advice about medications is not within nurses' scope of practice, as they do not prescribe. Rationale 3: Comparing this client's situation to her mother's is neither relevant nor therapeutic. Her mother's age group was going through experiences in a different time and culture. Rationale 4: Clients experiencing developmental stressors like menopause, the climacteric, aging, impending retirement, or any other situational stressors may experience anxiety and depression. These clients may benefit from support groups or individual therapy to help them cope with specific crises.

A parent is concerned that her 5-year-old is beginning to masturbate. How should the nurse, familiar with Freud's stages of development, respond? 1. "All children are curious, but make sure the child knows that this behavior might be offensive to others." 2. "You should probably consult a child psychologist if you're this concerned." 3. "Let's make sure to ask your physician at the next appointment." 4. "This behavior is a normal part of your child's development."

"This behavior is a normal part of your child's development." Rationale 4: In the phallic stage, as described by Freud, which occurs from age 4 to 6 years, the child's genitals are the center of pleasure. Masturbation offers pleasure, and questions about sexual topics from parents are normal. Assuring the parent that this is a normal part of development is the best response.

The nurse can identify movement into Kohlberg's postconventional level when the client, after being asked about work, makes which statement? 1. "Oh, the work isn't so bad anymore. I'm getting close to retirement." 2. "Work is fine, but my family and friends are so much more important to me." 3. "I've done a good job for the company. I'm proud of my years there." 4. "I don't like to talk about work when I'm not there."

"Work is fine, but my family and friends are so much more important to me.": Rationale 1: According to Kohlberg, the extensive experience of personal moral choice and responsibility is required to move into the postconventional level. A statement about work not being so bad shows a complacency about work that is not reflective of the postconventional level. Rationale 2: According to Kohlberg, the extensive experience of personal moral choice and responsibility is required to move into the postconventional level. Movement from a law-and-order orientation to a social contract orientation requires that the individual move to a stage in which rights of others take precedence—as in the statement that work is OK, but family and friends are more important. Rationale 3: Stating that the person has pride about work and the time spent doing it would be an example of Erikson's stage of integrity versus despair. Rationale 4: According to Kohlberg, the extensive experience of personal moral choice and responsibility is required to move into the postconventional level. A statement about not wanting to talk about work shows complacency about work that is not reflective of the postconventional level.

A nurse is working with a school-age client who is learning how to use a peak flow meter to monitor his asthma. The child has been frustrated at first, but now is able to give the reason to use the meter on a daily basis. Remembering the growth and development characteristics of the adolescent, how should the nurse respond to this client? 1. "You should feel very proud for understanding and using your meter." 2. "Think of using the meter as one of your daily chores." 3. "Maybe you could make a game out of the daily use of your meter." 4. "It's too bad if you don't want to use the meter, it's just something you'll have to do."

"You should feel very proud for understanding and using your meter." Rationale 1: School-age children (6-12 years) are in the preadolescent period, where the peer group begins to increasingly influence behavior. The nurse must allow time and energy for the school-age child to pursue hobbies and school activities and should recognize and support the child's achievement. Play and social activity are more important in the preschool-age child as new experiences and social roles are tried during play.

After analyzing behavior, the nurse determines that a client is demonstrating defense mechanisms. According to Freud, what should the nurse realize as being the cause of this behavior? Standard Text: Select all that apply. 1. Anxiety created by conflicts 2. Activation of the conscience 3. Conflict between the id's impulses 4. Immediate pleasure and gratification 5. Underlying motivation for development

1. Anxiety created by conflicts 3. Conflict between the id's impulses Rationale 1: Defense mechanisms or adaptive mechanisms are the result of anxiety created by the conflicts due to social and environmental restrictions Rationale 3: Defense mechanisms or adaptive mechanisms are the result of conflicts between the id's impulses.

During a family assessment, the nurse determines that a family functions according to the systems theory. What did the nurse assess to make this clinical decision? (select all that apply) 1. Family members work together towards goals 2. Family members seek out and use community resources 3. Family members interact with other community systems. 4. Healthy boundaries are used to regulate influence by other systems. 5. Family members encouraged to hold fast to beliefs and practices

1. Family members work together towards goals 2. Family members seek out and use community resources 3. Family members interact with other community systems 4. Healthy boundaries are used to regulate influence by other systems

The nurse has identified a coping problem in a family that recently lost their house and all of their belongings in a fire. What should the nurse identify as this familys external support system? (select all that apply) 1. Grandparents 2. The parents siblings 3. Local social services agencies 4. The families religious leader 5. The families communication skills

1. Grandparents 2. The parents siblings 3. Local social services agencies 4. The families religious leader

The nurse is discussing human growth and development with the parents of a newborn. What should the nurse include in this discussion? Standard Text: Select all that apply. 1. Growth involves physical change and increase in size. 2. Skills and function increase with growth. 3. Most humans experience a similar pattern of growth. 4. Being able to adapt to one's environment is an indicator of growth. 5. Children's growth is monitored by height, weight, bone size, and dentition.

1. Growth involves physical change and increase in size. 3. Most humans experience a similar pattern of growth. 5. Children's growth is monitored by height, weight, bone size, and dentition. Rationale 1: Growth is physical change and increase in size. Rationale 3: The pattern of physiologic growth is similar for all people. Rationale 5: Growth can be measured quantitatively. Indicators of growth include height, weight, bone size, and dentition.

The nurse is assessing a child's growth and development. What questions should the nurse ask the parents that demonstrate an understanding of the factors that affect growth and development processes? Standard Text: Select all that apply. 1. How tall the parents are 2. Whether noises seem to bother their child 3. How many ounces of formula their child drinks daily 4. What their yearly income is 5. Whether their child will receive day-care services

1. How tall the parents are 2. Whether noises seem to bother their child 3. How many ounces of formula their child drinks daily Rationale 1: The genetic inheritance of an individual is established at conception. It remains unchanged throughout life, and determines such characteristics as gender and physical characteristics (e.g., eye color, potential height). Rationale 2: Temperament sets the stage for the interactive dynamics of growth and development. Rationale 3: Adequate nutrition is an essential component of growth and development.

The nurse is planning to use the structural-functional theory when assessing a family new to a community. What should the nurse include when conducting this assessment? (select all that apply) 1. Individuals in the family 2. The familys sense of purpose 3. Relationships among family members 4. Strategies to restrict outside influences on the family 5. The approach the family uses to socialize new family members

1. Individuals in the family 2. The familys sense of purpose 3. Relationships among family members 5. The approach the family uses to socialize new family members

A family member is hospitalized with an illness. What should the nurse assess to determine the impact this illness will have on the family? (select all that apply) 1. Nature of the illness 2. Duration of the illness 3. Cause of the illness 4. Financial impact of the illness 5. Effect of the illness on future family functioning

1. Nature of the illness 2. Duration of the illness 4. Financial impact of the illness

A client approaching middle age asks for information to keep mentally sharp. What should the nurse explain about the cognitive abilities of the middle-aged client? Standard Text: Select all that apply. 1. Reaction time stays much the same. 2. Memory is maintained during this time. 3. Learning declines and cannot be completed. 4. Problem-solving ability is maintained during this time. 5. Cognitive and intellectual abilities change very little at this time.

1. Reaction time stays much the same. 2. Memory is maintained during this time. 4. Problem-solving ability is maintained during this time. 5. Cognitive and intellectual abilities change very little at this time.: Rationale 1: The middle-aged adult's cognitive and intellectual abilities change very little. Reaction time during the middle years stays much the same. Rationale 2: The middle-aged adult's cognitive and intellectual abilities change very little. Memory is maintained during middle adulthood. Rationale 3: The middle-aged adult's cognitive and intellectual abilities change very little. Learning continues and can be enhanced with motivation. Rationale 4: The middle-aged adult's cognitive and intellectual abilities change very little. Problem-solving ability is maintained during middle adulthood. Rationale 5: The middle-aged adult's cognitive and intellectual abilities change very little.

The nurse is working with young adults in the community. What should the nurse realize as being the psychosocial developmental tasks of this population? Standard Text: Select all that apply. 1. Selecting a mate 2. Rearing children 3. Achieving civic responsibility 4. Finding a congenial social group 5. Developing adult leisure-time activities

1. Selecting a mate 2. Rearing children 4. Finding a congenial social group: Rationale 1: Selecting a mate is a task appropriate for this age group. Rationale 2: Rearing children is a task appropriate for this age group. Rationale 3: Achieving civic responsibility is a task of the middle-aged adult. Rationale 4: Finding a congenial social group is a task appropriate for this age group. Rationale 5: Developing adult leisure-time activities is a task of the middle-aged adult.

The nurse concludes that a young adult client is completing developmental tasks within Havighurst's early adulthood age period. What did the nurse assess to come to this conclusion? Standard Text: Select all that apply. 1. Taking on civic responsibility 2. Developing adult leisure-time activities 3. Getting started in an occupation 4. Relating oneself to one's spouse as a person 5. Managing a home

1. Taking on civic responsibility 3. Getting started in an occupation Rationale 1: Taking on civic responsibilities is one of Havighurst's early adulthood tasks. Rationale 3: Getting started in an occupation is one of Havighurst's early adulthood tasks.

The nurse is preparing to assess a family regarding the impact of one of its members being diagnosed with diabetes. What should the nurse include in this assessment? (select all that apply) 1. The seriousness of the disorder 2. Whether the family has every dealt with chronic illness before 3. The age of the affected member 4. The financial impact the illness will have on the family 5. The number of members of the family

1. The seriousness of the disorder 2. Whether the family has ever dealt with chronic illness before 4. The financial impact the illness will have on the family

The nurse is confident that a family is functioning appropriately. What findings did the nurse use to make this determination? (select all that apply) 1. The teenage son keeps the money he earns from cutting grass for his car fund 2. All the children are expected to excel in the sport of their choice 3. A parent reads the preschool child a bedtime story each night 4. All the children have household chores once they reach school age. 5. A young adult moves back home after losing his job.

1. The teenage son keeps the money he earns from cutting grass for his car fund 3. A parent reads the preschool child a bedtime story each night 4. All the children have house chores once they reach school age. 5. A young adult moves back home after losing his job.

The nurse is planning to complete a family assessment. For which reasons is the nurse completing this assessment? (select all that apply) 1. To determine the family level of functioning 2. Identify family strengths and weaknesses 3. Provide legal guidelines for consent to healthcare 4. Clarify family interaction patterns 5. Describe the health status of individual members

1. To determine the family level of functioning 2. Identify family strengths and weaknesses 4. Clarify family interaction patterns 5. Describe the health status of individual members

The nurse is completing a spiritual assessment with a middle-aged client. What should the nurse recognize as expected characteristics of moral development in this client? Standard Text: Select all that apply. 1. Uses religion for comfort 2. Seeks religious explanations for death 3. Compares characteristics of various religions 4. Questions the purpose of religion in one's life 5. Relies upon spiritual beliefs to help with illness

1. Uses religion for comfort 2. Seeks religious explanations for death 5. Relies upon spiritual beliefs to help with illness: Rationale 1: In middle age, people tend to be less dogmatic about religious beliefs, and religion often offers more comfort to the middle-aged person than it did previously. Rationale 2: In middle age, people tend to be less dogmatic about religious beliefs, and religion often offers more comfort to the middle-aged person than it did previously. People in this age group often rely on spiritual beliefs to help them deal with death. Rationale 3: Comparing characteristics of various religions is a characteristic of an earlier stage of development. Rationale 4: Questioning the purpose of religion in one's life is a characteristic of an earlier stage of development. Rationale 5: In middle age, people tend to be less dogmatic about religious beliefs, and religion often offers more comfort to the middle-aged person than it did previously. People in this age group often rely on spiritual beliefs to help them deal with illness.

The nurse is plotting the height and weight of children during a school assessment clinic. Which aspect of the children's health is the nurse assessing? 1. Development 2. Health 3. Growth 4. Bone size

Growth Rationale 3: Growth refers to physical change and increase in size. Indicators include height, weight, bone size, and dentition.

While assisting in a community health project for middle-aged adults, the nurse attempts to identify members of the community who have been successful in the tasks identified by Erikson. What characteristic should the nurse identify in the community members? 1. Ability to have satisfaction in their volunteer activities 2. Ability to find an acceptable social group 3. Satisfaction with rearing children 4. Ability to manage a home

Ability to have satisfaction in their volunteer activities: Rationale 1: Erikson identifies this stage as generativity versus stagnation. Generative middle-aged persons are able to feel a sense of comfort in their lifestyle and receive gratification from charitable endeavors. Rationale 2: This option identifies tasks associated with the young adult stage. Rationale 3: This option identifies tasks associated with the young adult stage. Rationale 4: This option identifies tasks associated with the young adult stage.

A family struggles with clear communication, and members of the family often seek the help of other systems for personal validation and gratification. What should the nurse identify as an appropriate nursing diagnosis for this family?

Altered family processes related to communication pattern

The nurse is reviewing the four stages of development in Westerhoff's spiritual theory. In which order should the nurse review these stages to match the life cycle? Standard Text: Click and drag the options below to move them up or down. Choice 1. Owned faith Choice 2. Affiliative faith Choice 3. Experienced faith Choice 4. Searching faith

Correct Answer: 4, 2, 1, 3 Rationale 1: Puts faith into personal and social action and is willing to stand up for what the individual believes even against the nurturing community is Stage 4. Rationale 2: Actively participates in activities that characterize a particular faith tradition; experiences awe and wonderment; feels a sense of belonging is Stage 2. Rationale 3: Experiences faith through interaction with others who are living a particular faith tradition is Stage 1. Rationale 4: Through a process of questioning and doubting own faith, acquires a cognitive as well as an affective faith is Stage 3.

A parent brings a 16-month-old child to the clinic for a well-child checkup. During the assessment, the nurse finds that the child cannot stand next to furniture and does not try to pull himself up from a sitting position. In which process should the nurse identify that this child is lagging? 1. Growth 2. Development 3. Height 4. Behavior

Development Rationale 2: Development is an increase in the complexity of function and skill progression. It is the behavioral aspect of growth—the person's ability to walk, talk, and run, for example.

A nurse is conducting a family assessment and is focusing, for the moment, on the family members communication patterns. Which observation indicates that there are existing or potential problems with family communication?

Disagreements are not addressed by members; rather, they are ignored by the person who does the most talking.

A client who has a terminal diagnosis has been using her time to help family members deal with her impending death. Among her activities, she collected pictures for a scrapbook and wrote a journal of favorite memories for family members to read after the client dies. According to Peck, the nurse realizes that this client is working through which developmental task? 1. Body transcendence versus body preoccupation 2. Ego transcendence versus ego preoccupation 3. Ego differentiation versus work-role preoccupation 4. Integrity versus despair

Ego transcendence versus ego preoccupation Rationale 2: Ego transcendence is the acceptance without fear of one's death as inevitable. This acceptance includes being actively involved in one's own future beyond death. Peck proposes that there are three developmental tasks during old age, in contrast to Erikson's one—integrity versus despair.

The nurse is providing pre-employment physicals to a group of adults, aged 30 to 40. In which generation should the nurse categorize these adults? 1. Baby Boomers 2. Generation X 3. Generation Y 4. Millennials

Generation X: Rationale 1: The Baby Boomers were born in the years 1945 to 1964. Rationale 2: Generation X includes individuals born in the years 1965 to 1978. Rationale 3: Generation Y includes individuals born between the years 1979 and 2000. Rationale 4: Millennials were born between the years 1979 and 2000.

A community health nurse is planning adult health education classes. According to Erikson's stages of development, the nurse should address which task with this age group? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

Generativity versus stagnation Rationale 4: Adulthood, age 25 to 65 years, is characterized by the central task of generativity versus stagnation. Positive resolution is indicated by creativity, productivity, and concern for others. Negative resolution is characterized by self-indulgence, self-concern, and lack of interests and communication.

A young adult has never lived away from his parents and feels unable to make decisions on his own. According to Freud's theory of development, the nurse should suspect that this person would be fixated at which stage of development? 1. Phallic 2. Latency 3. Genital 4. Anal

Genital Rationale 3: Freud's genital stage is characterized by energy that is directed toward full sexual maturity and function and development of skills needed to cope with the environment. It occurs during puberty and extends beyond. Implications of this stage include separation from parents, achievement of independence, and decision making. Fixation occurs at any stage and is the immobilization or the inability of the personality to proceed to the next stage because of anxiety.

The nurse is conducting a family assessment as a part of the process for services provided through the community. Which part of the assessment should provide the nurse with the best information in identifying existing or potential health problems?

Genogram

A client comes to the clinic with a history of pain in his testicle. During the interview assessment, what information should be of concern to the nurse? 1. The client works as an auto-detailer. 2. He smokes half a pack of cigarettes per week. 3. He has not had a yearly exam for 5 years. 4. He does not perform testicular self-exams.

He has not had a yearly exam for 5 years.: Rationale 1: There is no current evidence to support such work as a risk factor for such symptoms. Rationale 2: There is no current evidence to support smoking as a risk factor for such symptoms. Rationale 3: Testicular cancer is the most common neoplasm in men between the ages of 20 and 34. Monthly testicular self-examination, a means of early identification of malignancy, used to be recommended for all men. More recent recommendations from the American Cancer Society (ACS) are that men should have a testicular exam as part of a yearly physical exam. Rationale 4: Men who have risk factors for testicular cancer should discuss monthly testicular self-examination with their primary care provider.

A colleague is telling the community health nurse that his adult child has just moved back in with him and his wife. They are finding this situation somewhat difficult to adjust to. The nurse offers support and listens, while understanding that which factor is least likely contributing to this particular trend? 1. Maladaptive behavior 2. High unemployment rate 3. High housing costs 4. High incidence of chronic disease

High incidence of chronic disease: Rationale 1: These young adults, known as "Boomerang Kids," have moved back into their parents' homes after an initial period of independent living. A factor that has contributed to this trend is maladaptive behavior. Rationale 2: These young adults, known as "Boomerang Kids," have moved back into their parents' homes after an initial period of independent living. A factor that has contributed to this trend is high unemployment rates. Rationale 3: These young adults, known as "Boomerang Kids," have moved back into their parents' homes after an initial period of independent living. A factor that has contributed to this trend is high housing costs. Rationale 4: These young adults, known as "Boomerang Kids," have moved back into their parents' homes after an initial period of independent living. Chronic disease is not a factor that has contributed to this trend.

A client is being seen in the mental health clinic for antisocial behavior. According to Erikson's stages of development, the nurse realizes that this client is dealing with which task of development? 1. Initiative versus guilt 2. Industry versus inferiority 3. Intimacy versus isolation 4. Identity versus role confusion

Identity versus role confusion Rationale 4: According to Erik Erikson, the adolescent stage is from 12 to 20 years and the central task is identity versus role confusion. Positive resolution indicates sense of self with plans to actualize one's abilities. Negative resolution indicates feelings of confusion, indecisiveness, and possible antisocial behavior.

A nurse is working with a particular cultural group in which it is not uncommon for grandparents to live with their married children and to assist with child rearing and discipline issues. For which type of family should the nurse plan care for these clients?

Intra-generational family

A parent tells the nurse that his child is quite creative and learning how to pretend with "almost anything in the house." According to Piaget, the nurse realizes this child is demonstrating which stage/phase? 1. Tertiary circular reaction: stage 5 2. Inventions of new means: stage 6 3. Preconceptual phase 4. Concrete operations phase

Inventions of new means: stage 6 Rationale 2: Stage 6, inventions of new means, is from 18 to 24 months. The significant behavior is identified by interpretation of the environment by mental image. Make-believe and pretend-play are in use during this stage.

The nurse is exploring the behavior of children and how they interpret right from wrong or bad from good. Which theorist should the nurse study to learn this information? 1. Vygotsky 2. Skinner 3. Kohlberg 4. Piaget

Kohlberg Rationale 3: Lawrence Kohlberg's theory specifically addresses the moral development of children and adults.

A toddler shows fear and begins to cry when her parent leaves her at day care. According to Havighurst, which developmental task should the nurse recognize this child is exhibiting? 1. Building wholesome attitudes toward oneself 2. Learning to get along with age-mates 3. Learning to relate emotionally 4. Achieving personal independence

Learning to relate emotionally Rationale 3: A toddler would be in the infancy and early childhood age period, in which learning to relate emotionally to parents, siblings, and other people is a developmental task.

A parent is concerned that her child is unable to sit alone. The nurse explains that development is based on in-born timetables and the child will be most likely able to meet this milestone at a specific time. Upon which theory did the nurse base the response to the client? 1. Havighurst's theory 2. Task theory 3. Psychosocial theory 4. Maturational theory

Maturational theory Rationale 4: The maturational theory (Arnold Gesell) postulates that child development is a maturational process based on an in-born timetable. Although children benefit from experience, they will achieve maturational milestones such as rolling over, sitting, and walking at specific times.

The nurse has been working with a family at the community health office and is concerned about signs of family violence. Which finding should the nurse identify as most concerning?

One of the children never speaks and seems on guard when in the presence of a parent

What does a nuclear family consist of?

Parents and offsprings

The nurse is providing assistance at a community health fair for middle-aged clients. Which information should the nurse use when working with this group of clients? 1. The middle-aged person has decreased intellectual and cognitive abilities as a result of the normal aging process. 2. Adults make the transition into this stage easily and without problems. 3. Physical capabilities and functions decrease with age, but mental and social capacities tend to increase in the latter part of life. 4. Cognitive and intellectual abilities are somewhat decreased due to slower reaction time, loss of memory, and changes in perception and problem solving.

Physical capabilities and functions decrease with age, but mental and social capacities tend to increase in the latter part of life.: Rationale 1: Cognitive and intellectual abilities change very little during this time. Rationale 2: Transition into middle life can be as critical as during adolescence. Some refer to the "midlife crisis" and call the decade between 35 and 45 years the "deadline decade." Rationale 3: Physical capabilities and functions do decrease with age, but mental and social capacities actually increase in the latter part of life. Rationale 4: Cognitive and intellectual abilities change very little during this time.

The nurse is observing a group of young adults engaged in a discussion regarding work schedules over the holidays. What should the nurse realize that these adults will use to balance the emotional as well as logical side of the discussion? 1. Formal operational stage 2. Postformal thought process 3. Kohlberg's theory of moral development 4. Fowler's spiritual development theory

Postformal thought process: Rationale 1: Young adults are able to use formal operations, characterized by the ability to think abstractly. Rationale 2: Postformal thought, sometimes called the problem-finding stage, is characterized by creative thought, realistic thinking, problem forming, and problem solving. Postformal thinkers are able to comprehend and balance arguments created by both logic and emotion. Rationale 3: Young adults enter the postconventional level of Kohlberg's moral theory. Rationale 4: This would not be considered a spiritual dilemma, so Fowler's theory would not be utilized.

A parent reports to the nurse that his child is learning new words faster than he can write them in the baby book. According to Piaget, the nurse realizes that this child is in which phase? 1. Intuitive thought phase 2. Preconceptual phase 3. Concrete operations phase 4. Formal operations phase

Preconceptual phase Rationale 2: Ages 2 to 4 years, according to Piaget, is the preconceptual phase where the child uses an egocentric approach to accommodate the demands of an environment. Language development is rapid and the child associates words with objects.

A group of middle-aged clients is inquiring about nutrition-related health problems inherent in their age group. In order to best address these concerns of this specific age group, the nurse should take which action? 1. Provide information, including a website, regarding-age specific diet plans. 2. Give all clients a handout on diets recommended by the ADA. 3. Tell the clients to check with their physician before dieting. 4. Have them write to the U.S. Department of Agriculture for more information.

Provide information, including a website, regarding-age specific diet plans.: Rationale 1: Decreased metabolic activity and decreased physical activity mean a decrease in caloric needs. This particular age group must be educated regarding nutrition, exercise, and the relationship of nutrition and exercise to chronic diseases such as diabetes mellitus and heart problems. Rationale 2: This option does not necessarily address the concerns of this specific age group. Rationale 3: Although this information is not incorrect, is the nurse's responsibility to provide general information, education, and sources for clients seeking improvement in their nutrition that would include but not be limited to encouragement to check with their physician before dieting. Rationale 4: Although encouraging the individuals to write for information is not incorrect, in this situation it is the nurse's responsibility to provide information, education, and resources for clients seeking improvement in their nutrition.

A nurse is presenting an educational session regarding psychosocial development to a group of middle-aged adults. According to Erikson's theory, what activity should the nurse select to best meet the needs of this stage? 1. Providing opportunities to mentor school-age children 2. Giving the group handouts regarding peer socialization 3. Helping the members of this group find appropriate civic responsibility 4. Assisting the group members to look at their life accomplishments

Providing opportunities to mentor school-age children: Rationale 1: Erikson viewed the developmental choice of the middle-aged adult as generativity versus stagnation. Generativity is defined as concern for establishing and guiding the next generation. This could be accomplished through a mentor program with school-age children. Rationale 2: Peer socialization is a task of the young adult and adolescent. Rationale 3: Finding civic responsibility is a task of the young adult and adolescent. Rationale 4: Taking inventory of past accomplishments is the task of the older adult.

A college-age client shares that he is struggling with feelings of both independence and dependence regarding his family. The nurse recognizes this as which stage of development, according to Roger Gould? 1. Stage 2 2. Stage 3 3. Stage 4 4. Stage 5

Stage 2 Rationale 1: Roger Gould studied adult development and described seven stages. Stage 2 (ages 18-22) is where individuals have established autonomy, feel it is in jeopardy, and feel they could be pulled back into their families.

A nurse educator believes that teaching students without caring about them is an exercise in futility. This educator also believes that in meeting the students' needs, educators must also work to take care of themselves and care for their own needs. From which stage of Gilligan's theory is the educator approaching the teaching of students? 1. Stage 1 2. Stage 2 3. Stage 3 4. Stage 4

Stage 3 Rationale 3: Gilligan's stage 3—caring for self and others—is the last stage of development, where a person sees the need for a balance between caring for others and caring for the self.

The nurse notes that a 20-month-old child is lagging in stage 6 of Piaget's phases of cognitive development. Which activity did the nurse observe that indicates that this child is struggling at this stage? 1. The child wants the same toy to sleep with during naptime and bedtime. 2. The child merely watches as the other children pretend-play. 3. The child cries when the parents leave the unit. 4. The child does not cooperate with some of the treatments.

The child merely watches as the other children pretend-play. Rationale 2: In this stage of development, inventions of new means, children interpret the environment by mental images. They use make-believe and pretend-play. A child who is unable to do this would not be demonstrating the behavior that is significant at this stage.

A client with an acute, serious illness has been hospitalized. Upon entering the room, the nurse observes the client praying. The client states to the nurse: "I don't know how people manage to get through difficult times without their faith. It's where I get my strength." With which theorist should the nurse associate this client's belief? 1. Fowler 2. Westerhoff 3. Gilligan 4. Kohlberg

Westerhoff Rationale 2: Westerhoff describes faith as a way of being and behaving that evolves from an experienced faith guided by parents and others during a person's infancy and childhood to an owned faith that is internalized in adulthood. For the client who is ill, faith provides strength and trust.

maturation

a process of differentiation and refining of abilities and skills

defense mechanisms

adaptive mechanism

development

an increase in the complexity of function and skill progression

developmental tasks

arises at a certain period in the life of an individual, successful achievement of which leads to success with later tasks

A nurse is working in a community of factory workers and is planning an educational session for wellness, targeting the young adult group. In order to address one of the health problems of this group, the nurse plans to: 1. help the group become more aware of marketing efforts by tobacco companies. 2. tell this group that smoking is unacceptable. 3. make sure the group is aware of the increased risk of liver disease and cancer of the esophagus. 4. counsel the group regarding addiction.

help the group become more aware of marketing efforts by tobacco companies.: Rationale 1: Smoking is a type of drug abuse prevalent in this age group, which can lead to lung cancer and cardiovascular disease. The nurse's role regarding smoking is to serve as a role model by not smoking, provide educational information regarding the dangers of smoking (not just "tell" or "counsel" about it), help make smoking socially unacceptable, suggest resources such as hypnosis, and assist with lifestyle training and behavior modification to clients who desire to stop smoking. Rationale 2: The nurse's role regarding smoking does not include making judgment statements. Rationale 3: There is not current research to support the role of tobacco in the development of liver and esophagus cancers. Rationale 4: The nursing role in this situation is to educate, not counsel.

fixation

inability of the personality to proceed to the next stage because of anxiety

growth

physical change and increase in size

accommodation

process of change whereby cognitive processes mature sufficiently to allow the person to solve problems that were unsolvable before

assimilation

process through which humans encounter and react to new situations by using the mechanisms they already possess

The part of an individual's mental life of which the individual is unaware

unconscious mind

libido

underlying motivation to human development

What does a traditional family consist of?

viewed as one in which both parents reside in the home with their children, the mother assuming the nurturing role and the father providing the necessary economic resources