Topic 1: Foundations of Gerontology and Theories of Aging (prep-u)
The gerontological nurse overhears another nurse state, "It's too bad people become mean as they age." What is the gerontological nurse's best response?
"Actually, theory suggests personalities are consistent throughout life."
The son of an older adult female client asks the nurse why the staff bothers his mother so much to go to the bathroom during the day. What is the nurse's best response?
"Bladder capacity decreases with age, hence the need for frequent toileting."
The nurse is teaching an older person about the concept of successful aging. Which of the nurse's questions addresses an important contributor to successful aging?
"Do you feel like you actively engage with life?"
A group of nurses is involved in the planning and implementation of a health promotion campaign that is aimed at older adults. Which of the following questions is the best guide to such a campaign?
"How can we help older adults maintain wellness as they age?"
A gerontological nurse is teaching a nursing student about publicly supported programs that benefit older Americans. The nurse knows that the teaching has been effective if the student makes which statement?
"Nursing home reform was implemented through the Omnibus Budget Reconciliation Act."
An 80-year-old man has been a widower for several years and expresses concern about finding female companionship. What is the nurse's best response? "Overall, there are more single women your age than single men." "Most older men are satisfied living alone once they adjust to it." "With time, you'll adjust to living independently." "I'll be glad to contact a grief counselor for you."
"Overall, there are more single women your age than single men." Despite recent changes, there are still many more female older adults than male. Stating that men are satisfied living alone and that the client will adjust to living independently does not address the desire to find female companionship and provides false reassurance. This male expresses a desire for companionship, which is a healthy sign of coping rather than a sign of complicated grief.
A new gerontological nurse correctly identifies the rationale for frequent turning and repositioning of the older client when making which statement?
"The older client has a reduced ability to sense pain and pressure."
A 75-year-old female asks to talk to the nurse about how to maintain safe and satisfying sexual relationships. What is the nurse's best response?
"Water-based lubricants are helpful for relieving vaginal dryness."
A diabetes nurse is providing care for a 73-year-old man who is a regular client of the hospital's outpatient diabetes clinic. What assessment question most clearly addresses this client's potential for optimal function?
"What are some goals that you have for maximizing your level of wellness?"
The nurse hears a colleague make the statement, "Most older adults have nothing to worry about financially." Which of the following statements reflects an accurate response to this? "You have to remember that there's a huge economic disparity among older adults." "Actually, the number of older people living below the poverty line has been increasing, not decreasing." "This isn't really true now, but it is true that the gaps that disadvantaged groups live with are expected to shrink." "This is true for some groups, but not for minorities who are less likely to be living with their relatives."
"You have to remember that there's a huge economic disparity among older adults." Older people exhibit great diversity in terms of socioeconomic status, as well as cultural background, lifestyle, living arrangement, and health status. Contrary to the other statements, the number of adults living below the poverty line has decreased in recent years. The gaps that separate disadvantaged groups from more economically secure older adults are predicted to persist. Minorities are more likely, not less likely, to be living with their relatives.
A nurse who works with older adults recognizes that late adulthood is a time of life that is characterized by a number of significant life events. What psychosocial consequences occur because of life events that are common in late adulthood? (Select all that apply.) A broadening of social networks Adjusting to relocation from home Adjustment to a lower income Adaptation to chronic illnesses Coming to terms with one's mortality
Adjusting to relocation from home Adjustment to a lower income Adaptation to chronic illnesses Coming to terms with one's mortality The life events of late adulthood have profound psychosocial ramifications, including reduced income, acknowledgment of mortality, relocation from home, and chronic illness. Social networks typically shrink rather than expand.
A 68-year-old female with arthritis is scheduled to attend a low-impact exercise class. What is the nurse's best action?
Administer analgesics before class
What is the best nursing action to promote the safety of the older client with decreased thymus activity? Avoid bright lights. Administer influenza vaccine. Monitor caloric intake. Assess intake and output.
Administer influenza vaccine. As the immune system ages, the activity of the thymus diminishes, causing older adults to be more prone to illness. Routine vaccination is recommended for older adults. The thymus does not cause visual changes, reduced metabolism, or kidney problems.
A nurse is assessing a group of older clients for achievement of developmental tasks based on Erikson's theory. Which situation would lead the nurse to suspect that the client would be at risk for disappointment and despair?
An 80-year-old man describes himself as "useless" since he is unable to help his adult children with their yard and garden work.
The nurse prepares an educational seminar on aging for a group of college students. Which information should the nurse include that explains the categorization of older adults?
An oldest-old person is over age 85
A 77-year-old man was put on broad-spectrum antibiotics when he was hospitalized for sepsis. He has a history of rheumatoid arthritis and a recurring problem with pneumonia. Which of the following best explains why he has had these illnesses? Apoptosis Neuroendocrine theory Autoimmune factors Genetic theory
Autoimmune factors Older adults are more susceptible to cancer, autoimmune disorders, and infections, a phenomenon that can be attributable to age-related increases in autoimmune reactions. Apoptosis is a noninflammatory, gene-driven, normal developmental process that occurs continuously throughout life. Neuroendocrine theories are based on the understanding that the neuroendocrine system integrates body functions and facilitates adaptation to changes in both internal and external environments. Genetic theories emphasize the role of genes in the development of age-related changes.
Which aging theory suggests that life expectancy has increased due to elimination of pathogens? Biogerontology Apoptosis Genetic Autoimmune reaction
Biogerontology The biogerontology theory has been stimulated by the fact that human beings and animals have enjoyed longer life expectancies with the control or elimination of certain pathogens through immunization and use of antimicrobial drugs. Apoptosis theory refers to programmed cell death. Genetic theories refer to genetic changes and mutations that alter the aging process. Autoimmune reaction theory refers to the processes of the body attacking itself due to various factors and speeding the aging process.
A nurse is aware that many health care providers prioritize the role of biology in the aging process. What is a weakness of biologic theories of aging?
Biologic theories of aging do not adequately address issues of wellness and quality of life.
A 74-year-old woman has presented to the emergency department with a suspected hip fracture following a fall on the sidewalk outside her home. While gathering the client's history, the nurse suspects that which underlying factor most likely contributed to the suspected injury?
Bone minerals and mass are reduced as part of the aging process.
How can the gerontologic nurse best advocate for older adult benefits? Suggest spending limits appropriated for older adult care. Encourage setting limits on tax dollar funding of older adult care. Endorse cost-containment efforts that maximize welfare of older adults. Avoid discussions related to rationing of older adult services.
Endorse cost-containment efforts that maximize welfare of older adults. Gerontological nurses need to be advocates in ensuring that cost-containment efforts do not jeopardize the welfare of older adults. Spending limits and tax dollar limitations may jeopardize the welfare of older adults if needed services are cut. Open discussion and problem-solving are needed to address the concern of continuting benefits for older adults.
The nurse is encouraging a client to limit exposure to pesticides by eating organic foods whenever possible. This nursing addressing what theory of aging? Radiation Evolutionary Nutrition Environmental
Environmental Environmental theories suggest environmental factors such as exposure to mercury and pesticides affect the aging process. Radation theories suggest exposure to ultraviolet light affects aging. Evolutionary theories suggest genetic changes, such as emphasis on reproductive organs, affect aging. Nutrition theories address the importance of a quality diet of vitamins and minerals more than exposure to pesticides and eating organic.
When establishing a bowel routine for an older adult, what should the nurse include in the plan of care?
Establish a toileting schedule.
When establishing a bowel routine for an older adult, what should the nurse include in the plan of care? Routinely check the pH of stomach content. Decrease the intake of high-fiber foods. Apply an adult incontinence brief during the day. Establish a toileting schedule.
Establish a toileting schedule. The older adult can suffer loss of tone and slower transmission of neural impulses to the lower bowel, which reduces awareness of the need to evacuate the bowels. Establish a toileting schedule is effective in promoting bowel emptying. The pH of gastric contents does increase with age, but routinely checking the pH is not necessary. Older adults require adequate fiber intake; reducing fiber intake creates a high risk for constipation. Wearing and adult diaper is not routinely recommended as this practice can contribute to skin breakdown and fosters ageist stereotypes.
The nurse teaches the importance of using sunscreen. Which theory of aging is the nurse's teaching based upon? Neuroendocrine Disengagement Radiation Nutrition
Radiation Radiation theories address the relationship between radiation and age. In humans, repeated exposure to ultraviolet light is known to cause skin wrinkling and cancer. Disengagement theory is a sociologic theory addressing the impact of society on older adults and vice versa. Neuroendocrine theories suggest aging is a result of changes in the brain and endocrine glands. Nutrition theories emphasize the importance of good nutrition throughout life.
How can the gerontological nurse best promote a sense of purpose and longevity in older adults?
Remain open-minded in realizing the limitations of aging theories.
An older client plays tennis twice a week. Which body system should the nurse expect the most improvement to occur in this client? Urinary Respiratory Cardiovascular Gastrointestinal
Respiratory Endurance training can produce a significant increase in lung capacity of older adults. Maximum exercise capacity and maximum oxygen consumption vary among older people which influences cardiovascular status. Normal aging does not interfere with the motility of feces through the bowel, although other factors that are highly prevalent in late life do contribute to constipation. Engaging in activity will help prevent constipation however other factors have to be taken into consideration. Exercise and activity does not impact the urinary system.
An older client who retired from a position that was held for 45 years plays golf every Wednesday, swims with the "guys" on Tuesdays and Thursdays, and has a "date night" with his spouse every Saturday. Which phase of retirement does the nurse realize this client is demonstrating?
Routine
The nurse is inquiring about an older adult's usual daily activities while developing a plan of care for discharge. Which activity does the nurse need to question that may result in the most apparent cardiovascular changes?
Shoveling first seasonal snow
Which source of income is the older adult most likely to use to finance daily activities? Part time employment Pension plan Social security Investments
Social security Most older adults depend on Social Security for more than half of their income.
The nurse determines that a client widowed for 8 months is adjusting to the loss of her spouse. What did the nurse observe to make this clinical determination?
Talking with a friend on a cell phone in the waiting room
The nurse determines that a client widowed for 8 months is adjusting to the loss of her spouse. What did the nurse observe to make this clinical determination? Talking with a friend on a cell phone in the waiting room Sitting quietly with the head down in the examination room Becoming emotional when talking about living at home alone Twisting a tissue in the hands when discussing household chores
Talking with a friend on a cell phone in the waiting room The high proportion of older women who are widowed provides an availability of friends who share similar problems and lifestyles, especially in urban areas. Old friendships may be revived to provide sources of activity and enjoyment. Talking with a friend on the cell phone demonstrates adjustment to the loss of her spouse. Sitting with the head down demonstrates being withdrawn from the environment. Becoming emotional indicates mourning continues. Twisting a tissue when discussing household chores indicates that the client is overwhelmed with everything that needs to be done without having a spouse to help. This behavior indicates an issue with adjusting to widowhood.
What is the best nursing action to address the thyroid changes in old age?
Teach the client to monitor caloric intake.
An 80-year-old male whose wife passed away two years ago has a busy schedule that includes golfing, bowling, dining out, and singing in the church choir. What is the nurse's best interpretation of this client's lifestyle?
The client is exhibiting survivor competencies of aging
An 80-year-old male whose wife passed away two years ago has a busy schedule that includes golfing, bowling, dining out, and singing in the church choir. What is the nurse's best interpretation of this client's lifestyle? The client likely has an inadequate support system The client's fast-paced lifestyle presents health risks The client is exhibiting survivor competencies of aging The client has not accepted the reality of his wife's death
The client is exhibiting survivor competencies of aging The client's activities indicate he is adapting to old age and the loss of his wife by staying busy and establishing a support system of friends and spiritual activities. These adaptive behaviors are characteristics reflective of survivor competencies of aging individuals. Most older individuals are capable of these activities, which are not unhealthy. High levels of activity do not indicate that he has not accepted his wife's death.
A grandmother from the baby boomer generation is planning to retire soon and expresses to a nurse concern over taking care of her grandchildren. Her daughter has assumed she would be saving in daycare costs because her mother is retiring and can take care of the children. What discussion topic should the nurse prioritize with the grandmother? The possibility of relocating to assisted living The grandmother's desire to keep working part-time The legal implications of providing unpaid childcare Teaching the grandmother to resist the daughter's manipulation
The grandmother's desire to keep working part-time Most baby boomers are expressing a desire and need to continue working as they enter retirement age. There is no indication that assisted living is necessary and there are not major legal implications when providing occasional care for grandchildren. There is not enough information to characterize the daughter's desire as being manipulative.
The nurse knows that which statement is accurate about the subsets of the older adult population today?
The healthcare challenges of the young-old and old-old groups can vary greatly.
The nurse knows that which statement is accurate about the subsets of the older adult population today? All persons over age 65 are grouped together under the category of "older adults." The healthcare challenges of the young-old and old-old groups can vary greatly. Standardized care plans are appropriate for the older adult population. Same or similar interests are usually found in all categories of older adults.
The healthcare challenges of the young-old and old-old groups can vary greatly. It is now recognized that much diversity exists between different age groups in late life. The interests and healthcare challenges of each of these subsets can be vastly different. Standardized care plans do not permit for the varied interests and healthcare challenges of the subsets in the older adult population.
Which statement made by a gerontological nurse to a new graduate nurse is most accurate?
The healthcare system is currently greatly impacted by the aging of baby boomers.
Until recently, a 77-year-old woman lived alone in her own home. Her younger sister assisted her with grocery shopping, and they would occasionally have lunch together. Recently, the woman fell on some ice and fractured her ankle. Her orthopedic surgeon and her case manager have obtained for her a short-term placement in a long-term care facility for rehabilitation physical therapy. After the patient's physical therapy is finished and her ankle is healed, the patient tells her nurse that she wants to stay at the facility; she is very happy living there and likes the social interaction that she experiences there. Which of the following theories of aging best describes the status of this patient?
Theory of thriving
The nurse is identifying positive functional consequences as part of the development of an older patient's care plan. Which of the following statements best captures the concept of positive functional consequences? They are synonymous with functional assessment. They are the result of conscious intent. They are not outcomes of age-related changes. They result from automatic actions or purposeful interventions.
They result from automatic actions or purposeful interventions. Positive functional consequences may result from either the automatic actions of the patient himself or herself or the conscious interventions of nursing and other health care providers. The notion of positive functional consequences is broader than that of functional assessment. They are not always the result of conscious intent, and they may in fact be the outcome of age-related changes.
A nurse in the break room is overheard saying, "It's important to confirm the truth of what older people say because most of them have dementia." What is the gerontological nurse's interpretation of this statement? This is an example of ageism. This is an example of critical thinking. This demonstrates awareness of many older adults' needs. This shows appreciation of common age-related changes.
This is an example of ageism. The nurse in the break room is making a broad generalization based on ageism, defined as prejudices and stereotypes that are applied to older people on the basis of their age. This is contrary to critical thinking. The nurse making the ageist statement is demonstrating a lack of awareness in adjusting to caring for older adults and understanding the differences in their needs from other client populations.
An older adult has begun writing paragraphs about significant events and the year they occurred. Which activity is this older adult creating?
Time Line
The family believes that an older client should move to an assisted living facility that promotes the activity theory of aging. What should the client expect if relocating to this facility?
Weekly trips to the local shopping mall
An older client's daughter is concerned because her father has disengaged from the mainstream of society. What is the nurse's best response? Disengagement is a process expected of all older adults. Most older adults do not feel respected and tend to disengage. What factors have caused you to be concerned? Societal norms are changing. Has your father considered moving?
What factors have caused you to be concerned? The nurse should first assess the factors that are causing the daughter's concern. Disengagement is not necessarily a process to be expected from all aged persons. Societal norms are changing everywhere, so moving is probably not a feasible solution.
A nurse is leading a word-quiz game with a group of nursing home residents because the nurse knows this activity will assist the residents in maintaining: fluid intelligence. adaptive thinking. crystallized intelligence. psychomotor memory.
crystallized intelligence. Crystallized intelligence is the knowledge accumulated over a lifetime and refers to vocabulary skills, information, and verbal comprehension. Fluid intelligence involves a person's emotional, creative, and inherent abilities; it involves spatial perceptions and adaptive thinking and is believed to decline in later years.
An older client reports engaging in physical activity several times a week however the nurse plans to focus on ways to maintain the client's musculoskeletal status. What did the nurse assess to make this clinical decision?
Loose upper arm tissue
An expensive anti-hypertensive medication is prescribed for an older adult. The gerontological nurse should suggest the client apply for which type of insurance coverage to cover the cost of medication?
Medicare part D
When obtaining the health history from an 80-year-old female, the nurse discovers that the client has been exposed repeatedly to ultraviolet light in her younger years. Which assessment finding would be most likely attributable to this risk factor?
Mole changes
An older client who is nondiabetic has a reported glucose level of 126 mg/dL (7.0 mmol/L). What is the nurse's best action?
Monitor for signs of hyperglycemia.
The experienced gerontological nurse should provide further teaching when a new nurse makes which statement?
Most baby boomers did not have children and do not have much support.
Which is a true statement regarding healthcare and long-term care spending for older adults?
Most of the Medicaid budget is spent on long-term care.
Which is a true statement regarding healthcare and long-term care spending for older adults? The average length of hospital stays decreases with increasing age. Most of the Medicaid budget is spent on long-term care. Budget deficits are currently decreasing today. Revenue is currently increasing in today's healthcare system
Most of the Medicaid budget is spent on long-term care. Most of the Medicaid budget is spent on long-term care. In this era of budget deficits and shrinking revenue, the government may not be able to provide a wide range of services for older adults. The average length of hospital stays increases with age.
According to one evolutionary theory of aging, the effects of natural selection decline with age. Which theory does this statement refer to?
Mutation accumulation theory
When reviewing theories of aging, the nurse should recognize which accurate explanation? Biological theories of aging best explain the aging process. Most theories focus on achieving eternal youth. Studying the aging process can eliminate the negative consequences of aging. No single known factor causes or prevents the aging process.
No single known factor causes or prevents the aging process. No single known factor causes or prevents aging. One theory cannot explain the complexities of aging. Some interest in the aging process focuses on achieving eternal youth, but sound research aims to gain a better understanding of the aging process itself. Understanding the aging process only serves to possibly postpone some of the negative consequences of aging.
A nursing student is overheard discussing biological theories of aging. Which explanation requires further teaching?
Physiological changes occur at a constant rate among different body systems.
What is the priority safety recommendation the nurse should make for the older adult in regards to changes in the respiratory system?
Pneumococcoal vaccination
An older male client reports a recent history of urinary frequency. After collecting a urine specimen, what is the nurse's next action?
Prepare for prostate examination.
The home care agency models care delivery after the theory of thriving. Which nursing intervention supports this theory? Encourage an older client to relocate to a nursing home Suggest the older client enroll in a senior citizen day-care center Provide information about caregivers to help a client in the home Remind the older client that an annual influenza vaccination is needed
Provide information about caregivers to help a client in the home With the theory of thriving, it is believed that thriving is possible when harmony exists between individuals and their physical and human environments. The intervention that best supports this theory is providing information about caregivers so that the client receives help in the home. Encouraging an older client to relocate to a nursing home is the antithesis of the theory of thriving since the physical environment would be disrupted. Enrolling in a senior citizen day-care center promotes socialization and does not necessarily support any particular theory. Reminding an older client about an annual vaccination support the functional consequences theory of aging.
The nurse should anticipate that which client will require the most assistance with self-care and activities of daily living? 68-year-old female recently diagnosed with arthritis 80-year-old male with a hearing impairment 74-year-old diagnosed with diabetes mellitus 88-year-old with orthostatic hypotension
88-year-old with orthostatic hypotension The older the person is, the greater the likelihood of difficulty with self-care activities and independent living. As well, a client with orthostatic hypotension will have difficulty with activities of daily living because of loss of balance and falls risk.
A 78-year-old retired Army serviceman states he would like to locate and connect with his old Army buddies. What suggestion should the nurse give to this man and his family?
Access the internet
A 78-year-old man has received a recent diagnosis of community-acquired pneumonia. Potential pathological findings on a recent chest x-ray have prompted his health care provider to order a bronchoscopy and lung function tests. The nurse is reviewing the client's medical record. Which finding would lead the nurse to suspect a pathological process rather than a normal, age-related respiratory change?
Accumulation of serous fluid is seen between the lungs and the pleural membrane.
Circumstances have dictated that an older adult's retirement phase must terminate early. What is the nurse's best action?
Acknowledge this loss and allow the client to explore his or her feelings.
A gerontological nurse is aware that quality of life is an important consideration when assessing the functioning of older adults. What measure should the nurse use when appraising older adults' quality of life?
Active life expectancy
An 85-year-old female client tells stories of raising her children every time the nurse enters the room to administer medication. What is the nurse's most therapeutic action? Actively listen to the client's stories Arrange for the children to visit more frequently Ask the nursing assistant to sit with her Relocate client's room near the nurse's station to ensure safety
Actively listen to the client's stories The most therapeutic action is to actively listen. Nurses should be receptive and accepting listeners. The nurse may be very busy and ask a nursing assistant to sit with her; however, this action is not the most therapeutic. Relocating the client's room does not ensure someone will actively listen to the client's stories. Arranging for the children to visit does not directly demonstrate the nurse's interest and acceptance of the client.
A nurse who provides care for older adults in a long-term care setting is aware of the importance of maintaining residents' connectedness to society. How can this aspect of quality of life be best achieved? Ensuring that there are multiple television sets available to residents of the facility Arranging regular visits by school children to the facility Conducting reminiscence therapy Allowing residents to have input into the meal planning at the facility
Arranging regular visits by school children to the facility Social connectedness can be fostered by arranging meaningful contact between older adults and other members of society. Television, reminiscence, and input into routines may all have benefits, but none is likely to create a sense of connectedness and interaction with actual individuals in outside society.
The nurse suspects that an older client's quality of life has been deteriorating over the last several years. Which chronic health problem most likely has contributed to this client's change in health status? Cancer Arthritis Osteoporosis Poor dentition
Arthritis Chronic conditions result in some limitations in activities of daily living and instrumental activities of daily living for many individuals. Arthritis is the number one chronic condition that affects older adults and impacts functional activities. Cancer, osteoporosis, and poor dentition are not identified as chronic conditions that affect functional ability in the older adult.
The nurse is concerned that unlicensed assistive personnel (UAP) engage in ageism. What did the nurse observe to come to this conclusion? Asked how long the older client has been confused Assisted an older client with applying socks and shoes Requested to take an older client outside to the courtyard Washed the older client's hair and help style it as desired
Asked how long the older client has been confused Ageism is defined as the prejudices and stereotypes that are applied to older people on the basis of their age. A myth of ageism is that dementia comes with old age. Assisting with care needs and taking a client outdoors does not demonstrate ageism.
The nurse is conducting a study on the needs and living situations of older adults in the community. Which of the following statements should the nurse take into account?
Assisted-living arrangements have become increasingly common.
The nurse is conducting a study on the needs and living situations of older adults in the community. Which of the following statements should the nurse take into account? A majority of older Americans will live in a nursing home at some point. More older men live alone than older women. Assisted-living arrangements have become increasingly common. Most older Americans reside in some form of institutional arrangement.
Assisted-living arrangements have become increasingly common. Assisted-living arrangements have become an increasingly common alternative to nursing homes. The number of Americans living in nursing homes has recently decreased, not increased, and more older women live alone than do older men. Ninety percent of older Americans live in an apartment or house, rather than in an institutional arrangement.
A 77-year-old man was put on broad-spectrum antibiotics when he was hospitalized for sepsis. He has a history of rheumatoid arthritis and a recurring problem with pneumonia. Which of the following best explains why he has had these illnesses?
Autoimmune factors
An older client asks what can be done to reduce the amount of glare that occurs the most when driving at night. What should the nurse suspect is occurring with this client?
Cataracts
A nurse is aware that addressing issues related to connectedness and quality of life is central to the Functional Consequences Theory. Which of the following actions is most likely to enhance the older adult's connectedness? Teaching a patient who has had a below-the-knee amputation how to care for his stump Organizing a client's intravenous antibiotic therapy on an outpatient basis Performing a focused respiratory assessment on a client who has a diagnosis of lung cancer Changing a policy so that a husband and wife can remain in the same room of a care facility
Changing a policy so that a husband and wife can remain in the same room of a care facility Fostering connectedness to others is a component of the older adult's quality of life. Teaching wound care, organizing treatment, and adequately assessing a patient are aspects of good care, but none is a direct contributor to connectedness.
Assessment of an older adult client reveals thinning, fragile skin. The nurse institutes safety measures for this client based on the understanding that this client has increased sensitivity to which sensation?
Cold
How can the gerontologic nurse best advocate for older adult benefits?
Endorse cost-containment efforts that maximize welfare of older adults.
An older client's lab results reveal an altered fluid volume status. What assessment finding is the most significant risk for this client as a result of decreased intracellular fluid?
Dehydration
Ageism can hinder the older adult from overcoming which developmental task according to Erikson? Inferiority Shame Despair Isolation
Despair The developmental task older adults encounter, according to Erikson's theory, is Integrity versus despair. Inferiority is addressed in middle childhood. Shame is overcome in toddlers. Isolation is overcome in adulthood.
An older adult on a fixed income is close to retiring and often fantasizes about owning a yacht and sailing around the world. This client may likely experience depression based upon the experience of which retirement phase?
Disenchantment
Which question is priority to consider when an older adult is contemplating caring for a grandchild full-time? Do you have any health conditions that might interfere with providing childcare? Do you have any peers who are currently raising their grandchildren? How will this affect your relationship with your children? Will you still have time to fit in your usual recreational activities?
Do you have any health conditions that might interfere with providing childcare? The priority questions focus on the older adult's physiological needs and physical ability to care for a young child. All other questions are irrelevant if the client is physically unable to care for the child.
The nurse is caring for a 71-year-old client who is concerned about the accumulation of free radicals. What is the nurse's best recommendation?
Eat an ample quantity of vitamin C
An 82-year-old grandmother on a fixed income expresses a desire to communicate more with her adolescent grandchildren who live out of state. What is the nurse's best recommendation? Journaling Social media by smartphone Email at the nearby public library Making scarves or crafts for grandchildren
Email at the nearby public library Email at the local library is a great recommendation, since the client is on a fixed income. Most libraries offer free internet. The nurse can recommend the library staff assist the client with setting up a free email account. Journaling is an example of an activity for self reflection. A smartphone may not be practical if the client is on a fixed income, and the small screen and letter keys may be difficult to view and manipulate. Making scarves or crafts does not enhance communication.
The Functional Consequences Theory can be applied to promote wellness in older adults in diverse settings. Which of the following examples demonstrates this application?
Facilitating early mobilization to prevent muscle wasting and loss of function in an older hospital patient
A 74-year-old woman has recently begun integrating more fresh fruit and vitamin supplements into her diet in an effort to increase the levels of antioxidants in her body. This woman's actions indicate an understanding of what theory of aging?
Free radical theory
An older male with a history of hyperlipidemia and hypertension is grieving the recent loss of his wife of 40 years. What is the nurse's best recommendation to this client's family? Cardiac rehabilitation Frequent observation and contact with others Transition to assisted living Change to the medication regimen
Frequent observation and contact with others Acute psychological stress is associated with an increase in cardiovascular events. Nurses should assure that this client who is experiencing grief is observed often and has contact with others. Cardiac rehabilitation may be recommended if a cardiovascular event occurs but would not normally be provided on a preventative basis. Most clients do not require assisted living for the sole basis of the death of a spouse. There may or may not be a need to change the client's medications, but this is not within the nurse's scope.
The nurse recognizes that which statement is true about older adults?
Functional age describes physical, psychological, and social aspects of aging.
When discussing the effects of chronic stress on the aging process, the nurse should include which conditions? Select all that apply. Gastric ulcers Heart attacks Enhanced thyroid function Skin problems Improved crisis response
Gastric ulcers Heart attacks Skin problems Stresses to the body can have adverse effects such as gastric ulcers, thyroiditis, heart attacks, and inflammatory dermatoses. Individuals react differently to stress. Acute stress enhances crisis responses, but this is not associated with chronic stress. Stress does not enhance thyroid function.
A nurse administrator is involved in strategic planning for a large long-term care facility that has locations in numerous regions of the country. The nurse should anticipate what trend when planning for the future care of older adults? A gradual decline in overall life expectancy A decrease in the proportion of older adults who are members of minority groups Average longevity of males exceeding that of females Increased proportion of Americans who are older than 65
Increased proportion of Americans who are older than 65 Due to the aging of baby boomers, the proportion of the American population that is older than 65 is anticipated to increase. Life expectancy is continuing to increase, with women usually outliving men. An increasing proportion of the older adult population will be members of minority groups.
The nurse planning a group teaching session for older adults should prioritize teaching about which condition? Respiratory disease Falls prevention Heart disease Cataracts
Heart disease Heart disease remains the leading cause of death among older adults, exceeding rates of accidents and lung disease. Cataracts are a common cause of disability, but not death.
Gerontological nurses can foster discussions among older adults about their life stories by open discussion of which possible topics? (Select all that apply.) Few details of recent hospitalization How and where spouse was met Favorite interests Spiritual growth Family dynamics
How and where spouse was met Favorite interests Spiritual growth Family dynamics Possible topics in life stories include: various jobs held, education, spouse information, family dynamics, favorite interests, spiritual growth, and legacy one would like to leave. The nurse should foster open discussion with the client about all topics, not just a few details about an experience.
A 65-year-old client refuses to participate in a senior citizens' group because all of the people who attend are "old." What characteristic of aging is this client demonstrating?
Identity
The gerontologic nurse manager is preparing information for an in-service on safety. Which action should the nurse identify as a safety hazard for older adults?
Imposing younger age demands on the body
An older adult who appears thin and emaciated with little subcutaneous fat is admitted to the geriatric unit. What is the priority safety concern for this client?
Increased chance of hypothermia
An older adult who appears thin and emaciated with little subcutaneous fat is admitted to the geriatric unit. What is the priority safety concern for this client? Increased chance of hypothermia Decreased skinfold thickness Decreased stature Decreased bone mass
Increased chance of hypothermia The loss of subcutaneous fat in older adults is responsible for a decline in skin-fold thickness and natural insulation, making older adults more sensitive to cold temperatures. Hypothermia is the priority concern that can cause the most adverse effects. Stature decreases due to reduced hydration, loss of cartilage, and thinning of the vertebrae. Decreased bone mass occurs due to changes at the cellular level and is not affected by loss of fat.
An older adult's family member expresses concern about her father's increasing difficulty swallowing. What is the nurse's best action?
Instruct her to increase his fluid intake with meals.
An older male client states he is satisfied with his life accomplishments. According to Erikson's theory, what developmental task has this client achieved?
Integrity
When reviewing the demographic data in a new 74-year-old female client's chart, what finding is most likely? Recently divorced Widowed for 3 years Long-term care resident Employed full-time
Widowed for 3 years More than half of women older than 65 years are widowed. Most older adults live in homes with spouses or with family members. Women are more likely to marry older men, therefore being widowed is a higher probability then being divorced. There has been little change in the low labor force participation of women 65 years of age and older.
The nurse is concerned that a 70-year-old client is aging faster than the chronological age suggests. What should the nurse recommend to this client to help delay the effects of aging? Select all that apply.
•Attend religious services as desired •Increase eating fresh fruits and vegetables •Play bridge with the ladies club every week •Take a walk with the neighbor every morning
A nurse demonstrates understanding of the age-related changes in the renal system by which action?
•Ensuring that age-adjusted drug dosages are prescribed
An 80-year-old widower experiences loneliness because his children and grandchildren live three states away. What suggestions could the nurse make to pass the time? Select all that apply.
•Scrapbooking •Journaling •Local religious activities •Arts and crafts activities
