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Exam (elaborations) NR 222

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test 3 health n wellness Exam (elaborations) NR 222 Edelman: Health Promotion Throughout the Life Span, 8th Edition

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Chapter 24: Older Adult
Edelman: Health Promotion Throughout the Life Span, 8th Edition


MULTIPLE CHOICE

1. A nurse is planning to write a grant for a health promotion project in the community. Which of
considerations should the nurse make when determining the appropriate population for this
project?
a. The fastest growing population is children under the age of 12.
b. The fastest growing population is young Black American adults.
c. The fastest growing population is White middle-age adults.
d. The fastest growing population is non-White older adults age 65 and older.

ANS: D
Adults age 85 and older are the fastest growing population in the United States, and the
percentage of White Americans greater than age of 65 is decreasing compared with other ethnic
groups.

DIF: Cognitive Level: Apply (Application) REF: p. 592

2. Which of the following statements made by a client best identifies someone who would benefit
from health promotion interventions?
a. “I have a new grandchild and want to be part of her life.”
b. “My mother lived until she was 90, so a long life is in my genes.”
c. “Some chronic illness is just a part of aging.”
d. “I hope I’ll live a lot longer, but one never knows.”

ANS: A
Motivation to adopt a healthy lifestyle is a primary predictor of successful interventions. Feeling
that illness is just part of aging or leaving health up to chance will not help the person make
necessary lifestyle changes.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 595

3. Which of the following statements concerning nutrition and older adults is true?
a. Older adults who live in their own homes are more likely to be malnourished than
older adults living in a nursing home.
b. Older adults lose their desire for high-fat, salty foods.
c. Meals served in long-term care institutions are usually more well-balanced than
foods eaten by older adults living at home.
d. Many older adults are not aware of food assistance programs.

ANS: D

, Barriers that may interfere with the ability of independent seniors to obtain adequate nutritional
food include limited transportation, income, and social support resources. Many older persons
are unaware that they are eligible to participate in SNAP. The percent of older adults who live in
their own homes and are malnourished is lower than that of older adults who live in a nursing
home. Older adults do not lose their desire for high-fat, high-cholesterol, high-sodium foods.
Fresh fruits and vegetables are not always available for older adults living in nursing homes.

DIF: Cognitive Level: Understand (Comprehension) REF: pp. 596-597

4. Which of the following statements concerning urinary incontinence is correct?
a. Urge incontinence occurs when one has the urge to void but is unable.
b. Stress incontinence is associated with emotional turmoil.
c. Functional incontinence occurs is associated with environmental barriers.
d. Incontinence with high post-void residual occurs when someone laughs or sneezes.

ANS: C
Functional incontinence is associated with environmental barriers, physical limitations, or
cognitive impairment in which the client is unable to reach the toilet. Stress incontinence occurs
when someone coughs or sneezes. Urge incontinence occurs when someone cannot wait to void
once the urge to void is felt. Urge, mixed, or stress incontinence with high post-void residual is
caused by physiological changes that affect voiding, such as an enlarged prostate gland.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 597

5. Which of the following nursing diagnoses is a priority related to the problem of urinary
incontinence?
a. Risk for social isolation
b. Risk for impaired skin integrity
c. Risk for inadequate fluid intake
d. Risk for impaired coping

ANS: B
Although social isolation and decreased fluid intake may occur because of urinary incontinence,
impaired skin integrity is a major concern because of its impact on physical and psychological
health.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 597

6. A 75-year-old man tells the nurse that he has difficulty staying asleep during the night. Which of
the following responses should be made by the nurse?
a. “Older adults need as much sleep as middle-age and younger adults. Let’s talk
about your sleep patterns.”
b. “I’ll ask the nurse practitioner to prescribe a sleeping pill for you.”
c. “Taking naps during the day can help relieve excessive fatigue and will help you
sleep better.”
d. “Let’s talk about your sleep schedule and things that may prevent you from getting
a restful night’s sleep.”

, ANS: D
Nurses should assist older adults in achieving a good night’s sleep through assessment that might
reveal possible causes of sleep disturbances. Older adults need less sleep than younger adults.
Daytime naps may prevent sleeping adequately at night. Medications to assist in sleeping are not
the initial therapy choice because of side effects.

DIF: Cognitive Level: Apply (Application) REF: pp. 599-560

7. A nurse is conducting a community education program about cognition in older adults. Which of
the following information should be included?
a. Some form of mild dementia is a normal part of aging.
b. All forms of dementia have the same symptoms, but progress at different rates.
c. Assessment for dementia should be part of routine physical exams.
d. Elders who score below 27 points on the Mini-Mental State Exam (MMSE) are not
likely to have a cognition problem.

ANS: C
Cognitive alterations are key symptoms that indicate changes in physiological function among
older persons. Thus, assessment of cognition is an important part of routine assessments.
Dementia is not a normal part of aging. Dementia symptoms vary according to the specific type
of dementia. A score of 23 or lower on the MMSE indicates a problem with cognition.

DIF: Cognitive Level: Apply (Application) REF: pp. 600-601

8. A nurse has recently accepted the position of unit nurse manager on a long-term care unit. Which
of the following directives should the nurse give to the staff nurses?
a. Encourage residents to participate in unit activities such as Scrabble™ and bingo.
b. Demonstrate the caring aspect of nursing by dressing residents before breakfast.
c. Fill in “missing words” during conversation with the residents to avoid
embarrassment.
d. Instruct the aides to get residents ready for breakfast as quickly as possible to make
sure they are ready to eat.

ANS: A
To encourage cognitive health nurses should inspire older individuals to take classes, read,
engage in stimulating conversation and entertainment, keep their minds active, and continue
learning throughout their lives. They are encouraged to continue with self-care activities rather
than relinquish them to caregivers. Residents should be encouraged to perform self-care
activities themselves. When help is required, it should be provided in an unhurried manner.
Filling in missing words makes the resident dependent on the staff and reduces motivation to
communicate, and the words supplied may not be the intended words.

DIF: Cognitive Level: Apply (Application) REF: p. 602

9. A nurse is assisting with development of menu items at a long-term care facility. Which of the
following menus would the nurse most likely recommend?

, a. One egg over easy, one slice of whole wheat toast with sugar-free jam, 4 oz orange
juice
b. 5-oz cheeseburger cooked medium well with lettuce and tomato, 10 baked potato
chips, and 1 cup of decaf coffee with low-fat milk and artificial sweetener
c. Chef salad with 2 oz each ham and turkey, lettuce, tomato, bean sprouts, onion,
green pepper with low-fat dressing, and one small roll with low-fat spread
d. Turkey bacon, lettuce, and tomato sandwich on whole wheat bread with two
teaspoons of low-fat mayonnaise, 10 vegetable chips, and ice tea with artificial
sweetener

ANS: D
The United States Department of Agriculture recommends that infants and young children,
pregnant women, older adults, and those who are immune compromised should not consume raw
(unpasteurized) milk or any products from unpasteurized milk, raw or partially cooked eggs or
foods containing raw eggs, raw or undercooked meat and poultry, raw or undercooked fish or
shellfish, unpasteurized juices, or raw sprouts.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 603

10. Which of the following individuals would be at greatest risk of injury?
a. 80-year-old who does not have air conditioning or a fan
b. 70-year-old who has new dentures
c. 68-year-old who has difficulty tasting salt in food
d. 84-year-old who needs hearing aids

ANS: A
Sweating decreases in older adults, predisposing them to heat stroke.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 603

11. According to Erikson’s theory of development, which of the following older adults has
successfully navigated the stage of ego integrity versus despair?
a. 72-year-old man who is reluctant to retire because “work is everything to me”
b. 78-year-old woman who has scheduled her third face lift
c. 80-year-old man who has informed his children that he has made his funeral
arrangements
d. 67-year-old woman who is depressed because she has not been promoted at work
for the past 10 years

ANS: C
Successfully navigating the stage of ego integrity versus despair requires that the individual
accept normal bodily changes associated with aging, find meaning in life apart from work,
accepts the inevitability of death, and is at peace with his or her life.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 604

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