Basic Nursing Concepts Skills and Reasoning: 1st Edition Test Bank - Treas1

Basic Nursing Concepts Skills and Reasoning: 1st Edition Test Bank – Treas1

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Basic Nursing Concepts Skills and Reasoning: 1st Edition Test Bank – Treas1
What: TEST BANK
Year Published: 2014
Authors: Treas1
Edition: 1st

Product Description

Basic Nursing Concepts Skills and Reasoning: 1st Edition Test Bank – Treas1

 

Basic Nursing Concepts Skills and Reasoning: 1st Edition Test Bank – Treas1

 

Sample

 

Chapter 10. Development: Older Adults

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

 

____    1.         Which of the following is the most common major challenge for older adults?

1)

Dealing with the needs of their children

2)

Chronic health problems leading to the loss of independence

3)

Loss of the ability to reminisce about the past

4)

The decline of intellectual abilities

 

ANS:   2

Older adults have many losses to deal with, including the development of chronic health concerns and loss of independence. During the older adult years, children often provide care for their aging parents. Loss of short-term memory is more common than recollection of events involving long-term memory. Older adults have vivid memories of past events. Intellectual abilities do not become impaired with age; short-term memory and reaction time decline.

 

PTS:    1          DIF:    Moderate         REF:    p.205

KEY:   Nursing process: N/A | Client need: PHSI/PSI | Cognitive level: Comprehension

 

 

 

____    2.         Which of the following would be the most important health assessment focus for older adulthood?

1)

Cancer screening with the annual health examinations

2)

Seeking information about consistent use of seat belts

3)

Screening for eating disorders

4)

A bone scan (DEXA test) for osteoporosis

 

ANS:   1

Chronic diseases, including cancer, are major health problems for older adults. In fact, cancer is the second leading cause of deaths for older adults. Older adults should also have an annual physical exam; they should receive cancer screening at that time. Habits for seat belt use should have already been established; although it may be important to reinforce seat belt use, the most important assessment is cancer screening. Eating disorders are more common in adolescence and young adulthood. Although loss of bone density is fairly common in older adults and can be pathological, it does not assume the status as cancer with regard to mortality for older adults.

 

PTS:    1          DIF:    Difficult          REF:    pp. 211-212

KEY:   Nursing process: Assessment | Client need: HPM | Cognitive level: Comprehension

 

 

 

____    3.         To which age group do most hospitalized patients belong?

1)

Infants

2)

Young adults

3)

Middle adults

4)

Older adults

 

ANS:   4

Half of all hospitalized patients are older adults.

 

PTS:    1          DIF:    Easy    REF:    p. 202

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Recall

 

 

 

____    4.         Which of the following reflects an understanding of the characteristics of older adults?

1)

Fewer than 5% of all older adults live in nursing homes.

2)

Average life expectancy at birth has declined slightly over the past 10 years.

3)

In general, males tend to live longer than do females.

4)

Black men have the lowest life expectancy, but the gap decreases as a person ages.

 

ANS:   1

Only 3.3% of people 65 and over live in nursing homes; this rises to 15% for those over 85 years. In the United States, life expectancy at birth has risen dramatically in the past century: In 1900, average life expectancy was 49.2 years; in 2005, average life expectancy was 77.8 years. At age 65, white women led life expectancy with 20 years, followed closely by black women at 18.7 and white men at 17.2 years, whereas black men at age 65 had the lowest life expectancy at 15.2. The disparity in death rates for people of different races is less for older adults than younger ones.

 

PTS:    1          DIF:    Moderate         REF:    p. 206

KEY:   Nursing process: N/A | Client need: HPM  | Cognitive level: Comprehension

 

 

 

____    5          A 75-year-old white female patient says, “I’ve heard that women live to an older age than men do. My husband and I are the same age, so I am afraid I will have to spend some years without him. That really worries me.” Which response is based on correct information?

1)

“That is a realistic concern, as women do have a longer life expectancy than men. But many things can happen to change that.”

2)

“You need not worry, because both you and your husband are white. That statistic is true only for black men and women.”

3)

“It is true that women have a longer life expectancy at birth. However, life expectancy measured at age 65 is almost the same for both sexes. You are both well past 65.”

4)

“That is true only in certain geographical areas, such as those with a high population of newly retired persons.”

 

ANS:   3

For infants born in 2005, the average total life expectancy for females is 80.4 years.

Life expectancy measured at age 65 was nearly the same for men and women in 1900; however, women had a lead of about 3 years over men in 2005, narrowing the gap as men age. So the longer men live, the longer they will live. The statistics are true for white people as well as black people. The answer saying, “That is a realistic concern . . .” is only partially true. Women do have a longer life expectancy at birth, but that tends to almost disappear after men reach age 65, and it continues to lessen as they continue to age. In-migration and out-migration have nothing to do with gender differences in life expectancy, although they do affect the population distribution within a state, for example.

 

PTS:    1          DIF:    Difficult          REF:    p. 202

KEY:   Nursing process: Implementation | Client need: HPM  | Cognitive level: Application

 

 

 

____    6          An 86-year-old patient had prostate surgery 2 days ago. Which nursing action best meets his developmental needs?

1)

Perform a spiritual assessment and make referrals as needed.

2)

Provide a complete bed bath and other hygiene needs.

3)

Encourage the patient to perform self-care as much as possible.

4)

Administer pain medications to keep the patient comfortable.

 

ANS:   3

An important nursing goals for all older adults should be to maintain the person’s ability to function independently for as long as possible. Encouraging self-care will help to achieve that goal. A spiritual assessment is appropriate but is not a need of older adults any more than of other age groups. Providing hygiene needs does not promote independence. Administering analgesics is appropriate but does not encourage functional independence.

 

PTS:    1          DIF:    Moderate         REF:    Cp. 212

KEY:   Nursing process: Planning | Client need: HPM | Cognitive level: Application

 

 

 

____    7. A client tells the nurse, “I can’t see well enough to read anymore. I have new glasses, but it’s still hard.” What should the nurse advise her to do first?

1)

“Go back to the eye doctor and have him check your glasses.”

2)

“Buy some audio books and listen to those.”

3)

“Adapt to reading less and find a new leisure activity.”

4)

“Install a bright but glare-free light near where you read.”

 

ANS:   4

With aging, there is decreased pupil accommodation, decreased tear production, and thickening of the lens of the eye. All of these contribute to impaired near vision (presbyopia). Decrease in pupil accommodation allows less light into the eye, so in order to read, the person needs a good light. However, there is also increased sensitivity to glare, so the light should have a glare-free bulb. The patient should try this first, since she already has new glasses. If this doesn’t help, then perhaps she should have the glasses rechecked. If her vision cannot be improved, then she could think about buying audio books and other ways to adapt to her difficulty reading.

 

PTS:    1          DIF:    Moderate         REF:    Cp. 214

KEY:   Nursing process: Implementation | Client need: HPM | Cognitive level: Application

 

 

 

____    8.         A couple is planning to move to a housing development that has been built to provide elder-friendly dwellings and environments for independent living. The houses are smaller and on a single level. Their purchase includes home maintenance and repair, snow and trash removal, a pool, and a walking track. Only people 60 years and older qualify to buy a house in this community. Medical and nursing care are not a part of the purchase. How would their living situation be described?

1)

Naturally occurring retirement community

2)

Retirement community

3)

Continuing care retirement community

4)

Assisted living facilities

 

ANS:   2

The scenario describes a retirement community. A naturally occurring retirement community is one in which the person ages in place, living in the same home as always and in a neighborhood where the neighbors have aged together and have provided support for each other through the years. A continuing care retirement community is residential living (e.g., cottages, cluster homes, apartments) into which a person must move. The person pays an entrance fee and monthly fees. In return, the contract provides for assistance with activities of daily living, coordinated social activities, health monitoring, and so on. There is usually a health clinic on site. Assisted living facilities (ALFs) are congregate residential settings that provide or coordinate personal services, 24-hour supervision and assistance (scheduled and unscheduled), activities, and health-related services. State regulations and level of services preclude residents from staying in an ALF when their needs become greater than the resources and services provided.

 

PTS:    1          DIF:    Moderate         REF:    p. 205

KEY:   Nursing process: Implementation | Client need: HPM | Cognitive level: Application

 

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.         A client is concerned about the age-related changes of her mother, who is 80 years old. Which statement(s) made by the client would likely represent a normal change of aging?

1)

“My mother seems to get cold very easily.”

2)

“My mother complains of her mouth being dry.”

3)

“Mother goes around the house turning on all the lights.”

4)

“Mother complains of leaking urine when she coughs.”

 

ANS:   1, 2, 3

Incontinence is not a normal part of aging and should be explored further. The thinning of the layers of the skin causes older adults to feel cold—a normal part of aging. With aging, the brown fat layer, which contributes to generating and maintaining body temperature, becomes thinner as well. This is not the same type of fat as adipose, which is a white fat layer. Additionally, older adults who are sedentary often feel cooler. The elderly normally experience a decrease in saliva production, so although this is also a symptom of dehydration, dry mouth is a normal change of aging. Visual acuity decreases with age, but this, too, is a normal part of aging.

 

PTS:    1          DIF:    Moderate         REF:    pp. 208-209, 214

KEY:   Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Analysis

 

 

 

____    2.         A client lives alone. He is very weak, stays in bed most of the time, and becomes fatigued after taking only two or three steps with a walker. His personal hygiene is poor. He moves very slowly when doing even small tasks, such as eating a meal. Which of the following are appropriate interventions for this patient? Choose all that apply; assume all are possible.

1)

Arrange for a home aide to assist with activities of daily living.

2)

Refer the client to a senior center for an adapted physical activity (APA) program.

3)

Assess the patient for symptoms of depression and memory loss.

4)

Arrange for nutritious meals to be delivered to the patient’s home.

 

ANS:   1, 3, 4

This client has the characteristics of frailty: low physical activity, muscle weakness, fatigue, and slowed performance. Clearly, the client is not able to perform ADLs adequately; therefore, a home aide is needed. Adapted physical activity programs are designed for adults in better physical health, not for frail elders. The client would be unlikely to benefit from an APA and probably could not even participate in such a group activity. Depression and impaired mental abilities tend to accompany frailty, so it is important to assess those for this client. Nutrition is essential to slow the progression of frailty, so having meals delivered is both appropriate and important.

 

PTS:    1          DIF:    Difficult          REF:    pp. 214-216

KEY:   Nursing process: Interventions | Client need: PHSI/PSI  | Cognitive level: Application

 

 

 

____    3.         When interpreting a population pyramid, which of the following do you need to know?

1)

The youngest age group makes up the base of the pyramid.

2)

Men are on the left side of the pyramid and women on the right.

3)

The length of a bar indicates how many people are in that age category.

4)

Adolescents are the youngest group on the pyramid.

 

ANS:   1, 2

Age distribution of a population is often illustrated in a pyramid, with the youngest age group (0–4) at the base and the oldest age group (85+) at the peak, and men on the left of the figure and women on the right. The shape of a population pyramid changes to rectangle in developed countries with fewer births and increased life expectancy. The length of a bar does not indicate the absolute number of people in a category; it indicates the proportion of the total population represented by that category.

 

PTS:    1          DIF:    Difficult          REF:    pp. 203-204

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

 

 

 

____    4.         How can the nurse facilitate communication with an older adult?

1)

Assess for hearing deficit at the beginning of the interaction.

2)

Speak in a more loudly than normal, and at a slightly higher pitch.

3)

Pay special attention to cues from body language.

4)

Speak slowly, allowing time for the patient to word his answers.

 

ANS:   1, 3, 4

The nurse should check for sensory deficits at the beginning of the interaction so he can allow for lip reading, as needed. Because older adults sometimes have difficulty expressing themselves, body language (e.g., wringing hands, fidgeting) is especially important. Because older adults process information slowly, the nurse should speak slowly, allowing them to formulate their answers. Speaking slowly does not mean the nurse should speak loudly or at a higher pitch. Many older adults have high-pitch hearing loss.

 

PTS:    1          DIF:    Moderate         REF:    p. 214

KEY:   Nursing process: Implementation | Client need: HPM | Cognitive level: Comprehension

 

 

 

____    5.         Which older adult is experiencing normal aging changes of the urinary system?

1)

A man who has difficulty voiding, especially when starting his stream

2)

A woman who wakes up to void once during the night

3)

A man who has difficulty getting a hard erection

4)

A man who says he has burning when he urinates

 

ANS:   2, 3

Because of changes in bladder capacity and changes in blood flow to the kidneys, many older adults wake at least once during the night to void. Sexual response changes are also normal; it is common for older adult men to have less firm erections. A man who has difficulty starting his urine stream and voiding likely has an enlarged prostate, which is physiologically not normal. Burning on urination is indicative of a bladder infection and is not normal.

 

PTS:    1          DIF:    Moderate         REF:    p. 214

KEY:   Nursing process: Analysis/Diagnosis | Client need: HPM | Cognitive level: Analysis

 

 

 

Matching

 

Match the paramount developmental challenge with the appropriate age group.

 

1)

Young-old

2)

Middle-old

3)

Old-old

4)

Frail elderly

 

____    1.         Preventing or slowing the spiral of vulnerability

 

____    2.         Transitioning to retirement

 

____    3.         Sensory impairments, oral health, nutritional intake, functional limitations

 

____    4.         An increasing solitary, sedentary lifestyle

 

 

 

Match the descriptions of the theory with the appropriate theory of aging.

 

5)

The person should stay as active and engaged as possible to enjoy the most life satisfaction.

6)

People age because repeated insults and the accumulation of metabolic wastes eventually cause cells to wear out and cease functioning.

7)

The older adult and society gradually and mutually withdraw from each other. Interaction between a person and his world decreases over time.

8)

Ego integrity versus despair is the task for older adults. The person accepts that his life has had meaning and that death is a part of the continuum of life.

9)

People age because cells have a preprogrammed, finite number of cell divisions. Hence, the time of death is determined at birth.

10)

A malfunction in the cell causes changes in cellular DNA, leading to problems with cell replication. The cellular malfunction may be the result of free radicals that damage cells and impair their ability to function normally.

 

____    5.         Disengagement theory

 

____    6.         Activity theory

 

____    7.         Psychosocial development theory

 

____    8.         Wear-and-tear theory

 

____    9.         Genetic theories

 

____    10.       Cellular malfunction theory

 

  1. ANS: 4          PTS:    1          DIF:    Moderate         REF:    pp. 206-207

KEY:   Nursing process: Planning | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 1          PTS:    1          DIF:    Moderate         REF:    pp. 206-207

KEY:   Nursing process: Planning | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 3          PTS:    1          DIF:    Moderate         REF:    pp. 206-207

KEY:   Nursing process: Planning | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 2          PTS:    1          DIF:    Moderate         REF:    pp. 206-207

KEY:   Nursing process: Planning | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 3          PTS:    1          DIF:    Moderate         REF:    p. 209

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 1          PTS:    1          DIF:    Moderate         REF:    p. 209

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 4          PTS:    1          DIF:    Moderate         REF:    p. 209

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 2          PTS:    1          DIF:    Moderate         REF:    p. 206

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 5          PTS:    1          DIF:    Moderate         REF:    p. 206

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

 

  1. ANS: 6          PTS:    1          DIF:    Moderate         REF:    p. 206

KEY:   Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

 

Basic Nursing Concepts Skills and Reasoning: 1st Edition Test Bank – Treas1

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