Chapter 24: Older Adult
Edelman: Health Promotion Throughout the Life Span, 9th 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?
1.
2.
3.
4.
The fastest growing population is children under the age of 12.
The fastest growing population is young Black American adults.
The fastest growing population is White middle-age adults.
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 65 is decreasing compared with other ethnic
groups.
DIF: Cognitive Level: Apply (Application) REF: p. 619
2. Which of the following statements made by a client best identifies someone who would likely
to be receptive to health-promotion interventions?
1. “I have a new grandchild and want to be part of her life.”
2. “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.”
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ANS: A
Motivation to adopt a healthy lifestyle is a primary predictor of successful interventions. Choice
A depicts a patient who is motivated by a desire to be with her new grandchild. Feeling that
illness is an inevitable part of aging, leaving one’s health up to chance or assuming a fatalistic
approach will not motivate a person to make necessary lifestyle changes. Also not likely to make
changes is the person who believes that his/her own longevity is guaranteed by virtue of
inheriting such genes.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 623
3. Which of the following statements concerning nutrition and older adults is true?
1. Older adults who live in their own homes are more likely to be malnourished than
older adults living in a nursing home.
2. Older adults lose their desire for high-fat, salty foods.
3. Meals served in long-term care institutions are usually more well balanced than
foods eaten by older adults living at home.
4. Many older adults are not aware of food assistance programs.
ANS: D
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
When the economy declines, there is an increase in unemployment and poverty and more people
need help buying nutritious food. SNAP can provide needed help but many people who are
eligible for SNAP benefits, including 67% of struggling older adults, do not apply. Only 3 out of
5 older adults who qualify for SNAP actually use it, which means that 5.2 million seniors are
missing out on benefits of the program. Some older adults are too embarrassed to apply and
others think it is too difficult to apply or do not even know the program exists.
Research shows that the percentage of malnourished older adults who live in their own homes is
lower than that of older adults who live in a nursing home. Moreover, fresh fruits and vegetables
are not always available for older adults living in nursing homes. Older adults do not lose their
desire for foods high in fat, cholesterol, or sodium.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 626
4. Which of the following statements concerning urinary incontinence is correct?
1.
2.
3.
4.
Urge incontinence occurs when one has the urge to void but is unable to do so.
Stress incontinence is associated with emotional turmoil.
Functional incontinence is associated with environmental barriers.
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 care recipient 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. 626
5. Which of the following measure is appropriate for treating urinary incontinence?
1.
2.
3.
4.
Increase caffeine to tighten urinary sphincter.
Utilize voiding schedules.
Decrease fiber to lessen pressure on the bladder from the colon.
Avoid pilates, which have been shown to inflame pelvic floor in the elderly.
ANS: B
Voiding schedules are appropriate in treating incontinence. Caffeine will worsen incontinence.
Increased fiber may help to improve constipation-related incontinence; decreasing fiber will
increase risks for constipation and thus may worsen incontinence. Pilates have been shown to
improve incontinence for some patients.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 627
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?
1. “It is best to avoid milk or reading before bedtime.”
2. “I’ll ask the nurse practitioner to prescribe a sleeping pill for you.”
3. “Taking naps during the day can help relieve excessive fatigue and will help you sleep
better.”
4. “Let’s talk about your sleep schedule and things that may prevent you from getting
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
a restful night’s sleep.”
ANS: D
Nurses should assist older adults in achieving a good night’s sleep through assessment which
might reveal possible causes of sleep disturbances. Bedtime rituals to include a glass of milk or
reading have been shown to promote sleep. 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: p. 628
7. A nurse is conducting a community education program about cognition in older adults. Which
of the following information should be included?
1. Some form of mild dementia is a normal part of aging.
2. Confusion is a reliable indicator of dementia.
3. Assessment for dementia should be part of routine physical exams.
4. 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. Confusion is not always an indicator of dementia but can result from many other
causes to include electrolyte imbalance, diabetes, and hypoxia. Accordingly, assessment of
cognition is an important part of routine assessments. Dementia is not a normal part of aging and
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: ApplyN(ApRplicaItionG) B.C
M
REF: p. 629 USNT
O
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?
Encourage residents to participate in unit activities such as Scrabble and bingo.
a.
2. Demonstrate the caring aspect of nursing by dressing residents before breakfast.
3. Discourage exercise for patients with Parkinson because it has been shown to
accelerate muscle stiffness.
d. Switch places at the table every 3 weeks and change roommates every 6 weeks to
alleviate boredom.
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, such as dressing, themselves. When help is required, it should be provided in an
unhurried manner. Elderly patients like consistency in their environment and do not relish
change. Change often fosters confusion. Familiar environments and consistent routines are
encouraged. Exercise has been shown to minimize many of the debilitating aspects of
Parkinson’s disease.
DIF: Cognitive Level: Apply (Application) REF: p. 622
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
9. Which of the following statements is correct concerning the “obesity paradox” as it pertains to
older adults?
1.
2.
3.
4.
Obesity in older adults is more detrimental than it is for younger adults.
Unlike younger people, fruits and vegetables cause obesity in elderly people.
Obesity in older adults is not related to caloric intake or exercise.
Obesity in older adults is not clearly linked with shorter life span.
ANS: D
It is important to recognize, however, that scientists have described a phenomenon called “the
obesity paradox,” in which obesity in older adults, unlike in younger individuals, does not appear
to be clearly associated with a shorter life span. Some studies have suggested that the “ideal”
protective weight might be higher in the older population. There is still much debate about this,
however, and since obesity is clearly linked to a lesser quality of life, it is important to discuss
options for weight reduction. During weight loss, muscle is lost, as well as fat. This is an
important consideration when planning a weight loss program for older adults since, as a result
of normal aging and often deconditioning, they are likely to have less muscle mass and more fat
than when they were younger.
Fruits and vegetables are encouraged for everyone. Obesity is related to caloric take and energy
expenditure (exercise), also for everyone. Obesity in younger adults is clearly detrimental to
health. It may not be as detrimental for older adults especially given the concept of ideal
protective weight.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 625
10. Which of the following is correct concerning heat regulation in the older adult?
a. Remaining indoors where temps are 90 degrees or higher is recommended.
b. Increased sweating, characteristic of older adults, increases the risk of dehydration.
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c. Increased use of salt, secondary to declining taste, increases the risk for heat stroke.
d. The ability to feel heat and cold is typically enhanced in the elderly due to thinner skin.
ANS: A
The older adult’s ability to feel changes in heat and cold may be impaired as a result of normal
and pathological changes of aging. This process can cause older adults to die from the effects of
excessive heat or cold. During periods of high heat and humidity, older people should increase
fluid and salt intake, stay in a cool and shaded environment, remain calm, have more rest
periods, and refrain from going outdoors when the temperature is higher than 90 F. Sweating,
which is reduced in older adults, can be accommodated by wearing light-colored, lightweight
cotton clothing. If sweating ceases or is inadequate, the older person is at risk for heat stroke.
Heat stroke can contribute to sepsis, myocardial infarction, and cerebrovascular accidents
(CVAs), particularly in people with diabetes. Reduced body heat can also present problems in
the older adult. Symptoms of and interventions for hypothermia are listed in Box 24-9.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 637
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”
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
2. 78-year-old woman who has scheduled her third face lift
3. 80-year-old man who has informed his children that he has made his funeral
arrangements
4. 67-year-old woman who is depressed because she has not been promoted at work
for the past 10 years
ANS: C
Ego integrity versus despair is the developmental stage of older adults. The quality associated
with successful passage of this stage is to achieve a balance between integrity and despair. “The
process of bringing into balance feelings of integrity and despair involves a review of and a
coming to terms with the life one has lived thus far.” Based on the increasing life span, this stage
of development was expanded into three additional stages: ego differentiation versus work role
preoccupation, which involves achieving identity apart from work; body transcendence versus
body preoccupation, which focuses on adjusting to normal aging changes; and ego transcendence
versus ego preoccupation, which involves accepting death. 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. Choices A, B, and D do not depict individuals who are transitioning
well to their advancing years.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 632
12. A couple in their sixties has assumed responsibility for raising their two grandchildren ages 9
and 12 because the children’s parents died in a car accident. Which of the following is nursing
interventions is a priority to help the grandparents cope with the responsibility of raising their
grandchildren?
a. Connecting them with the “Grandparents Raising Grandchildren” support group
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2. Encouraging them by reminding them how they successfully raised their own children
3. Volunteering to provide respite time for them as needed
4. Assuring them that their stress level will lessen, as they gain confidence
ANS: A
In the United States in 2012, 7 million grandparents (10%) lived with at least one grandchild.
The role of grandparent frequently brings great joy and happiness at a time when the older adult
feels loss; however, grandparents who rear grandchildren encounter both emotional and physical
stress. Their new role as grandparent–caregiver may lead to role confusion and increased healthrelated problems. .... Thus, it is important for nurses to explore with these individuals what
activities may help to reduce stress. Coping strategies such as accepting responsibility, selfcontrol, positive reappraisal, planned problem-solving, and distancing may be helpful. Support
groups, counseling, and education to help them manage stress more effectively are other
resources that should be explored. Encouraging and supporting older adults in their caregiving
role is important to help them ease the stress and strain of changes that come with the caregiving
experience.
DIF: Cognitive Level: Apply (Application) REF: p. 633
13. A nurse is conducting a staff development program about human sexuality for nurses who
work in a long-term care facility. Which of the following statements is accurate?
1. “The desire for sexual intimacy declines rapidly with age.”
2. “Older adults are very well-informed about sexuality.”
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
c. “Older adults need to practice safe sex.”
d. “The danger of contracting STDs during sexual intimacy is extremely low in older
adults.”
ANS: C
No data were found to show that men or women lose interest in sexual activity as they age. Older
adults also need to fulfill the human need for intimacy and love, and to touch and be touched.
Touch is an overt expression of closeness and an integral part of sexuality ..., the number of
cases of HIV (human immunodeficiency virus) and AIDS in older adults continues to increase
because greater numbers of older adults are becoming newly infected with the HIV virus and an
increasing proportion of those who have been living with the virus are reaching their older years.
Older adults are just as susceptible to sexually transmitted disease (STD) as younger adults. Yet
one survey showed that only 5.1% of men over 61 had used a condom in recent sex. There seems
to be a lack of awareness in the older adult population about risks of STDs in their sexual
relationships.
The desire for sexual intimacy remains a primary force throughout life. Older adults need
teaching related to safe sexual practices, STD transmission, etc. HIV infection in older adults is
increasing yet only 5% of men over 61 are using condoms thus choice C is correct. All of the
other choices are contradicted by the evidence.
DIF: Cognitive Level: Apply (Application) REF: p. 634
14. The clinic nurse has seen the following four widows today. Which of the following persons is
demonstrating a healthy coping pattern for her loss?
1. The widow who discusses very little except the loss of her husband 3 years ago
2. The widow who talks about the “good times” she and her husband had before his
illness and death 1 year ago
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c. The widow who states that life is not worth living without her husband, who died 2 years ago
d. The widow who blames herself for her husband’s death because she did not “make him go” to
the doctor
ANS: B
An individual’s ability to cope with the common stresses of older adulthood is a key factor in
maintaining self-concept. As people age, they tend to encounter many losses, such as the loss of
a home, spouses, friends, siblings, and even children. The nurse who cares for the older adult can
provide support during the coping process related to these losses. Trying to find the positive and
developmental benefits of losses is preferable to continually thinking about a loss or bad event.
Negative associations have been found between depressive symptoms and rumination,
catastrophizing, and self-blame. After assessing the most appropriate way in which the individual
desires to cope with a situation, the nurse may help create a suitable environment for coping.
Choice “B” depicts a widow who has a positive focus, not withstanding the loss of her husband
one year ago. She focuses on positive memories pertaining to her deceased husband. Choices A,
C, and D all depict widows with a very negative outlook or a negative focus, as it pertains to the
loss of their husbands.
DIF: Cognitive Level: Apply (Application) REF: p. 634
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
15. A nurse is assigned to provide care for a 96-year-old bedridden man who experiences severe
pain from a chronic neurological disease. The man asks the nurse to please help him leave this
world so that his suffering will end. Which of the following actions would be most appropriate
for the nurse to take?
1. Assist the doctor with the man’s request.
2. Refuse to care for the man.
3. Contact the pain care specialist.
4. Provide the man with names of doctors who participate in assisted suicide.
ANS: C
The suicide rate for older Americans is disproportionally high in the American population. Many
older adults have serious medical illnesses that provide an explanation for wanting to die. Nurses
caring for chronically ill older adults have the added responsibility of determining who is at risk
for wanting physician-assisted suicide and helping them to be as comfortable as possible and free
of pain through the use of pharmacological and nonpharmacological interventions. Nurses are
instrumental in ensuring that the older person experiences a pain-free death by advocating for an
appropriate pain-management program and working with other health care professionals toward
this goal.
Refusing to care for the man could be construed as abandonment and is not appropriate in any
event. If the patient’s pain is controlled, he may have less focus on suicide. Consulting a pain
care specialist is the correct action.
DIF: Cognitive Level: Apply (Application) REF: p. 635
16. A nurse is conducting a home visit for an older adult in the summer. Which of the following
items should the nurse should locate in the home in the interest of preventing a heat stroke?
1.
2.
3.
4.
Fan
Porch chair
Synthetic blend clothing
Air thermometer
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ANS: A
The older adult’s ability to feel changes in heat and cold may be impaired as a result of normal
and pathological changes of aging. This process can cause older adults to die from the effects of
excessive heat or cold. During periods of high heat and humidity, older people should increase
fluid and salt intake, stay in a cool and shaded environment, remain calm, have more rest
periods, and refrain from going outdoors when the temperature is higher than 90 F. Sweating,
which is reduced in older adults, can be accommodated by wearing light-colored, lightweight
cotton clothing
Older adults are susceptible to heat stroke. The availability of a fan will help cool the ambient
air. Light-weight cotton clothing “breathes” and facilitates cooling, whereas synthetic material
typically retains heat. The temperature can be quite hot on the porch, especially absent a fan.
Remaining inside during very hot weather is recommended.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 637
17. The community health nurse has obtained a grant to offer a “Safe Driving” series for older
adults. Which of the following information should the nurse stress during the series?
1. Traffic fatalities involving older adults occur mainly at dusk.
2. The cause of two-vehicle accidents is frequently an older driver striking another
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
car.
c. The average blood alcohol level in older adults involved in accidents is higher than
the blood alcohol level of younger drivers involved in accidents.
d. Relearning the art of defensive driving can reduce the likelihood that an older
driver will be involved in a motor vehicle accident.
ANS: D
There is a decline in defensive driving as opposed to an increase in aggressive driving among
older adults. Older adults are encouraged to take a Seniors Driving Safety Course to learn how
aging changes can affect their driving and strategies for safer driving. Traffic fatalities involving
older adults occur mainly during the daytime. The cause of two vehicle accidents is frequently a
younger driver striking the car driven by an older adult. The average blood alcohol level in older
adults involved in accidents is lower than the blood alcohol level of younger drivers involved in
accidents.
DIF: Cognitive Level: Apply (Application) REF: p. 638
18. As part of a community-wide flu vaccination program for older adults, the nurse is assisting
at a vaccination clinic. Which of the following questions should the nurse ask before
administering the vaccine?
1.
2.
3.
4.
“Do you have any food allergies?”
“Have you had the pneumococcal vaccine?”
“Have you had the flu in the past 5 years?”
“Do you have Medicare?”
ANS: A
An allergy to eggs is a contraindication to receiving flu vaccine grown in chick embryo cells.
Choices B, C, and D are not relevant to the issue of whether the person should have a flu
vaccine.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 639
19. A man tells a nurse that he is concerned about his risk and his wife’s risk of developing
cancer. Which of the following statements concerning cancer is accurate?
1. PSA assessment alone is not ideal for purposes of screening for prostate cancer.
2. Breast cancer risks are lower in women who have never had children.
3. Smoking does increase the risk of cancer but non-smoking tobacco products do not
increase risk.
4. Increased immune function to adults after age 65 impacts cancer rates.
ANS: A
Theories include longer exposure to carcinogens, increased susceptibility to cancer in the older
body, decreased cellular healing ability, loss of tumor-suppressing genes, and decreased immune
function. There are three key components of an appropriate prostate screen: symptomatology,
prostate-specific antigen level measurement, and a digital rectal examination. Women who have
never had children or had their first child after age 30 appear to have an increased risk for breast
cancer. Stopping smoking and other use of tobacco products are a few of the approaches that
nurses can advise to promote individual wellness. PSA alone is not recommended for screening.
Patients should have digital rectal exams and be questioned concerning symptoms. Both smoking
and smokeless tobacco product are implicated in cancer. Immune function decreases with age.
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
DIF: Cognitive Level: Apply (Application) REF: p. 639
20. Which of the following statements is the best definition of polypharmacy?
1.
2.
3.
4.
The use of more than five medications prescribed by different physicians
The use of multiple medications for the same or different health problems
The use of multiple pharmacies and self-management of medications
The use of multiple medications and supplements simultaneously
ANS: B
Polypharmacy, or the use of multiple medications for the same or for different health problems,
is a major concern for older adults. Approximately one-third of older adults in the United States
take 5 or more prescription drugs.
Polypharmacy is a major concern for elderly people, with the rate of polypharmacy in this
population being between 9% and 39%. The fact that medications are prescribed by different
licensed providers is not a hallmark for polypharmacy. Neither is there a specific number, i.e., 5
medications. The fact that multiple medications are prescribed for the same or different health
problems is consistent with polypharmacy. No specific number is specified in the definition but
commonly the elderly have very large numbers of medications prescribed for them.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 640
21. A person is preparing to return home following a 2-week hospital stay for congestive heart
failure and pneumonia. Which of the following referrals would be most beneficial for the
person?
1. Transportation assistance
2. Home-delivered meals NURSINGTB.COM
3. Adult day care
4. Home health nursing
ANS: D
Home care nurses provide health care information and services to individuals and families. The
resources available to community health nurses are often extensive and enable the nurses to draw
on a variety of sources to assist in promoting the health of community-dwelling older adults.
Although all of the referrals listed may be of benefit to the person, the home health nurse will
provide the most comprehensive services. The nurse will be able to connect the person to
necessary community resources.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 643
22. The son of a 70-year-old man dying of cancer asks the nurse to tell him about the hospice
program, so he can help his father decide if the program would be of benefit to him. Which of
the following responses should be given by the nurse?
1.
2.
3.
4.
“At hospice, your father will be heavily medicated, so he will not have pain.”
“All of your father’s care will be provided by nurses at hospice.”
“Hospice care can take place either at home or in a hospice facility.”
“Visiting hours are about the same at hospice as they are here in the hospital.”
ANS: C
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Once the person is placed in hospice care, treatment to relieve pain and other symptoms is
continued but the person and their physician have decided to end all curative treatment .... The
majority of hospice care provided in 2010 was in the person’s home (41.1%), followed by a
hospice inpatient facility (21.9%), nursing home (18%), and acute-care hospital (11.4%).
Hospice services provided include direct clinical care for persons and bereavement services for
the person and their family. Hospice persons are empowered to live with dignity, alert, and free
of pain. The goal of hospice care is to facilitate a “good death” for individuals. Families and
loved ones are consistently engaged in caregiving for the dying and helping them maintain the
highest possible quality of life.
The focus of hospice care is to help the person remain alert but free of pain. Families are
encouraged to participate in care giving. There are no restrictions to visiting hours.
DIF: Cognitive Level: Apply (Application) REF: p. 644
23. A community health nurse is working with a diverse population of older adults within the
community. Based on the data from the National Health Interview Survey, which of the
following assumptions should be made by the nurse when working with this diverse population?
1. White Non-Hispanic older adults tend to require more assistance with their activities of
daily living.
2. Hispanic older adults tend to rate their health as poorer than other ethnic groups.
3. Older adults who tend to rate their health as fair or poor are also financially poor.
4. Older adults tend to require more assistance with activities of daily living than with
meeting their routine needs.
ANS: C
In all groups, those who described their health as fair or poor were also more likely to be
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financially poor, with 40% of White older adults, 51.6% of Black older adults, 53.4% of
Hispanic older adults, and 45.6% of Asian older adults who reported their health status as fair or
poor also being financially poor.
Choice C is supported by data from the National Health Interview Survey. The data contradict all
of the other choices.
DIF: Cognitive Level: Apply (Application) REF: p. 623, Box 24-3
24. A woman who is being discharged from the hospital is oriented to person, place, and time,
and her memory is intact. She has occasional forgetfulness without a consistent pattern of
memory loss. Which of the following housing options would be most appropriate for this
woman?
1.
2.
3.
4.
Independent living
Retirement community
Assisted living
Nursing facility
ANS: B
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Retirement community living is suited for a person who is oriented to person, place, and time
and has a memory that is intact. This individual may experience occasional forgetfulness without
a consistent pattern of memory loss. Independent living may be appropriate for the person if she
had a consistent pattern of memory loss. Assisted living or nursing facility living may be
appropriate if the woman has difficulty with orientation to person, place, or time or has difficulty
with confusion that results in anxiety, social withdrawal, or depression. Nursing facility is
appropriate for patients who require much more extensive care up to and including total care.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 643, TBL 24-4
MULTIPLE RESPONSE
1. Which of the following interventions will have the greatest impact on reducing constipation in
older adults? (Select all that apply.)
1.
2.
3.
4.
Offering strained fruit and vegetable juices to increase fiber content in the diet
Encouraging fluids between meals
Administering laxatives on a daily basis
Assisting with ambulation
ANS: A, B, D
Encouraging older adults to exercise and increase their fluid intake helps reduce the incidence
of constipation. Integrating more fiber into the diet and eating prunes each day can also be
very effective for preventing constipation.
Nurses can help reduce the incidence of constipation by encouraging older adults to exercise
and increase their fluid and dietary intake. Dietary modifications, such as increasing fiber and
fluid intake, can stimulate theNcoRlonIandGresoBl.veCconMstipation. While pureed foods
do retain USNT O
fiber, straining juices to remove the pulp removes most of the fiber content. Fiber helps to
prevent constipation. Increased fluid intake and exercise should be implemented before relying
on medication to relieve constipation.
DIF: Cognitive Level: Apply (Application) REF: p. 626
2. Which of the following factors would be considered predictors of satisfaction with retirement?
(Select all that apply.)
1.
2.
3.
4.
Participation in competitive sports but most especially golf
Adequate income
Having grandchildren
Good functional ability
ANS: B, D
Hooyman and Kiyak (2011) noted a variety of factors that were predictors of satisfaction with
retirement. Those factors included good health and functional ability, adequate income, a
suitable living environment, a strong social support system, and a positive outlook.
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While many retired persons do, in fact enjoy their grandchildren, having grandchildren is not a
predictor of satisfaction in retirement. Some happily retired persons have no grandchildren while
others rarely interact with their grandchildren. Still others may feel burdened by a need to
become caregivers for the grandchildren. An interest in sports, including golf, also has no
predictive value for satisfaction in retirement. Many happily retired persons have absolutely no
interest in sports including golf. They may have wide and varied interests in the form of hobbies
and other pursuits.
DIF: Cognitive Level: Apply (Application) REF: p. 633
3. The nurse working in a retirement community for older adults is conducting a psychosocial
assessment of all residents to screen for depression and suicidal ideation. Which of the following
questions should the nurse ask during the assessment process? (Select all that apply.)
1.
2.
3.
4.
“Have you thought about harming yourself?”
“Are you still playing bridge every Thursday?”
“How does your congestive heart failure affect your life?”
“Do you still have any money left in your IRA account”
ANS: A, B, C
The National Institute of Mental Health noted that the risk of depression increases in older
adults as they experience chronic illnesses and when their ability to function becomes
impaired .... Depression is also caused by physiological changes in the aging body. The
suicide rate for older Americans is disproportionally high in the American population. The
suicide rate for men is highest in those who are age 75 or older. Risk factors for suicide
include social isolation, alcohol and substance abuse, psychosis, bereavement, and serious
medical illness. Many who committed suicide were found to have alcohol and/or pain-killing
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drugs in their bodies on autopsy.
Suicide ideation, loss of interest in activities, and chronic illness are signs of, or may lead to,
depression. Depression, in turn, could lead to suicide. Choices A, B, and C are all consistent with
known predictors of suicide. Economic issues are not predictors of suicide in older adults.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 635
4. Which of the following nursing interventions implies respect for a person’s spirituality?
(Select all that apply.)
1. Changing the position of the bed in a Muslim client’s room so that it faces east
2. At the request of a Buddhist patient, asking the home health aide to pick up
incense when she next shops for the patient.
3. Saying a silent prayer with a client, at the client’s request
4. Praying out loud in the room of a dying client
ANS: A, B, C
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
Because of the highly personal quality of spirituality, an unobtrusive and sensitive presence by
the nurse is needed to allow the person in any setting to achieve spiritual health. Spiritual
assessment tools are available to guide nurses with questions to better understand the person’s
spirituality. Open-ended questions, such as, “What is your perception of a higher being and
spirituality?” encourage discussions about the person’s innermost spirituality. The nurse can
provide an environment that is supportive to the practice of the person’s spirituality. Assisting
older persons to actualize their spirituality can provide great comfort to the person and lead
nurses to a deeper understanding of their own spirituality.
Choices A, B, and C all represent unobtrusive and sensitive efforts to actualize a given patient’s
spirituality. Praying out loud does not demonstrate respect for a person’s spirituality but imposes
the nurse’s belief system on the person. Home health aides appropriately shop for a patient
purchasing food and/or personal supplies. Picking up incense while at the store would
appropriate and consistent with this role.
DIF: Cognitive Level: Apply (Application) REF: p. 636
5. A nurse is conducting a community health-education program about osteoporosis with a group
of older adults. Which of the following individuals in attendance is at greatest risk for developing
osteoporosis? (Select all that apply.)
1. 65-year-old Asian woman who smokes one pack of cigarettes per week
2. 80-year-old White man who has three glasses of wine per day
3. 74-year-old White woman on daily oral prednisone for emphysema
4. 68-year-old Black man who has a sedentary lifestyle
ANS: A, B, C
Because of the higher risk of osteoporosis in the older population, a fall can result in a
fracture. Osteoporosis is a disease of bone loss common to women age 70 and older and men
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age 80 and older. The disease develops six times more frequently in women than it does in men
.... Risk factors for osteoporosis include a small, thin frame; White or Asian ancestry; family
history; excessive thyroid medication or high doses of cortisone-like drugs for asthma, arthritis,
or cancer; a diet low in dairy products and other sources of calcium; physical inactivity; smoking
cigarettes; and drinking alcohol.
Choices A, B, and C all depict persons with one or more risk factors. Choice D describes a
patient with no risk factors.
DIF: Cognitive Level: Apply (Application) REF: p. 636
6. An 80-year-old person is admitted to the hospital. During the health assessment process, the
nurse should screen for which of the following conditions? (Select all that apply.)
1.
2.
3.
4.
Polypharmacy
Renal insufficiency
Illegal drug use
Alcoholism
ANS: A, B, C, D
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Health Promotion Throughout the Life Span 9th Edition Edelman Test Bank
Substance abuse among Americans 60 years and older, including misuse of prescription
drugs, is estimated to affect about 17% of older adults. By 2020, it is anticipated that the number
of older adults with substance abuse problems will double. Forty percent of adults age 65 and
over drink alcohol. Alcohol and drug abuse problems among older adults have been
underestimated. In Americans age 65 and older, excessive alcohol use, including binge drinking,
accounts for more than 21,000 deaths each year .... Older adults are more vulnerable to the
effects of alcohol and illicit drugs, because their systems do not detoxify and excrete as
efficiently as do those of younger people.
Substance and alcohol abuse are problems in the elderly population. Substance abuse, in
particular, is increasing. Polypharmacy is long-standing problem with elderly population, as
well. Renal insufficiency, which is common in the elderly, hampers the ability of the body to
detoxify alcohol, substances and pharmaceuticals thus further exacerbating the problem.
DIF: Cognitive Level: Apply (Application) REF: p. 640