A nurse is conducting a health history with an 80-year-old client. According to Erikson’s theory of psychosocial development, which of the following is the primary task the nurse should expect the client to be navigating?
A. Generativity vs. Stagnation
B. Trust vs. Mistrust
C. Ego Integrity vs. Despair
D. Intimacy vs. Isolation
Answer: C. Ego Integrity vs. Despair
Rationale: Erikson’s final stage, Ego Integrity vs. Despair, occurs in late adulthood (65+). During this stage, adults reflect on their lives. A sense of Ego Integrity is achieved by accepting one’s life as having been meaningful. Despair occurs if the person has many regrets and feels their life was a waste. Generativity vs. Stagnation is for middle adulthood, Intimacy vs. Isolation is for young adulthood, and Trust vs. Mistrust is for infancy.
A 78-year-old client tells the nurse, “I feel like my life hasn’t mattered. I wish I had made different choices.” The nurse identifies that the client is experiencing which stage of Erikson’s development?
A. Stagnation
B. Despair
C. Isolation
D. Role Confusion
Answer: B. Despair
Rationale: The client’s statement, reflecting regret and a feeling that their life “hasn’t mattered,” is a classic manifestation of Despair. This is the negative outcome of Erikson’s final developmental stage, which contrasts with Ego Integrity.
A nurse observes a colleague consistently speaking to an alert and oriented 85-year-old client using a high-pitched, sing-song voice and simple, childlike phrases. The nurse identifies this as an example of:
A. Ageism
B. Empathy
C. Therapeutic communication
D. Reality orientation
Answer: A. Ageism
Rationale: This type of communication is known as “elderspeak” and is a form of ageism. It is based on the incorrect stereotype that all older adults are confused, hard of hearing, or cognitively impaired. It is demeaning and non-therapeutic.
Which of the following is a common stereotype about aging?
A. Most older adults live in nursing homes.
B. Older workers are less reliable than younger workers.
C. Cognitive decline is an inevitable and severe part of aging.
D. All of the above.
Answer: D. All of the above.
Rationale: All three statements are common, false stereotypes. In reality, only a small percentage of older adults live in nursing homes, older workers have high rates of reliability, and while some processing-speed changes are normal, severe cognitive decline (like dementia) is a disease, not a normal part of aging.
. A nurse is assessing an older adult in the emergency department and notes multiple bruises in various stages of healing on the client’s arms and torso. The client’s caregiver, who is their adult child, refuses to leave the room and answers all questions for the client. What is the nurse’s priority action?
A. Document the bruises and tell the caregiver to be more careful.
B. Ask the caregiver to step out of the room so the client can be interviewed in private.
C. Call social services immediately without speaking to the client first.
D. Ask the client directly, in front of the caregiver, “Is your child hurting you?”
Answer: B. Ask the caregiver to step out of the room so the client can be interviewed in private.
Rationale: The nurse’s priority is to conduct a private assessment. The bruises and the caregiver’s behavior (controlling, not leaving the client alone) are significant red flags for elder abuse. The nurse must create a safe environment to interview the client alone to gather more data. Asking directly in front of the abuser (Option D) could endanger the client. While social services will be notified (Option C), a private assessment should be attempted first to confirm suspicions.
Which finding is the clearest indicator of potential financial abuse in an older adult client who lives with a family member?
A. The client has a joint bank account with the family member.
B. The client states, “My son helps me pay all my bills.”
C. The client reports their “usual” utilities have been shut off for non-payment.
D. The client recently decided to give their car to their grandchild.
Answer: C. The client reports their “usual” utilities have been shut off for non-payment.
Rationale: While joint accounts and helping with bills can be appropriate, the sudden inability to pay for basic necessities like utilities, especially when the client has a known source of income (like social security), is a major red flag that someone else may be misappropriating the client’s funds.
An 88-year-old client is admitted from home with dehydration and severe malnutrition. The client appears unkempt, has a strong body odor, and is wearing soiled clothing. The nurse recognizes these findings as potential indicators of:
A. Physical abuse
B. Neglect
C. Financial abuse
D. A normal part of aging
Answer: B. Neglect
Rationale: Neglect is the failure of a caregiver to provide necessary goods or services, such as food, water, hygiene, and medical care. The client’s unkempt appearance, poor hygiene, dehydration, and malnutrition strongly suggest their basic needs are not being met.
A 70-year-old client is preparing for retirement. Which question by the nurse is most appropriate to assess the client’s adjustment to this life change?
A. “Are you worried you won’t have enough money?”
B. “What do you plan to do with all your free time?” C. “Have you thought about how this change might affect your daily routine and social life?”
D. “Do you think you will be bored?”
Answer: C. “Have you thought about how this change might affect your daily routine and social life?”
Rationale: This open-ended, non-judgmental question encourages the client to reflect on the significant psychosocial adjustments related to retirement, including the loss of a daily work structure and social interaction with colleagues. The other options are closed-ended and make negative assumptions (boredom, financial worry).
A devoutly religious client is distressed about their declining health. Which nursing intervention best addresses the client’s spiritual needs?
A. Telling the client that their faith will heal them. B. Asking the client if they would like to speak with the hospital chaplain.
C. Reading a passage from the nurse’s own religious text to the client. D. Explaining that illness is a normal part of aging.
Answer: B. Asking the client if they would like to speak with the hospital chaplain. Rationale: This intervention respects the client’s expressed spirituality by offering a resource (chaplain) that aligns with their needs, without imposing the nurse’s own beliefs (Option C) or offering false reassurance (Option A).
A nurse is caring for a client who is grieving the recent death of their spouse. Which action by the nurse is most therapeutic?
A. Telling the client, “Don’t cry, they are in a better place.”
B. Sitting with the client and allowing them to express their feelings.
C. Asking the client if they have considered getting a pet for companionship.
D. Sharing a story about a time the nurse experienced a similar loss.
Answer: B. Sitting with the client and allowing them to express their feelings. Rationale: The most therapeutic intervention for grief is to use therapeutic presence. This involves sitting with the client, actively listening, and creating a safe space for them to express their emotions without judgment or attempts to “fix” their sadness. The other options are non-therapeutic and block communication.
Which of the following is considered a normal neurological change associated with aging?
A. A new onset of tremors in the hands.
B. A decline in long-term memory.
C. Slower reaction time and cognitive processing. D. A sudden onset of confusion and disorientation.
Answer: C. Slower reaction time and cognitive processing.
Rationale: A modest slowing of reaction time and processing speed is a normal part of aging due to a decrease in neurons and slower nerve conduction. New tremors (Option A) could indicate Parkinson’s disease. Significant loss of long-term memory (Option B) is not normal. Sudden confusion (Option D) is a hallmark of delirium, an acute medical emergency.
A nurse is teaching a community class about sensory changes in aging. Which change is associated with presbycusis?
A. Difficulty distinguishing colors, especially blues and greens.
B. A slow, progressive loss of high-frequency hearing.
C. Increased pressure within the eye.
D. A clouding of the lens of the eye.
Answer: B. A slow, progressive loss of high-frequency hearing.
Rationale: Presbycusis is the age-related, progressive hearing loss that typically affects the ability to hear high-pitched sounds first (e.g., consonants like “s” and “th”). Option A describes changes to the lens (yellowing), Option C is glaucoma, and Option D is a cataract.
A 75-year-old client reports that they have to hold their newspaper at arm’s length to read it. The nurse recognizes this as a common finding associated with:
A. Presbyopia
B. Cataracts
C. Glaucoma
D. Macular degeneration
Answer: A. Presbyopia
Rationale: Presbyopia is the age-related loss of the eye’s ability to focus on nearby objects. This is caused by the lens becoming less flexible. Holding reading material farther away is a classic compensatory mechanism.
A nurse is communicating with an older adult client who has severe presbycusis. Which intervention is most appropriate?
A. Shouting directly into the client’s ear.
B. Facing the client and speaking clearly in a lower-pitched voice.
C. Using “elderspeak” with simple words and a high pitch.
D. Writing everything down, as the client cannot hear at all.
Answer: B. Facing the client and speaking clearly in a lower-pitched voice.
Rationale: Since presbycusis involves the loss of high-frequency sounds, shouting (which raises the pitch) makes speech harder to understand. The best approach is to face the client (allowing for lip-reading), reduce background noise, and speak clearly and at a slightly lower, moderate-paced tone.
A client is diagnosed with cataracts. The nurse anticipates the client will report which primary symptom?
A. Sudden, severe eye pain.
B. A loss of peripheral (side) vision.
C. Blurred vision and increased glare, especially at night.
D. A dark spot in the center of the visual field.
Answer: C. Blurred vision and increased glare, especially at night.
Rationale: A cataract is a clouding of the eye’s natural lens. This clouding causes light to scatter, leading to symptoms of blurred or hazy vision, decreased color perception, and a significant increase in glare, particularly from headlights at night. Sudden pain (A) is linked to acute glaucoma. Peripheral vision loss (B) is classic glaucoma. Central vision loss (D) is macular degeneration.
A nurse is teaching a client about self-care for newly diagnosed open-angle glaucoma. Which statement is essential to include?
A. “This condition is curable with surgery, so you will only need eye drops for a few weeks.”
B. “You must use your prescribed eye drops for the rest of your life to prevent blindness.”
C. “This condition causes a blind spot in the center of your vision, so you must stop driving.”
D. “A yearly eye exam is all that is needed to monitor this condition.”
Answer: B. “You must use your prescribed eye drops for the rest of your life to prevent blindness.”
Rationale: Open-angle glaucoma is a chronic, progressive condition that damages the optic nerve, usually from increased intraocular pressure. It is not curable. The goal of treatment (typically with lifelong eye drops) is to lower the pressure and prevent further vision loss and blindness.
A client with age-related macular degeneration (AMD) is being discharged. Which nursing intervention is most important for the client’s safety?
A. Teaching the client to self-administer daily eye drops.
B. Reminding the client to wear sunglasses outdoors.
C. Recommending the use of magnifying glasses and large-print books.
D. Instructing the client on the “Amsler grid” to monitor for central vision loss.
Answer: C. Recommending the use of magnifying glasses and large-print books.
Rationale: Macular degeneration causes the loss of central vision, which is critical for reading, recognizing faces, and seeing fine detail. Magnification aids and large-print items are essential adaptations to help the client maintain function and safety in reading labels, instructions, etc. The Amsler grid (D) is for monitoring, not a safety adaptation.
An 82-year-old client is admitted to the hospital and exhibits sudden, fluctuating confusion, inattention, and disorganized thinking. The client’s family reports this behavior started “yesterday.” The nurse suspects:
A. Delirium
B. Dementia
C. Depression
D. Normal aging
Answer: A. Delirium Rationale: The key features are its acute/sudden onset and fluctuating course with inattention. This clinical picture is characteristic of delirium, which is a medical emergency often caused by an underlying issue (like infection, dehydration, or medication). Dementia (B) has a slow, progressive onset.
A nurse is providing education to the family of a client with Alzheimer’s disease (dementia). Which statement indicates the caregiver understands the disease?
A. “If we find the right medication, this disease can be cured.”
B. “This is just temporary confusion, and it will go away.”
C. “I should reorient my mother to the correct date and time every time she is confused.”
D. “I will maintain a consistent daily schedule and safe environment for my mother.”
Answer: D. “I will maintain a consistent daily schedule and safe environment for my mother.”
Rationale: Dementia is a progressive, incurable disease. The best non-pharmacological interventions involve providing a safe, predictable, and calm environment. Maintaining a consistent routine (structural environmental intervention) reduces anxiety and confusion for the client. Constantly reorienting (C) a client with moderate to severe dementia can increase agitation.
A nurse is explaining age-related respiratory changes to a new graduate. Which statement is accurate?
A. “The lungs become more elastic, increasing vital capacity.”
B. “The cough reflex becomes stronger and more sensitive.”
C. “Cilia in the airways become more numerous and effective.”
D. “The chest wall stiffens, and lung elasticity decreases.”
Answer: D. “The chest wall stiffens, and lung elasticity decreases.”
Rationale: Normal aging causes the costal cartilage to calcify and the chest wall to stiffen. The lungs also lose elastic recoil. This combination decreases vital capacity and increases residual volume, making breathing less efficient. The cough reflex (B) and ciliary action (C) both weaken, increasing the risk of pneumonia.
An older adult client is admitted with pneumonia. The nurse knows that age-related changes place this client at high risk for this condition. Which age-related change is the most significant contributing factor?
A. Decreased number of alveoli.
B. Decreased inspiratory muscle strength and a less effective cough.
C. Increased flexibility of the thoracic cage.
D. Increased sensitivity of the respiratory center to hypoxia.
Answer: B. Decreased inspiratory muscle strength and a less effective cough.
Rationale: A weaker cough reflex and reduced cough strength, combined with weaker inspiratory muscles, make it difficult for the older adult to clear secretions and foreign matter from the airway. This pooling of secretions provides a medium for bacterial growth, leading to pneumonia.
A nurse is teaching an older adult client about health promotion. Which intervention is most important to promote respiratory health?
A. Recommending complete bed rest to conserve energy.
B. Encouraging regular physical activity, such as walking.
C. Suggesting the client move to a drier climate.
D. Advising the client to drink less water to avoid fluid overload.
Answer: B. Encouraging regular physical activity, such as walking.
Rationale: Regular, moderate exercise (like walking) helps maintain inspiratory muscle strength, prevents atelectasis, and promotes mobilization of secretions. Bed rest (A) is a major risk factor for respiratory complications.
Which cardiovascular change is commonly seen in older adults?
A. A decrease in systolic blood pressure.
B. An increase in maximum heart rate during exercise.
C. Stiffening of blood vessels and a slight increase in systolic blood pressure.
D. A thinner, more flexible heart muscle.
Answer: C. Stiffening of blood vessels and a slight increase in systolic blood pressure.
Rationale: As a person ages, the arteries lose elasticity and become stiffer (arteriosclerosis). This increased vascular resistance causes systolic blood pressure to rise. The heart muscle hypertrophies (thickens) to pump against this resistance, and the maximum heart rate (B) and cardiac output decrease.
A nurse is assessing an 80-year-old client’s vital signs. Which finding is the most immediate cause for concern?
A. Heart rate of 62 bpm.
B. Respiratory rate of 18 breaths/min.
C. Blood pressure of 148/88 mmHg.
D. A report of dizziness when standing up from a chair.
Answer: D. A report of dizziness when standing up from a chair.
Rationale: The report of dizziness upon standing is a classic symptom of orthostatic hypotension (a drop in blood pressure with a position change). This is a major concern because it significantly increases the risk for falls and injury. The other vital signs are within a range that is common (though not ideal, in the case of the BP) for an older adult and are not as immediately dangerous as a fall risk.
-
Pharmacology Week 318
-
Week 5 Ch. 38 Practice Questions (AI Generated)35
-
Week 4 Exam49
-
Pharmacology Week 426
-
Week 5 Reading Material Questions (AI Generated)30
-
Week 5 Ch. 38 (pp. 986-987) Questions (AI Generated)30
-
Ch. 28 Pneumonia non-rationale72
-
Week 5 Ch. 28 Questions (AI Generated)40
-
Week 6 Ch. 35 Questions (AI Generated)50
-
Ch. 35.90
-
Ch. 2675
-
Ch. 4073
-
Ch. 3093
-
Ch. 53 Powerpoint75
-
Ch. 1876
-
Week 9 Powerpoint49
-
Ch. 3325
-
Pharm77
