Caring for Older Adults: Addressing Emerging Health Challenges, Exams of Nursing

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Question and Answer A+ Guide 2024-

A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man's wellness? a. Wellness can only be achieved with aggressive medical interventions. b. Wellness is not a real option for this client because he is terminally ill. c. Wellness is defined as the absence of disease. d. Nursing interventions can help empower a client to achieve a higher level of wellness - correct answer ✅✅ ANS: D Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse can foster wellness in his or her clients. Wellness is defined by the individual and is multidimensional. It is not just the absence of disease. A wellness perspective is based on the belief that every person has an optimal level of health independent of his or her situation or functional level. Even in the presence of chronic illness or while dying, a movement toward wellness is possible if emphasis of care is placed on the promotion of well-being in a supportive environment.

Question and Answer A+ Guide 2024-

In differentiating between health and wellness in health care, which of the following statements is true? a. Health is a broad term encompassing attitudes and behaviors. b. The concept of illness prevention was never considered by previous generations. c. Wellness and self-actualization develop through learning and growth. d. Wellness is impossible when one's health is compromised. - correct answer ✅✅ ANS: A Health is a broad term that encompasses attitudes and behaviors; holistically, health includes wellness, which involves one's whole being. The concept of illness prevention was never considered by previous generations; throughout history, basic self-care requirements have been recognized. Wellness and self- actualization develop through learning and growth—as basic needs are met, higher level needs can be satisfied in turn, with ever-deepening richness to life. Wellness is possible when one's health is compromised—even with chronic illness, with multiple disabilities, or in dying, movement toward a higher level of wellness is possible.

Question and Answer A+ Guide 2024-

Which racial or ethnic group has the highest life expectancy in the United States? a. Native Americans b. African Americans c. Hispanic Americans d. Asian and Pacific Island Americans - correct answer ✅✅ ANS: C As shown in Figure 1.4, Hispanic men and women have the highest life expectancy of all. In 2011, for those of Hispanic origin of any race, the overall life expectancy at 65 years of age was 20.7 more years in 2011 (19.1 years for men and 21.8 years for women). Historical influences that have shaped the lives of the majority of the in-between cohort in the United States today include which of the following? a. Influenza epidemic of 1918 b. World War I c. Child rearing in the Depression

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d. World War II - correct answer ✅✅ ANS: D Those who are in the in-between cohort in 2016 were born between 1915 and 1945. The men were likely to have fought in World War II. The last of the Holocaust survivors are in this group. A person who survived the influenza epidemic would be at least 98 years old in 2016 and therefore would be considered old-old or a centenarian. Most of those who are of the in-between cohort had not reached childbearing age by the end of the Depression. Individuals in the in-between cohort would not have been old enough to fight in World War II. According to researchers, which characteristic do most centenarians share? a. Female b. Hispanic c. Living in rural areas d. Located in the Midwestern states - correct answer ✅✅ ANS: A

Question and Answer A+ Guide 2024-

Based on the U.S. census report of 2010, centenarians were overwhelmingly white, female, and living in the urban areas of the Southern states. Which nursing intervention is a holistic approach to an older adult? a. Performs glucose testing during the weekly worship service b. Wheels ambulatory adults to exercise when running late c. Assigns female nurses to older women who are Islamic d. Allows older adults in a nursing home to eat meals alone - correct answer ✅✅ ANS: C The nurse uses a holistic approach to the care of an older female adult who is Islamic because the woman and her family are more likely to be willing participants in a therapeutic regimen that respects a tenet of their culture. Interrupting an older adult's worship with glucose testing can be interpreted as a lack of respect for spiritual needs. The nurse can provide for and respect the physical and spiritual aspects of the older adult's life by testing for glucose before the service begins. In transporting

Question and Answer A+ Guide 2024-

ambulatory adults to the exercise program in wheelchairs to save time, the nurse disregards the need for self- esteem and exercise, both important aspects of physical well-being. Ambulatory adults can walk with assistance, if needed, to exercise programs and can benefit from the additional activity and independence. The nurse can be tempted to allow an older adult to eat meals alone in his or her room if this will motivate the person to eat or if the older adult has dysphasia and is embarrassed. However, although focusing on physical needs, the nurse ignores psychosocial and other aspects of health and well-being. An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL. Which nursing intervention is most likely to assist this man in achieving his highest level of wellness? a. Instruct him about increasing dietary fiber. b. Ask the health care provider for a low-fat diet. c. Schedule a consultation for him with the dietitian. d. Review a menu with him to choose suitable foods. - correct answer ✅✅ ANS: D

Question and Answer A+ Guide 2024-

The nurse collaborates with the older adult to choose suitable foods, which is likely to be an effective nursing intervention to help an older adult with hyperlipidemia achieve optimal health and well-being; it gives him some control over the regimen and thus engages him in the process of lowering serum cholesterol. Informing the older man about dietary fiber offers no control to him because he is not part of the decision. Nursing interventions developed with the older adult's collaboration are most likely to help the older adult achieve health and wellness. Collaborating with the health care provider for a low-fat diet is a reasonable approach to help this man with hyperlipidemia to achieve health and wellness. However, he is more likely to have motivation and enthusiasm for a therapeutic regimen over which he has had some control. Scheduling a consultation with a dietitian is a reasonable approach to an older adult with hyperlipidemia and is a part of a multifaceted approach to optimizing his health. However, the older adult is more likely to engage in a regimen over which he has input. Which approach requires the nurse to integrate and balance all aspects of an individual's life into the plan of care?

Question and Answer A+ Guide 2024-

a. Holistic nursing b. Healthy People 2020 c. Maslow's hierarchy of human needs d. Orem's self-care requirements - correct answer ✅✅ ANS: A Holistic nursing integrates all aspects of an individual's life into the plan of care by balancing an individual's internal and external environment with psychosocial, spiritual, cultural, and physical processes. Healthy People 2020, an updated document from 2000 that outlines the goals for achieving health in this country, is a mandate for health care professionals to follow with 467 objectives in 28 focus areas. Maslow's hierarchy of human needs provides a basis for understanding individuals in context and for ranking nursing assessments, diagnoses, goals, and interventions in order of importance. Dorothea Orem's self-care requirements lists human needs, including the need for air, fluids, nutrition, hygiene, elimination, activity, comfort, relief from suffering, and skin integrity. The nurse helps individuals meet these needs to achieve optimal health and wellness.

Question and Answer A+ Guide 2024-

The nurse plans activities for older women born between 1920 and 1930 and who reside in an assisted-living facility. Which is the best intervention for the nurse to implement? a. Have them bake cookies twice a week. b. Conduct interviews for specific interests. c. Arrange dog and cat visits from volunteers. d. Take them to the library for guest speakers. - correct answer ✅✅ ANS: B The nurse conducts individual interviews with the women to determine their interests and to avoid generalizing; as people live longer, they become more and more unique. Because most of these women are in their 80s and 90s were born between 1920 and 1930 and have generally spent their lives as homemakers, the nurse presumes to know what activities they will enjoy. The nurse avoids arranging group activities until individual interests are determined. In addition, the nurse must assess for allergies and individual fears of animals before exposing an older adult to a pet visit. Unless it is organized on a voluntary basis, the nurse avoids arranging visits by guest speakers. In addition, the nurse will assess each

Question and Answer A+ Guide 2024-

older woman before an outside visit to avoid embarrassing events, including incontinence and hearing and vision problems. Which of the following issues in the care of older adults are identified in Healthy People 2020? a. Delineating nursing staffing levels in long term care b. Eradicating pressure ulcers in all care settings c. Identifying minimum levels of training for people who care for older adults d. Instituting mandatory training in identification of elder abuse for all caregivers of older adults - correct answer ✅✅ ANS: C Identifying minimum training levels for people who care for older adults is one of the issues identified in Healthy People 2020. The rest of the issues are not discussed in Healthy People 2020. An older man asks a nurse: "How do you define aging? Do I meet the criteria of a senior citizen?" The nurse understands that one can define aging in many different

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manners. If the nurse chooses to define aging as "social aging," the nurse would consider which of the following aspects? a. The man retired from his job as a police officer. b. The man takes six different medications multiple times over the course of the day. c. The man walks with a rolling walker. d. The man celebrated his 65th birthday. - correct answer ✅✅ ANS: A Social aging is determined by changes in roles. Taking multiple medications multiple times over the course of the day and walking with a rolling walker are functional determinants of aging. Age refers to chronological aging. The holistic health movement has impacted health care in which of the following ways? a. It has focused health care on disease prevention. b. It has reshaped how health and health care are perceived.

Question and Answer A+ Guide 2024-

c. It has improved access to health care. d. It has introduced numerous alternative modalities into health care. - correct answer ✅✅ ANS: B The holistic paradigm has reshaped how health and health care are perceived. Wellness is seen as a state of being which can be defined anywhere along the continuum of health. According to Healthy People 2020, older adults have been identified as a priority, with a goal to improve their health, function, and quality of life. Identify the targeted chronic focus areas for improvement. (Select all that apply.) a. Diabetes b. Arthritis c. Congestive heart failure d. Dementia e. Cancer f. Pressure ulcers - correct answer ✅✅ ANS: A, B, C, D

Question and Answer A+ Guide 2024-

In a push toward wellness, older adults were identified as a priority area for the first time. The targeted chronic areas of focus were identified as diabetes, arthritis, congestive heart failure, and dementia. Identify the Healthy People 2020 emerging issues in the health of older adults. (Select all that apply.) a. Coordinating care for the older adult population b. Assisting older adults in the management of their own care c. Identifying levels of training for those caring for older adults d. Making community resources available for older adults e. Increase in health disparities for rural older adults - correct answer ✅✅ ANS: A, B, C According to United States Department of Health and Human Services' Healthy People 2020, emerging issues in the health of older adults include coordinating care, helping older adults manage their own care, establishing quality measures, identifying minimum levels of training for people who care for older adults, and researching and

Question and Answer A+ Guide 2024-

evaluating appropriate training to equip providers with the tools they need to meet the needs of older adults. Researchers hypothesize that most super-centenarians survive and are in good health due to which of the following factors? (Select all that apply.) a. They have a different genetic makeup than other older adults have. b. They tend to live in wealthier areas of the world. c. The exact cause of this phenomenon is not known. d. Contributing factors to their good health include quality medical care and improved social conditions. e. They have large extended families to assist in their care - correct answer ✅✅ ANS: C, D The exact cause of super-centenarians' longevity is not known; researchers describe it as attributable to "rare and unpredictable reasons." Contributing factors include medical care and improved sociopolitical conditions. There is no known difference in biological or sociological factors between super-centenarians and other older adults. Super-centenarians exist all over the world.

Question and Answer A+ Guide 2024-

The nurse in an assisted living facility (ALF) is preparing a lecture on aging for the residents. The philosophy of the ALF is to approach aging from the viewpoint of health. Based on this philosophy, the nurse includes which of the following topics? (Select all that apply.) a. "The Many Chronic Illnesses of Aging" b. "Channeling Your Inner Strength Toward Wellness" c. "Maximizing Function As You Age" d. "Conserving Your Strength As You Age" e. "Keep Moving, Maintain Your Mobility" - correct answer ✅✅ ANS: B, C, D A wellness perspective is based on the belief that every person has an optimal level of wellness independent of functional ability. This viewpoint approaches aging with an emphasis on resilience, strength, resources, and capabilities rather than focusing on existing pathological conditions. Which of the following is a true statement about differing health belief systems?

Question and Answer A+ Guide 2024-

a. Personalistic or magicoreligious beliefs have been superseded in Western minds by biomedical principles. b. In most cultures, older adults are likely to treat themselves using traditional methods before turning to biomedical professionals. c. Ayurvedic medicine is another name for traditional Chinese medicine. d. The belief that health depends on maintaining a balance among opposite qualities is characteristic of a magicoreligious belief system. - correct answer ✅✅ ANS: B Older adults in most cultures usually have had experience with traditional methods that have worked as well as expected. After these treatments fail, older adults turn to the formal health care system. Even in the United States, it is common for older adults to pray for cures or wonder what they did to incur an illness as punishment. The Ayurvedic system is a naturalistic health belief system practiced in India and in some neighboring countries. This belief is characteristic of a holistic or naturalistic approach.

Question and Answer A+ Guide 2024-

Which of the following considerations is most likely to be true when working with an interpreter? a. An interpreter is never needed if the nurse speaks the same language as the patient. b. When working with interpreters, the nurse can use technical terms or metaphors. c. A patient's young granddaughter who speaks fluent English would make the best interpreter because she is familiar with and loves the patient. d. The nurse should face the patient rather than the interpreter. - correct answer ✅✅ ANS: D The nurse should face the patient rather than the interpreter is a true statement; the intent is to converse with the patient, not with a third party about the patient. Many reasons may prevent the patient from speaking directly to a nurse. Technical terms and metaphors may be difficult or impossible to translate. Cultural restrictions may prevent some topics from being spoken of to a grandparent or child. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and refuses to remain in

Question and Answer A+ Guide 2024-

the bed. Which intervention should the nurse use to promote and maintain his health? a. Have the health care provider speak to him. b. Use principles of the holistic health system. c. Ask about his perceptions and treatment ideas. d. Consult with a practitioner of Chinese medicine. - correct answer ✅✅ ANS: C Using the LEARN model (listen with sympathy to the patient's perception of the problem, explain your perception of the problem, acknowledge the differences and similarities, recommend treatment, and negotiate agreement), the nurse gathers information from the patient about cultural beliefs concerning health care and avoids stereotyping the patient. In the assessment, the nurse determines what the patient believes about caregiving, decision making, treatment, and other pertinent health-related information. Speaking with the health care provider is premature until the assessment is complete. Unless he accepts the beliefs, principles of the holistic health system can be potentially unsuitable and insulting for this patient. Unless he accepts the treatments, consulting with a practitioner of Chinese

Question and Answer A+ Guide 2024-

medicine can also be unsuitable and insulting for this patient. Which action should the nurse take when addressing older adults? a. Speak in an exaggerated pitch. b. Use a lower quality of speech. c. Use endearing terms such as "honey." d. Speak clearly. - correct answer ✅✅ ANS: D Some health professionals demonstrate ageism, in part because providers tend to see many frail, older persons and fewer of those who are healthy and active. Providers should not assume that all older adults are hearing or mentally impaired. The most appropriate action when addressing an older adult would be to speak clearly. Examples of unintentional ageism in language are an exaggerated pitch, a demeaning emotional tone, and a lower quality of speech. The nurse prepares an older woman, who is Polish, for discharge through an interpreter and notes that she

Question and Answer A+ Guide 2024-

becomes tense during the instructions about elimination. Which intervention should the nurse implement? a. Move on to the discussion about medication. b. Ask the older woman how she feels about this topic. c. Instruct the interpreter to repeat the instructions. d. Have the older woman repeat the instructions for clarity. - correct answer ✅✅ ANS: B When working with an interpreter, the nurse closely watches the older adult for nonverbal communication and emotion regarding a specific topic and therefore validates the assessment about the older adult's tension before proceeding. Because the nurse notices her tension, the nurse temporarily suspends the preparation to validate her assessment. If the nurse proceeds and the older adult is uncomfortable discussing elimination, then important instructions can be missed, leading to adverse effects for the older adult. Repeating the instructions can aggravate the older adult's discomfort. Instructing the older adult to repeat the nurse's instruction ignores her needs.

Question and Answer A+ Guide 2024-

The nurse plans care for an older African American man who is from Jamaica and resides in New York City. Which should the nurse include in planning care? a. Attribute his illness to breaking a voodoo. b. Help him improve social relationships. c. Maintain blood pressure below 120/70 mm Hg. d. Review the principles of the magicoreligious system. - correct answer ✅✅ ANS: C Because African Americans tend to be at risk for cardiovascular disease and hypertension, the nurse plans to maintain the patient's blood pressure at or below the current recommendation by the American Heart Association. The nurse can be incorrectly assuming that he practices and believes in the magicoreligious system. The nurse should assess his spiritual beliefs and determine how much they influence his attitudes toward Western health care. The magicoreligious system maintains social relationships in good condition to prevent illness; however, if the older adult does not follow this cultural practice, then this goal can be unsuitable. The older adult may not believe in this system; therefore, the information can be irrelevant.

Question and Answer A+ Guide 2024-

Which health belief system uses treatments to repair a body part? a. Holistic b. Biomedical c. Personalistic d. Magicoreligious - correct answer ✅✅ ANS: B Because dysfunction or a structural abnormality is thought to cause disease, the biomedical system believes in repairing the structural abnormality. The holistic system holds that health is attained through balance. The personalistic system uses treatments such as meditation, fasting, and praying. The magicoreligious system is the same as the personalistic system. A nurse is caring for a culturally diverse patient who has missed follow-up appointments with the primary care provider three times over the past year. The patient has a chronic illness that requires periodic monitoring of blood test values. The patient tells the nurse: "You don't understand—in my culture, we don't do things like that. I

Question and Answer A+ Guide 2024-

cannot be troubled with worrying about appointments in the future; I deal with each day as it comes." The nurse understands which of the following about the patient's culture? a. The culture does not value Western medicine. b. The culture has a different orientation to time than Western medicine. c. The culture is an interdependent culture. d. The culture does not believe in preventative care. - correct answer ✅✅ ANS: B Time orientation is a culturally constructed factor. Westernized medical care is future oriented. Conflicts between future oriented Westernized medical care and those with a present or past time orientation may arise. Patients are likely to be labeled as noncompliant for failing to keep appointments. A paper on culture and illness would be likely to include the statement that a. culture is the same as ethnicity.

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b. ethnic groups always share common geographic origin and religion. c. ethnicity involves recognized traditions, symbols, and literature. d. most members of an ethnic group exhibit identical cultural traits. - correct answer ✅✅ ANS: C Ethnicity is a complex phenomenon that includes traditions, symbols, literature, folklore, food preferences, and dress. It is a shared identity. Ethnicity is more than just culture. It is social differentiation based on culture. Even within ethnic groups, there is considerable diversity. A home care nurse is caring for an older patient from a different culture who is bedbound and high risk for development of a pressure ulcer. The nurse discusses the plan of care with the patient's daughter, emphasizing the importance of turning every 2 hours, and posts a turning clock on the wall. When the nurse returns later in the week, the turning clock has been removed, and the patient's daughter reports that she turns her mother occasionally. She states, "I am taking very good care of my mother. You just don't understand—our ways do not involve doing things on schedules." The best response by the nurse is:

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a. "You must follow my guidelines and turn her every 2 hours, or I will not be able to take care of her." b. "I understand that you value your culture, but culture cannot stop you from providing good care to your mother." c. 'I understand that you care very much for your mother. Perhaps caring for her is t - correct answer ✅✅ ANS: D In providing cross-cultural care, it is important that the nurse work with the patient and family and listen carefully and find a way to include the values and beliefs of the patient in the plan of care. An older patient learns that she has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief? a. Biomedical b. Magicoreligious c. Naturalistic d. Ayurvedic - correct answer ✅✅ ANS: B