Care of the Older Population Study Guide Question and Answers

Care of the Older Population Study Guide Question and Answers

 

 

1) The population health nurse is presenting a workshop about aging. The nurse is including information about longevity and declining endocrine and immune function. In what theory category does this information belong?

1. Psychological.
2. Biological.
3. Sociological.
4. Individualism.

Answer:  2

Explanation:  2. In general there are three categories of theories that explain how and why aging occurs. Biological theories posit that aging is a phenomenon experienced by all members of a given species, that it is a process of physical decline, that it is progressive and gradual, and that it is irreversible. Psychological theories focus on psychological changes that occur with age. Sociological theories focus on changes in roles and relationships that occur with advancing aging. Individualism is not a theory category for aging.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  19-1

 

2) The nurse is comparing and contrasting examples from the psychological and sociological theories. Which should the nurse identify as a psychological theory?

1. Error theory.
2. Mutually exclusive theory.
3. Jung’s theory.
4. Disengagement theory.

Answer:  3

Explanation:  3. Psychological theories include Jung’s theory of individualism, in which the individual’s mental focus changes from the external to the internal world, and the developmental theories. Error theories are biological theories. Theories in the sociological category tend to be mutually exclusive. Disengagement theory is a sociological theory.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  19-1

 

3) A student is developing a poster for a class presentation. The purpose of the poster is to explain aging. Part of the information on the poster demonstrates how the elderly withdraw from life as a means of making way for a younger generation in preparation for death. The theory that the student is using is:

1. Disengagement theory.
2. Erikson’s theory.
3. Programmed theory.
4. Jung’s theory.

Answer:  1

Explanation:  1. Disengagement theory proposes that individuals withdraw themselves from life as a means of making way for a younger generation in preparation for death. Erikson’s theory focuses on psychological/developmental stages. Programmed theories address longevity and declining endocrine and immune function. Jung’s theory involves individualism, in which the individual’s mental focus changes from the external to the internal world.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-1

 

4) A client is experiencing changes of aging to the musculoskeletal and nervous system. What should the nurse expect to assess in this client?

1. Loss of verbal ability and increased urine flow.
2. Decreased walking speed and increase in verbal memory.
3. Decreased reaction times and declining strength.
4. Slowed reaction time and loss of skeletal muscle.

Answer:  4

Explanation:  4. A loss of skeletal muscle is a musculoskeletal system change associated with aging. Increased reaction time is a neurological system change associated with aging. Loss of verbal ability and increased verbal memory are not changes expected with aging. Urine flow change is not associated with aging.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  19-2

 

5) The population health nurse is reviewing health information for a group of community members. Which client should the nurse identify as having comorbidities?

1. The 65-year-old client and his spouse both have diabetes mellitus.
2. The 72-year-old client is taking an antihypertensive medication that interferes with his asthma.
3. The 86-year-old client is the primary caregiver for his 90-year-old spouse.
4. The 67-year-old client does not experience the usual symptoms that are associated with emphysema.

Answer:  2

Explanation:  2. Comorbidity is the coexistence of more than one chronic physical and/or mental illness in the same person at the same time. This complicates diagnosis and treatment of illness in older adults. The 72-year-old client with hypertension and asthma has comorbidities. The other clients would not be considered as having comorbidities.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  19-2

 

6) The population health nurse is assessing a 72-year-old client’s ability to perform the basic activities of daily living (BADLs). For which activities is the nurse assessing? (Select all that apply.)

1. Walk at least 12 steps.
2. Dress oneself.
3. Bathe oneself.
4. Feed oneself.
5. Use the telephone.

Answer:  2, 3, 4

Explanation:  2. Basic activities of daily living are personal care activities and include the ability to feed, bathe, and dress oneself, plus toileting and transfer skills (getting in or out of a chair or bed). Use of the telephone is an intermediate of instrumental activity of daily living. Walking at least 12 steps is not a basic activity of daily living.

3. Basic activities of daily living are personal care activities and include the ability to feed, bathe, and dress oneself, plus toileting and transfer skills (getting in or out of a chair or bed). Use of the telephone is an intermediate of instrumental activity of daily living. Walking at least 12 steps is not a basic activity of daily living.
4. Basic activities of daily living are personal care activities and include the ability to feed, bathe, and dress oneself, plus toileting and transfer skills (getting in or out of a chair or bed). Use of the telephone is an intermediate of instrumental activity of daily living. Walking at least 12 steps is not a basic activity of daily living.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  19-2

 

7) The intervention that would be most appropriate for the client with functional incontinence would be to encourage the client:

1. To empty the bladder every two hours while awake.
2. Not to drink any liquids after 5:00 p.m. each evening.
3. To call for assistance when the urge to urinate is felt.
4. To wear an adult-type diaper during the daytime hours.

Answer:  3

Explanation:  3. Functional incontinence is the inability to reach the toilet in time due to impaired mobility or decreased manual dexterity in undressing. The most appropriate intervention would be to encourage the client to call for assistance when the urge to urinate is felt. Emptying the bladder every 2 hours while awake, restricting fluids after 5 p.m., and wearing an adult-type diaper during the daytime hours would not help with functional incontinence.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  19-2

 

8) The population health nurse is preparing a presentation on healthy aging for a community group. During this presentation the nurse should explain that the reason health promotion is important for this population is because they are the:

1. Group that has more acute illness.
2. Fastest-growing segment of the population.
3. Most politically involved group of the population.
4. Group that is the most health-conscious.

Answer:  2

Explanation:  2. The elderly population is the fastest growing segment of the population. They exhibit the highest prevalence of chronic (not acute) illness. They are not the most politically involved or the most health-conscious.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-3

 

9) The population health nurse is planning to evaluate care provided to a group of older clients. What should the nurse include when evaluating care on an individual basis? (Select all that apply.)

1. End-of-life issues.
2. Health risks and behaviors.
3. Efforts taken to prevent health problems.
4. Analysis of progress of health restoration.
5. Effects of interventions to promote health.

Answer:  3, 4, 5

Explanation:  3. At the individual level, the population health nurse would assess the client’s health status and the effects of interventions at each level of health care (promotion, prevention, resolution, and restoration) in improving health status. End-of-life issues and health risks and behaviors are key indicators of well-being among the elderly, which were developed by the Federal Interagency Forum on Aging-Related Statistics.

4. At the individual level, the population health nurse would assess the client’s health status and the effects of interventions at each level of health care (promotion, prevention, resolution, and restoration) in improving health status. End-of-life issues and health risks and behaviors are key indicators of well-being among the elderly, which were developed by the Federal Interagency Forum on Aging-Related Statistics.
5. At the individual level, the population health nurse would assess the client’s health status and the effects of interventions at each level of health care (promotion, prevention, resolution, and restoration) in improving health status. End-of-life issues and health risks and behaviors are key indicators of well-being among the elderly, which were developed by the Federal Interagency Forum on Aging-Related Statistics.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-8

 

10) The population health nurse is advocating for a screening service for older adults. Which type of activity is the nurse supporting for this population?

1. Health promotion.
2. Illness and injury prevention.
3. Problem resolution.
4. Health restoration.

Answer:  2

Explanation:  2. Illness and injury prevention with older adults includes screening for disease. Health promotion identifies ways to improve health. Resolution of existing health problems in the older population involves diagnosis and treatment of disease. Health restoration activities for older clients include restoring health and functional status as much as possible and providing palliative and end-of-life care.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-4

 

11) The population health nurse is talking with a 78-year-old client who has chronic obstructive pulmonary disorder (COPD) and has described excessive use of cough medicine. The nurse should teach the client that this excessive use can make him more susceptible to respiratory infections by:

1. Decreasing clearance of secretions.
2. Decreasing his immunity.
3. Causing less fluid intake.
4. Decreasing nutritional intake.

Answer:  1

Explanation:  1. Population health nurses can suggest that the client with COPD refrain from excessive use of cough medicines because they decrease clearance of secretions and make clients more susceptible to respiratory infection. The excessive use will not affect his immunity, cause less fluid intake, or cause a decrease in his nutritional intake.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-5

 

12) The population health nurse is identifying health restoration activities for a group of older community members. Which areas should the nurse identify as being appropriate for this population? (Select all that apply.)

1. Minimizing the use of medications.
2. Palliative care.
3. End-of-life care.
4. Attaining maximum function.
5. Providing rehabilitation.

Answer:  2, 3, 4, 5

Explanation:  2. Health restoration activities for older clients include restoring health and functional status as much as possible and providing palliative and end-of-life care. Rehabilitation is a part of health restoration activities. Minimizing the use of medications is not a health restoration activity for the older population.

3. Health restoration activities for older clients include restoring health and functional status as much as possible and providing palliative and end-of-life care. Rehabilitation is a part of health restoration activities. Minimizing the use of medications is not a health restoration activity for the older population.
4. Health restoration activities for older clients include restoring health and functional status as much as possible and providing palliative and end-of-life care. Rehabilitation is a part of health restoration activities. Minimizing the use of medications is not a health restoration activity for the older population.
5. Health restoration activities for older clients include restoring health and functional status as much as possible and providing palliative and end-of-life care. Rehabilitation is a part of health restoration activities. Minimizing the use of medications is not a health restoration activity for the older population.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-6

13) The population health nurse is teaching a group of elderly clients. What action should the nurse take to circumvent hearing loss?

1. Using a higher-pitched voice.
2. Employing verbal teaching techniques.
3. Facing the listener while speaking.
4. Using background music.

Answer:  3

Explanation:  3. Strategies to circumvent hearing loss include using a lower-pitched voice; facing the listener while speaking; employing nonverbal teaching techniques; using clear, concise terminology; and having the client use a hearing aid if needed. Background noise should be limited.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-7

 

14) The population health nurse is writing a pamphlet to be used by graduate students as they plan health promotion classes for elderly clients. What should be included in the pamphlet?

1. Teaching sessions should be at least 30 minutes.
2. Teaching sessions should occur prior to a mealtime.
3. Older clients do not retain material as well as younger clients.
4. Lessons should proceed at a slower pace.

Answer:  4

Explanation:  4. Lessons should proceed at a slower pace as the elderly client is more accepting of that pace. Teaching sessions should be kept short (10 to 15 minutes) because endurance may be limited. Lessons should occur at times when learners are rested and comfortable. Older clients do retain material as well as younger clients once material is learned.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-7

 

 

15) The population health nurse is working with a 76-year-old client who has recently moved in with his daughter and her family. The most appropriate intervention to foster independence in the client would be to encourage the client to:

1. Exercise several times a week.
2. Move into an assisted living facility.
3. Purchase a cellular phone.
4. Assume specific roles within the household.

Answer:  4

Explanation:  4. When older persons are living with family members, the nurse can encourage family members to foster independence in the client. This may include encouraging them to assign specific roles within the household to the older family member. Exercise, moving into an assisted living facility, and purchasing a cellular phone are not identified as fostering independence in an older client.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  19-3