Homework Lance
1. The nurse cautions a group of older adults that the greatest damage to self-worth is measuring self against:
a.
internal ideals.
b.
individual values.
c.
external standards.
d.
expressions of positive feedback.
ANS: C
The use of external standards rather than internal values is an inadequate platform for self-worth. The use of positive feedback and internal individual values supports a positive perception of self-worth.
DIF: Cognitive Level: Comprehension REF: 200 OBJ: 1
TOP: Self-Worth KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
2. The nurse is aware that a positive self-perception is largely dependent on the:
a.
ability to control life’s choices.
b.
financial success attained in life.
c.
family relationships.
d.
degree of wellness.
ANS: A
Being in control of life’s choices increases and maintains a positive self-perception.
DIF: Cognitive Level: Comprehension REF: 201 OBJ: 1
TOP: Self-Perception KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
3. The nurse recognizes that a major indicator of a positive self-image in an older adult living in a long-term care facility is:
a.
feeding self independently.
b.
maintaining urinary continence.
c.
having family visitors every week.
d.
neat grooming and wearing fresh clothing.
ANS: D
Neat grooming and care in personal appearance are cardinal indicators of a positive self-image.
DIF: Cognitive Level: Application REF: 201 OBJ: 1
TOP: Self-Image KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
4. The nurse explains that older adults often resort to cosmetic surgery to maintain the appearance of youth and self-worth because the concept of ageism has painted old age as:
a.
an inactive population of self-indulgent persons.
b.
a group that has opted to isolate themselves.
c.
physically inept and nonproductive.
d.
an antisocial but active group.
ANS: C
Ageism has defined the older adult as physically inept, nonproductive, and essentially unattractive.
DIF: Cognitive Level: Comprehension REF: 202 OBJ: 1
TOP: Ageism KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
5. The long-term care facility nurse sees evidence that the most devastating blow to the self-concept of the older adult is institutional placement because persons in a long-term care facility:
a.
are perceived as a single group.
b.
have individual needs that are not met.
c.
have lost many belongings that made up their identity.
d.
have lost social contact.
ANS: C
The losses of home, spouse, car, and independence in making choices are devastating blows to someone’s self-image, even if he or she has social contacts and individual needs are met.
DIF: Cognitive Level: Application REF: 202 OBJ: 2
TOP: Institutionalization KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
6. The nurse explains that the loss of emotional support of loved ones through death or separation makes the older adult feel:
a.
unloved and unlovable.
b.
angry with the isolation.
c.
unworthy for attention.
d.
determined to be his or her own support.
ANS: A
Without an emotional support system, the older adult comes to feel unloved and unlovable.
DIF: Cognitive Level: Analysis REF: 203 OBJ: 2
TOP: Emotional Support KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
7. The nurse explains that long-term care facility placement for the older adult usually makes the older adult feel a sense of:
a.
rejection.
b.
safety.
c.
making a fresh start.
d.
immediate assistance at hand.
ANS: A
Placement equals rejection in the minds of many older adults, even if the placement was unavoidable and necessary.
DIF: Cognitive Level: Comprehension REF: 203 OBJ: 1
TOP: Long-Term Care Facility Placement
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
8. The admission nurse at the long-term care facility suggests that to help the older adult make an easier transition to relocation, the family should:
a.
send cards or gifts instead of personal visits.
b.
visit and call often to remind the resident that she or he is cared for.
c.
limit contact for several weeks to encourage independence.
d.
communicate with the long-term facility’s staff to inquire about the resident’s well-being.
ANS: B
Frequent visits and calls by family and friends help maintain self-esteem and self-worth in the newly admitted resident.
DIF: Cognitive Level: Application REF: 203 OBJ: 2
TOP: Long-Term Care Facility Placement
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
9. The nurse takes into consideration that depression affects almost 50% of older adults who:
a.
live at home with a spouse.
b.
live alone.
c.
live in a long-term care facility.
d.
are hospitalized.
ANS: D
Studies show that 46% of older adults who are hospitalized have symptoms of depression.
DIF: Cognitive Level: Comprehension REF: 203 OBJ: 4
TOP: Depression KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
10. The nurse in a long-term care facility notes signs of depression in a resident who is ordinarily positive. The nurse suspects this new affective change is related to the initiation of a drug protocol of:
a.
erythropoietin.
b.
corticosteroids.
c.
calcium replacement.
d.
broad-spectrum antibiotics.
ANS: B
Depression can be caused by the initiation of drugs such as corticosteroids, glycosides, hormones, and antihypertensive agents.
DIF: Cognitive Level: Application REF: 203 OBJ: 2
TOP: Depression KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
11. The home health nurse instructs the family caring for an 80-year-old man to be alert for signs of depression, which include:
a.
daytime napping.
b.
agitation and irritability.
c.
constant talking.
d.
seeking the company of family members.
ANS: B
Irritability and agitation are signs of depression, as are mood swings, social withdrawal, and unwillingness to talk.
DIF: Cognitive Level: Application REF: 203 OBJ: 4
TOP: Signs of Depression KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
12. The home health nurse takes into consideration that as depression develops, the patient may begin to use excessive amounts of:
a.
antianxiety agents as a sedative.
b.
corticosteroids as a mood elevator.
c.
caffeine drinks as an energy booster.
d.
comfort foods as a morale booster.
ANS: A
Antianxiety prescription drugs, along with tobacco and alcohol, are frequently used excessively as depression increases.
DIF: Cognitive Level: Knowledge REF: 203 OBJ: 5
TOP: Depression KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
13. The nurse counseling a 75-year-old man who admits to the overuse of alcohol cautions him that alcohol has an increased effect on the older adult related to:
a.
lack of activity.
b.
altered nutritional intake.
c.
reduced kidney function.
d.
reduced lean muscle mass.
ANS: D
Reduced muscle mass decreases tolerance to alcohol, so relatively small amounts can cause alcohol toxicity.
DIF: Cognitive Level: Application REF: 203-204 OBJ: 4
TOP: Alcohol Use KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
14. The home health nurse assesses the depressed 80-year-old widow carefully for signs of substance abuse; indicators of substance abuse can easily be missed because these signs:
a.
occur only in the late evening or nighttime.
b.
are not particularly harmful to the older adult.
c.
mimic changes anticipated with the aging process.
d.
are disguised by the patient.
ANS: C
Many signs that would alert the nurse to the possibility of substance abuse can be mistaken for changes associated with aging—unsteady gait, forgetfulness, sleep disturbances, and incontinence.
DIF: Cognitive Level: Application REF: 203-204 OBJ: 3
TOP: Signs of Substance Abuse KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
15. The long-term care facility nurse is aware that the resident most at risk for suicide related to depression is the:
a.
70-year-old man with diabetes.
b.
75-year-old woman with chronic obstructive pulmonary disease.
c.
80-year-old woman with a bipolar disorder.
d.
85-year-old man with schizophrenia.
ANS: C
Persons with affective disorders are most at risk for suicide related to depression.
DIF: Cognitive Level: Analysis REF: 203 OBJ: 6
TOP: Suicide Risk KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
16. The home health nurse interviews the 70-year-old male patient about possible suicidal ideation after the patient:
a.
asks for assistance in writing a will.
b.
voices the intention to visit his brother.
c.
donates excess clothing to charity.
d.
asks the young widow next door for a dinner date.
ANS: A
Making or altering a will is an indication of suicidal ideation.
DIF: Cognitive Level: Application REF: 203 OBJ: 6
TOP: Suicidal Ideation KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
17. The pretty 70-year-old woman who had a stroke 3 months ago has a body image disturbance related to her spastic right arm and contracted fingers of the right hand. The nurse can assist the patient to improve her damaged body image by:
a.
teaching her to write with her left hand.
b.
placing articles within easy reach of her left hand.
c.
helping her select colorful scarves or accessories to cover her right arm.
d.
showing her massage techniques to increase circulation in her right arm.
ANS: C
The selection of colorful accessories to cover the arm will help with her damaged body image. Learning to write with the left hand, learning massage techniques, and being able to reach items are good nursing care but do nothing for enhancement of body image.
DIF: Cognitive Level: Analysis REF: 205 OBJ: 10
TOP: Altered Body Image KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
18. The newly admitted 80-year-old female resident who sits in her room and stares at the TV watching cartoons can be supported to maintain her self-esteem by:
a.
encouraging her to participate in self-care activities.
b.
suggesting that she change the channel to an intellectually stimulating program.
c.
giving her privacy until she becomes accustomed to the long-term care facility.
d.
arranging for a meal tray rather than having her eat in the dining room.
ANS: A
Participation in self-care activities increases self-esteem and independence and puts the resident in control of her appearance.
DIF: Cognitive Level: Application REF: 206 OBJ: 10
TOP: Support to Self-Esteem KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
19. The 75-year-old woman newly admitted to a long-term care facility seems fearful of her surroundings and is frequently tearful, saying, “I don’t know what to do!” The nurse can help allay her fear by:
a.
helping her identify and verbalize her specific fears.
b.
assuring the resident that she has nothing to be afraid of.
c.
keeping the light on in the room 24 hours a day.
d.
playing quiet music on the resident’s radio.
ANS: A
Identification of specific fears helps crystallize the resident’s concern and can help define the remedy.
DIF: Cognitive Level: Application REF: 208 OBJ: 10
TOP: Allaying Fear KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
20. The long-term facility nurse is aware that the anxious female resident can frequently be calmed by:
a.
stimulating her with group activity.
b.
sedating her to allow her to sleep.
c.
allowing time alone to control her anxiety.
d.
offering a diversion of quiet activity, such as a jigsaw puzzle.
ANS: D
Involving the anxious resident in a pleasant activity such as music therapy, conversation, or a craft can allay anxiety. Stimulation frequently adds to anxiety, and sedation does not address the need for anxiety-reducing coping skills.
DIF: Cognitive Level: Application REF: 209 OBJ: 10
TOP: Anxiety KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
21. The nurse admits a 70-year-old female to the long-term care facility. While assisting with the assessment, the nurse notes that the patient’s husband died 2 months ago and that she has pain daily in her deformed hands from rheumatoid arthritis, needs assistance to dress herself, and has become incontinent of urine. The most appropriate nursing diagnosis at this time is:
a.
risk for disturbed self-perception.
b.
powerlessness.
c.
hopelessness.
d.
risk for suicide.
e.
impaired social reaction.
ANS: A
Patients at risk for disturbed self-perception have had conditions that have resulted in changes in their body image, body function, loss, recent relocation, and chronic pain.
DIF: Cognitive Level: Comprehension REF: 202 OBJ: 9
TOP: Self-Perception KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
MULTIPLE RESPONSE
1. The nurse is aware that self-identity is formed by a person’s attitudes about her or his __________. (Select all that apply.)
a.
values
b.
ambition
c.
interaction with others
d.
high self-esteem
e.
ability to control his or her life
ANS: A, C, D, E
Ambition is not a part of self-identity.
DIF: Cognitive Level: Comprehension REF: 200 OBJ: 1
TOP: Self-Identity KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
2. To improve the self-image of the 80-year-old man who lives with his daughter due to a failing memory, the home health nurse urges that he take control of his __________. (Select all that apply.)
a.
attitude toward aging
b.
financial needs
c.
physical appearance
d.
time use
e.
relationships
ANS: A, C, D, E
Persons who take control of the many aspects of their personal lives and well-being will have a good self-image.
DIF: Cognitive Level: Comprehension REF: 201 OBJ: 10
TOP: Taking Control KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
3. To achieve Erikson’s developmental stage of integrity, the older adult must develop __________. (Select all that apply.)
a.
a positive attitude toward aging
b.
positive self-esteem
c.
a manageable degree of illness
d.
a ready support system
e.
control of all life choices
ANS: A, B, C, D
It is necessary for the older adult to have some degree of control but not complete control of life choices for the development of integrity rather than despair.
DIF: Cognitive Level: Comprehension REF: 202 OBJ: 2
TOP: Integrity KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
4. Self-concept of the older adult is influenced by the amount and degree of change experienced in his or her __________. (Select all that apply.)
a.
financial security
b.
social life
c.
physical health
d.
mobility
e.
cognitive function
ANS: A, B, C, D
Cognitive function is not directly related to a person’s self-concept.
DIF: Cognitive Level: Comprehension REF: 202 OBJ: 2
TOP: Age-Influenced Changes KEY: Nursing Process Step: N/A
MSC: NCLEX: Comprehension
5. The nurse lists indicators for the detection of substance abuse, which include __________. (Select all that apply.)
a.
urinary incontinence
b.
frequent falls
c.
unsteadiness
d.
altered sleep pattern
e.
stomach complaints
ANS: B, C, D, E
Urinary incontinence is not a sign of possible substance abuse.
DIF: Cognitive Level: Knowledge REF: 203-204 OBJ: 7
TOP: Signs of Substance Abuse KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
6. The nurse, who is aware that a sense of powerlessness is related to loss of control, can help reduce this perception by __________. (Select all that apply.)
a.
allowing the patient to make choices whenever possible
b.
assisting the patient to perform all self-care activities
c.
respecting the patient’s right to refuse treatment
d.
explaining all procedures ahead of time
e.
adapting the environment to enhance self-care
ANS: A, C, D, E
Assisting the patient in all self-care activities is going to increase the perception of powerlessness.
DIF: Cognitive Level: Comprehension REF: 210 OBJ: 10
TOP: Powerlessness KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
7. The nurse knows that a patient’s self-perception is influenced most significantly by his or her __________. (Select all that apply.)
a.
family support
b.
ethnic heritage
c.
health status
d.
financial status
e.
sense of independence
ANS: A, C, D, E
A patient’s sense of independence is the most significant aspect of self-perception.
DIF: Cognitive Level: Comprehension REF: 202 OBJ: 1
TOP: Self-Perception KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
8. The nurse notices there has been a change in the behavior of an 84-year-old home patient over the past few weeks. Methods used to assess his self-perception and self-concept include __________. (Select all that apply.)
a.
observing his physical appearance
b.
monitoring for changes in his vital signs
c.
encouraging him to verbalize his feelings
d.
observing for changes in activities
e.
participating in group activities
ANS: A, B, C, D
Patients’ self-perception is not assessed by having them participate in group activities.
DIF: Cognitive Level: Comprehension REF: 203 OBJ: 7
TOP: Self-Perception KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
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