Chapter 01: Introduction to Healthy Aging
MULTIPLE CHOICE
1. 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.
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.
PTS: 1 DIF: Apply REF: p. 7 TOP: Nursing Process: Diagnosis MSC: Health Promotion and
Maintenance
2. 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.
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.
PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation
MSC: Health Promotion and Maintenance
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,3. 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
Chapter 02: Cross-Cultural Caring and Aging
MULTIPLE CHOICE
1. Which of the following is a true statement about differing health belief systems?
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.
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.
PTS: 1 DIF: Understand REF: p. 16-17 TOP: Nursing Process: Assessment
MSC: Health Promotion and Maintenance
2. 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.
ANS: D
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, 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.
PTS: 1 DIF: Understand REF: p. 18-19
TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment
3. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg
and refuses to remain in 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.
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 medicine can also
be unsuitable and insulting for this patient.
PTS: 1 DIF: Apply REF: p. 18
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance
4. 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.
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
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, clearly. Examples of unintentional ageism in language are an exaggerated pitch, a
demeaning emotional tone, and a lower quality of speech.
PTS: 1 DIF: Apply REF: p. 15
TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance
5. The nurse prepares an older woman, who is Polish, for discharge through an interpreter
and notes that she 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.
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.
PTS: 1 DIF: Apply REF: p. 18-19
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
6. 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.
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
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