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Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019), Chapter 1-29 | All Chapters
Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019), Chapter 1-29 | All Chapters
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TEST BANKNursing for Wellness in Older Adults
Carol A. Miller
8th Edition
,Table of Contents
Chapter 01 Seeing Older Adults Through the Eyes of Wellness 1
Chapter 02 Addressing Diversity of Older Adults 8
Chapter 03 Applying a Nursing Model for Promoting Wellness in Older Adults 15
Chapter 04 Theoretical Perspectives on Aging Well 22
Chapter 05 Gerontological Nursing and Health Promotion 30
Chapter 06 Health Care Settings for Older Adults 37
Chapter 07 Assessment of Health and Functioning 44
Chapter 08 Medications and Other Bioactive Substances 51
Chapter 09 Legal and Ethical Concerns 58
Chapter 10 Elder Abuse and Neglect 66
Chapter 11 Cognitive Function 73
Chapter 12 Psychosocial Function 80
Chapter 13 Psychosocial Assessment 87
Chapter 14 Impaired Cognitive Function Delirium and Dementia 93
Chapter 15 Impaired Affective Function Depression 99
Chapter 16 Hearing 106
Chapter 17 Vision 112
Chapter 18 Digestion and Nutrition 118
Chapter 19 Urinary Function 124
Chapter 20 Cardiovascular Function 132
Chapter 21 Respiratory Function 138
Chapter 22 Mobility and Safety 144
Chapter 23 Integumentary Function 151
Chapter 24 Sleep and Rest 158
Chapter 25 Thermoregulation 164
Chapter 26 Sexual Function 170
Chapter 27 Caring for Older Adults During Illness 177
Chapter 28 Caring for Older Adults Experiencing Pain 185
Chapter 29 Caring for Older Adults at the End of Life 192
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Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019)
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
1. A nurse is discussing an older adult's recent diagnosis of rheumatoid arthritis with a
colleague. Which of the nurse's statements reflects an accurate view of the relationship
between aging and wellness?
A) "It's important that the individual knows this is an expected part of growing
older."
B) "We need to teach the older adult how he can keep living a fruitful life in spite of
his diagnosis."
C) "We need to make sure our teaching is not too detailed for someone of his age."
D) "We need to ensure his expectations of continuing to live alone are realistic."
Ans: B
Feedback:
Answer B reflects a desire to foster a fulfilling and productive life for the older adult
despite his diagnosis, and reflects an understanding of wellness and aging. Option A
implies that illness is an inevitability of aging. Option C suggests that older adults have
a limited capacity to learn by virtue of their age, and option D implies pessimism about
the health and functioning of the older adult.
2. A nurse is teaching an older person about the concept of successful aging. Which of the
nurse's questions addresses an important contributor to successful aging?
A) "Are you largely free of acute or chronic illnesses?"
B) "Do you feel financially secure?"
C) "Do you feel like you actively engage with life?"
D) "Do you have a reliable support network?"
Ans: C
Feedback:
Research has indicated that an active engagement with life is central to successful and
healthy aging. Absence of illness, financial security, and the nature of a person's
support network are not identified components of successful aging.
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Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019)
3. An older adult has recently begun to display unprecedented lapses in short-term
memory. The nurse overhears a colleague reassuring the person by saying, "Try not to
worry; it's just a part of growing older." The nurse recognizes that this is an example of
what phenomenon?
A) Multiple jeopardy
B) Gerontophobia
C) Age attribution
D) Implicit ageism
Ans: C
Feedback:
Age attribution is the act of attributing a problem to age rather than to a pathology, as in
the colleague's statement. Multiple jeopardy is the compounding of discrimination
based on factors such as race and gender, while gerontophobia is the fear or hatred of
older people. Implicit ageism is the unrecognized, negative perception of older people.
4. A nurse hears a colleague make the statement, "Most older adults have nothing to
worry about financially." Which of the following responses is most appropriate?
A) "You have to remember that there's a huge economic disparity among older
adults."
B) "Actually, the number of older people living below the poverty line has been
increasing, not decreasing."
C) "This isn't really true now, but it is true that the gaps that disadvantaged groups
live with are expected to shrink."
D) "This is true for some groups, but not for minorities who are less likely to be
living with their relatives."
Ans: A
Feedback:
An important consideration with regard to economic conditions of older adults is the
tremendous range in financial status, which varies significantly according to race,
gender, and living arrangements. The number of adults living below the poverty line,
however, has decreased in recent years. The disparities that separate disadvantaged
groups from more economically secure older adults are predicted to persist. Minorities
are more likely, not less likely, to be living with their relatives.
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Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019)
5. A nurse is conducting a study on the needs and living situations of older adults in the
community. Which of the following statements should the nurse take into account?
A) A majority of older Americans will live in a nursing home at some point.
B) More older men live alone than older women.
C) Assisted living arrangements have become increasingly common.
D) Most older Americans reside in some form of institutional arrangement.
Ans: C
Feedback:
Assisted living arrangements have become an increasingly common alternative to
nursing homes. The number of Americans living in nursing homes has recently
decreased, not increased, and more older women live alone than do older men. Ninety
percent of older Americans live in an apartment or house, rather than in an institutional
arrangement.
6. A nurse who provides care to many older adults recognizes the importance of
implementing a wellness approach to care. What principle underlies this approach to
the health care of older adults?
A) Older adults have decreasing expectations for wellness as they move through the
aging process.
B) Health problems are a Western cultural construct that has no objective,
physiologic basis.
C) Older adults must come to accept a decline in wellness as they age.
D) A holistic approach to caring for older adults can foster their well-being at every
stage of life.
Ans: D
Feedback:
An integral part of the wellness approach to the health care of older adults is a holistic
approach to care that considers mind, body, and spirit. Health problems are an
inevitable reality but a decrease in wellness does not necessarily accompany the aging
process.
7. A diabetes nurse is providing care for a 73-year-old client who is a regular client of the
hospital's out-client diabetes clinic. What assessment question most clearly addresses
this client's potential for optimal function?
A) "What are some goals that you have for maximizing your level of wellness?"
B) "How can we help you to take ownership of your own health?"
C) "Is there anything that you're doing that might be exacerbating your diabetes?"
D) "How long do you think that you'll be able to live independently?"
Ans: A
Feedback:
Eliciting an older adult's goals for wellness and high functioning can help promote
these outcomes. Questions about a client's living situation, disease management, and
personal responsibility may or may not promote wellness.
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Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019)
8. A nurse cares for an 81-year-old client whose current hospital admission has been
prompted by an exacerbation of chronic renal failure. Which of the following actions
by the nurse will best emphasize the goal of client wellness?
A) Ask for the client's code status be changed to "do not resuscitate."
B) Explore the client's abilities and strengths.
C) Show the client others who are more ill.
D) Teach the client that health problems do not have to affect daily routines.
Ans: B
Feedback:
A focus on existing strengths and abilities can foster wellness in older adults, even
when they are experiencing health challenges. It is inappropriate to actively compare
clients with each other, and changing Mr. Say's code status is unlikely to promote
wellness, even if this is necessary. It is inaccurate to claim that health problems do not
affect daily routines.
9. A nurse administrator is involved in strategic planning for a large long-term care
facility that has locations in numerous regions of the country. What trend should the
nurse administrator anticipate?
A) A decrease in the proportion of older adults who are members of minority groups
B) A gradual decline in overall life expectancy
C) Average longevity of men exceeding that of women
D) Increased use of assisted living facilities by older adults
Ans: D
Feedback:
Assisted living facilities have become a more common option for older adults; this
trend is expected to continue. Life expectancy is continuing to increase, with women
usually outliving men. An increasing proportion of the older adult population will be
members of minority groups.
10. A nurse identifies those who are at risk for familial stress. Which of the following
persons exemplifies the sandwich generation?
A) A 50-year-old who balances the care of an 82-year-old parent and a 20-year-old
child
B) A 58-year-old whose elderly parents have been forced to live in separate care
facilities
C) A 72-year-old who deals with own health problems with the care of a grandchild
D) An 83-year-old who is the sole caregiver for the 79-year-old spouse
Ans: A
Feedback:
The increasing numbers of middle-aged adults who simultaneously juggle the demands
of caring for older and younger generations are referred to as the sandwich generation.
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Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019)
11. A nurse interviews a centenarian gathering data for a large study. In the interview, the
centenarian defines aging as not growing older, but growing wiser. Which of the
following is the best response to this definition by the nurse?
A) "Aging might make you wiser, but it does lead to eventual death."
B) "Healthy maturity is characterized by wisdom."
C) "How did you get to live to this old?"
D) "I will never make it to be 100 like you."
Ans: B
Feedback:
Healthy maturity is characterized not only by physical decline but also by wisdom. The
other responses are not therapeutic.
12. A nurse interviews a centenarian gathering data for a large study. In the interview, the
centenarian defines aging as not growing older, but growing wiser. Which of the
following is the best response to this definition by the nurse?
A) Chronologic aging
B) Functional aging
C) Perceived aging
D) Subjective aging
Ans: D
Feedback:
Subjective age describes a person's perception of his or her age. While perceived age is
other people's estimation of someone's age. Chronologic age is the length of time that
has passed since birth, and functional age is associated with whether individuals can
contribute to society and experience personal quality of life.
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Test Bank - Nursing for Wellness in Older Adults, 8th Edition (Miller, 2019)
13. An 85-year-old client takes meals on wheels around the community. The client states,
"All those old people really need me, you know how older people are. They can't get
out, and are a burden to their family, and I just want to help." Most of the people on the
client's delivery route are in their 60s. Which of the following characterizes this
scenario?
A) Ageism
B) Aging anxiety
C) Aging attribution
D) Antiaging
Ans: A
Feedback:
Ageism is a way of pigeonholing people and not allowing them to be individuals with
unique ways of living their lives. Older adults between the ages 81 and 98 held more
ageist stereotypes and reported more avoidance of older adults than younger older
adults. The antiaging movement views aging as a process that can be stopped and the
life span as something that can be extended for up to 200 years. Aging anxiety is fears
about detrimental effects associated with older adulthood. Age attribution is the
tendency to attribute problems to the aging process rather than to pathologic and
potentially treatable conditions.
14. Which of the following statements, made by a new nurse, are myths and need
correcting? (Select all that apply.)
A) "Ageism is highly influenced by stereotypes and cultural values."
B) "Ageism is more common in industrialized societies."
C) "In the United States, 20% of the older adults who need care are in a nursing
home."
D) "People consider themselves old when they are old enough to apply for
Medicare."
E) "With increased age, people become more diverse and people become less like
their age peers."
Ans: C, D
Feedback:
The realities are that between 4% and 5% of older adults live in a nursing home at any
time. Most older adults live independently, have high levels of self-reported health, and
are aging successfully. People usually feel old based on their health and function, rather
than on their chronologic age. They are diverse, even though ageism is rampant in the
United States and is influenced by cultural values.
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