NURS 315Gerontological Nursing Chapter 4
Chapter 04: Life Transitions and Story Eliopoulos: Gerontological Nursing, 9th Edition
1.1. A nurse manager at a long-term care facility is engaged in efforts to change many staff
members' inaccurate and negative views of older adults. Which of the following statements
made by staff is most clearly indicative of ageism?
A) "Older people seem to have so many more chronic health problems than younger people."
B) "Older adults' motor skills get progressively slower as they age."
C) "It's normal to expect a gradual loss of memory and intelligence with age."
D) "A lot of the physical changes that accompany aging are inevitable.": Ans:
C Feedback:
A common ageist misconception is that senility and loss of intelligence inevitably, and
normally, accompany the aging process. Older adults do have more chronic conditions
than younger adults, and motor skills become slower. Many of the physical changes that
accompany aging are considered normal and largely inevitable.
2.2. According to Erikson, the final stage of the life cycle is centered on achieving integrity
versus despair. Which of the following situations would signal to the nurse that the client in
question is at risk for disappointment and despair as characterized by Erikson?
A) An 81-year-old woman has needed to adopt a minced diet following a recent stroke.
B) A 78-year-old man has had a pacemaker implanted to address his atrial fibrillation.
C) A 90-year-old woman is grieving the recent death of her husband to whom she was
married for 66 years.
D) An 80-year-old man describes himself as "useless" since he can no longer help his
adult children with their yard and garden work.: Ans: D
Feedback:
A perceived loss of useful function often constitutes a crisis for older men and can be
associated with despair rather than integrity in Erikson's typology of the life cycle. A
change in diet, a medical intervention, and grief at the loss of a spouse are less closely
associated with this conflict.
3.3. Which of the following clients of a nurse practitioner is demonstrative of a growing trend in the
role of grandparents in contemporary American society?
A) A 70-year-old grandmother is raising her two grandchildren because their mother is in prison.
B) An 80-year-old client of the nurse is going through a divorce with her husband of
several decades.
C) A 79-year-old man laments the fact that he is estranged from his son's children.
D) A married couple in their seventies who refuse to provide free child care for their
grandchildren on a daily basis.: Ans: A
Feedback:
A growing number of grandparents have primary responsibility for the care of their
grandchildren, a fact that can often be attributed to teen pregnancy, incarceration, or
substance abuse. Divorce late in life,
,NURS 315Gerontological Nursing Chapter 4
estrangement from grandchildren, and refusal to provide care are not noted to be
phenomena.
4.4. A nurse who works on a palliative care unit has developed a strong partnership with the 77-
year-old wife of a client who has recently died of lung cancer. The woman has expressed her
fears around being a widow to the nurse. How can the nurse best respond?
A) "You will likely find that once you are remarried the grief will subside and you will move on."
B) "It's very normal to have these fears, but antidepressant medications can help
immeasurably with this difficult transition."
C) "Though it might not feel like it now, many women eventually find joy in new friendships
and freedom after the death of a spouse."
D) "It will be important, and healthy, for you to maintain roles and routines similar to before
your spouse died.": Ans: C
Feedback:
Widows often find positive consequences of their status in time, often in the form of new
relationships. Suggesting that the grief will subside after remarriage and encouraging the
woman not to change would be inappropriate, as would specific recommendations for
medication.
5.5. A primary care nurse has a long-standing relationship with a 63-year-old male client who is
poised to retire. Place the following phases of the client's likely transition in the correct
chronological order. Use all the options.
A) A euphoric period involving testing of fantasies around retirement.
B) Near phase, often accompanied by fantasy regarding the retirement role.
C) Disenchantment phase
D) Establishment of a stable and sustainable retirement role.
E) Establishment of realistic and alternative sources of satisfaction during retirement.: Ans:
B, A, C, E, D
Feedback:
The near phase of preretirement and the accompanying fantasy is often followed by a
euphoric honeymoon phase. This can be followed by a disenchanting letdown, and a
subsequent reorientation that results in eventual stability.
6.6. Nurse M is employed in an assisted living facility and is privy to many of the changes that
, NURS 315Gerontological Nursing Chapter 4
accompany the aging process. An older female resident of the facility has expressed a fear that
Chapter 04: Life Transitions and Story Eliopoulos: Gerontological Nursing, 9th Edition
1.1. A nurse manager at a long-term care facility is engaged in efforts to change many staff
members' inaccurate and negative views of older adults. Which of the following statements
made by staff is most clearly indicative of ageism?
A) "Older people seem to have so many more chronic health problems than younger people."
B) "Older adults' motor skills get progressively slower as they age."
C) "It's normal to expect a gradual loss of memory and intelligence with age."
D) "A lot of the physical changes that accompany aging are inevitable.": Ans:
C Feedback:
A common ageist misconception is that senility and loss of intelligence inevitably, and
normally, accompany the aging process. Older adults do have more chronic conditions
than younger adults, and motor skills become slower. Many of the physical changes that
accompany aging are considered normal and largely inevitable.
2.2. According to Erikson, the final stage of the life cycle is centered on achieving integrity
versus despair. Which of the following situations would signal to the nurse that the client in
question is at risk for disappointment and despair as characterized by Erikson?
A) An 81-year-old woman has needed to adopt a minced diet following a recent stroke.
B) A 78-year-old man has had a pacemaker implanted to address his atrial fibrillation.
C) A 90-year-old woman is grieving the recent death of her husband to whom she was
married for 66 years.
D) An 80-year-old man describes himself as "useless" since he can no longer help his
adult children with their yard and garden work.: Ans: D
Feedback:
A perceived loss of useful function often constitutes a crisis for older men and can be
associated with despair rather than integrity in Erikson's typology of the life cycle. A
change in diet, a medical intervention, and grief at the loss of a spouse are less closely
associated with this conflict.
3.3. Which of the following clients of a nurse practitioner is demonstrative of a growing trend in the
role of grandparents in contemporary American society?
A) A 70-year-old grandmother is raising her two grandchildren because their mother is in prison.
B) An 80-year-old client of the nurse is going through a divorce with her husband of
several decades.
C) A 79-year-old man laments the fact that he is estranged from his son's children.
D) A married couple in their seventies who refuse to provide free child care for their
grandchildren on a daily basis.: Ans: A
Feedback:
A growing number of grandparents have primary responsibility for the care of their
grandchildren, a fact that can often be attributed to teen pregnancy, incarceration, or
substance abuse. Divorce late in life,
,NURS 315Gerontological Nursing Chapter 4
estrangement from grandchildren, and refusal to provide care are not noted to be
phenomena.
4.4. A nurse who works on a palliative care unit has developed a strong partnership with the 77-
year-old wife of a client who has recently died of lung cancer. The woman has expressed her
fears around being a widow to the nurse. How can the nurse best respond?
A) "You will likely find that once you are remarried the grief will subside and you will move on."
B) "It's very normal to have these fears, but antidepressant medications can help
immeasurably with this difficult transition."
C) "Though it might not feel like it now, many women eventually find joy in new friendships
and freedom after the death of a spouse."
D) "It will be important, and healthy, for you to maintain roles and routines similar to before
your spouse died.": Ans: C
Feedback:
Widows often find positive consequences of their status in time, often in the form of new
relationships. Suggesting that the grief will subside after remarriage and encouraging the
woman not to change would be inappropriate, as would specific recommendations for
medication.
5.5. A primary care nurse has a long-standing relationship with a 63-year-old male client who is
poised to retire. Place the following phases of the client's likely transition in the correct
chronological order. Use all the options.
A) A euphoric period involving testing of fantasies around retirement.
B) Near phase, often accompanied by fantasy regarding the retirement role.
C) Disenchantment phase
D) Establishment of a stable and sustainable retirement role.
E) Establishment of realistic and alternative sources of satisfaction during retirement.: Ans:
B, A, C, E, D
Feedback:
The near phase of preretirement and the accompanying fantasy is often followed by a
euphoric honeymoon phase. This can be followed by a disenchanting letdown, and a
subsequent reorientation that results in eventual stability.
6.6. Nurse M is employed in an assisted living facility and is privy to many of the changes that
, NURS 315Gerontological Nursing Chapter 4
accompany the aging process. An older female resident of the facility has expressed a fear that
