CHAPTER 18: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 18: Human Development Young Adult Through Older Adult Multiple Choice Questions 1. Which theory of aging proposes that body cells become damaged over time from years of use, leading to impaired organ function? A. Cross-linking theory B. Wear-and-tear theory C. Gould's theory on adult development D. Senescence theory Answer: B Explanation: The wear-and-tear theory posits that cellular damage accumulates over time due to metabolic processes and environmental stressors, resulting in organ system decline. This contrasts with cross-linking theory (cellular hardening) and Gould's psychosocial theory. Why Other Options Are Wrong: A is incorrect because cross-linking theory focuses on cellular hardening, not cumulative damage. C is incorrect as Gould's theory addresses psychosocial tasks, not physical aging. D is incorrect because senescence describes biological aging, not a specific theory. 2. A 37-year-old patient reports satisfaction with his family and career. Which developmental task has he achieved according to Gould's theory? A. Moving out of his parents' home B. Reminiscing about past accomplishments C. Questioning life choices D. Establishing stability in midlife Answer: D Explanation: Gould's midlife stage (35–43 years) involves achieving stability in career and relationships after earlier phases of questioning (28–34 years) or leaving parental dependence (18–27 years). Why Other Options Are Wrong: A aligns with early adulthood (18–27 years). B reflects older adulthood. C characterizes the 28–34-year phase. 3. What is the primary barrier to implementing health screenings for young adults? A. Lack of screening tool appropriateness B. Infrequent health provider visits C. Irrelevance of education due to risky behaviors D. Time constraints Answer: B Explanation: Young adults often neglect routine health visits due to perceived invincibility, making screenings less accessible despite their importance for early risk detection. Why Other Options Are Wrong: A is incorrect because tools can be adapted for any age. C is incorrect as education is critical for high-risk behaviors. D is incorrect because time is not the main barrier. 4. Using Havighurst's theory, which question best assesses a young adult's developmental success? A. "Do you adapt tasks to new methods?" B. "Can you count backward by 7s?" C. "What career have you chosen?" D. "Do you maintain family relationships?" Answer: C Explanation: Havighurst identifies career selection as a key young-adult task, unlike cognitive tests (B) or midlife adaptations (A). Family relationships (D) are secondary to independence. Why Other Options Are Wrong: A assesses middle-aged adaptability. B tests fluid intelligence. D evaluates emotional independence, not career achievement. 5. How should a nurse confirm sarcopenia in an older adult? A. Administer a cognitive exam B. Test muscle strength C. Assess gait and balance D. Evaluate sensory function Answer: B Explanation: Sarcopenia involves muscle mass loss, directly assessed through strength testing rather than cognitive (A), mobility (C), or sensory (D) evaluations. Why Other Options Are Wrong: A, C, and D are incorrect because they assess unrelated systems. 6. A middle-aged patient struggles with seriation tests. What is the nurse's best action? A. Document the finding B. Conduct additional fluid intelligence tests C. Screen for dementia D. Review family history Answer: B Explanation: Middle-aged adults may lack math fluency due to technology dependence; further fluid intelligence tests clarify if this is normative or pathological. Why Other Options Are Wrong: A is insufficient without follow-up. C is premature without broader deficits. D is irrelevant to isolated seriation difficulty. 7. Which question aligns with Erikson's Generativity vs. Stagnation stage for a middle aged adult? A. "Do you volunteer?" B. "Do your children visit?" C. "Do you exercise regularly?" D. "Do you enjoy reading?" Answer: A Explanation: Generativity involves contributing to society (e.g., volunteering), whereas B, C, and D focus on personal/family habits unrelated to societal engagement. Why Other Options Are Wrong: B assesses family ties, not generativity. C and D evaluate individual behaviors. 8. Where should a nurse host a stroke-risk screening to target high-risk individuals? A. Elder center B. African American church C. Rural synagogue D. Asian grocery store Answer: B Explanation: African Americans have higher stroke incidence due to hypertension prevalence, making this group a priority for screening. Why Other Options Are Wrong: A, C, and D are incorrect because they target lower-risk populations. 9. An older adult sleeps excessively. What is the nurse's priority action? A. Assess exercise habits B. Screen for depression C. Reassure the caregiver D. Request a sleep diary Answer: B Explanation: Excessive sleep may signal depression, a common but underdiagnosed condition in older adults, rather than normal aging. Why Other Options Are Wrong: A, C, and D are secondary to ruling out depression. 10. What is the priority assessment for a "sandwich generation" family caring for children and a dementia patient? A. Stress management B. Childcare arrangements C. Patient functional ability D. Health screening knowledge Answer: A Explanation: Caregiver burnout is a critical risk in multigenerational caregiving; stress relief supports family stability more than B, C, or D. Why Other Options Are Wrong: B, C, and D are important but less urgent than stress mitigation. 11. How should a nursing student approach sexuality assessment in older adults? A. Skip it due to irrelevance B. Wait for patient initiation C. Ask permission to discuss D. Include it as routine Answer: D Explanation: Sexuality is a lifelong need; nurses must routinely assess it without assuming disinterest (A), passivity (B), or hesitation (C). Why Other Options Are Wrong: A, B, and C neglect professional responsibility to address holistic needs. 12. What health instruction is most critical for older adults? A. Eat seven produce servings daily B. Sleep 8 hours nightly C. Exercise regularly D. Avoid sick individuals Answer: D Explanation: Immune decline makes infection prevention vital, outweighing diet (A), sleep (B), or exercise (C) for immediate risk reduction. Why Other Options Are Wrong: A, B, and C are important but less urgent than infection avoidance. 13. Which patient has the highest stroke risk? A. 55-year-old Caucasian with BP 148/92 B. 70-year-old African American with BP 150/100 C. 40-year-old Asian with BP 146/78 D. 74-year-old Caucasian with BP 150/82 Answer: B Explanation: African Americans face higher stroke rates, compounded by hypertension and age in this patient. Why Other Options Are Wrong: A, C, and D have lower-risk demographics or blood pressures. 14. At what age do age-related functional declines typically begin? A. 20 B. 30 C. 50 D. 70 Answer: B Explanation: Physiological peaks occur before age 30, with gradual declines in muscle mass, metabolism, and sensory acuity thereafter. Why Other Options Are Wrong: A is too early; C and D are too late for initial decline. 15. How should a nurse justify health screenings to a young adult? A. "Your choices now affect future health." B. "Screenings are free and informative." C. "Wouldn’t you want to know if sick?" D. "You can change habits if needed." Answer: A Explanation: Early lifestyle impacts long-term outcomes, making this the most compelling rationale over cost (B), fear (C), or habit change (D). Why Other Options Are Wrong: B, C, and D are less persuasive than emphasizing lifelong health. 16. A young adult switches from cigarettes to e-cigarettes. What is the nurse's best response? A. "E-cigarettes are much healthier." B. "Their long-term effects are unknown." C. "They’re worse than tobacco." D. "Quit all nicotine products." Answer: B Explanation: Evidence on e-cigarette safety is incomplete; the nurse should educate without endorsing (A) or exaggerating risks (C). Abstinence (D) is ideal but not the immediate focus. Why Other Options Are Wrong: A and C make unproven claims. D is unrealistic without context. 17. An older adult overuses salt due to taste loss. What intervention is best? A. Teach hypertension risks B. Ask why she uses salt C. Suggest reducing salt D. Explore alternative seasonings Answer: D Explanation: Offering flavor substitutes addresses the root cause (taste loss) without criticism (B) or oversimplification (C). Hypertension education (A) is secondary. Why Other Options Are Wrong: A, B, and C fail to solve the sensory impairment driving salt use. 18. How should a nurse assist a caregiver of a dementia patient who cannot be left alone? A. Refer to social work B. Recommend nursing home C. Mention dementia medications D. Discuss adult day care Answer: D Explanation: Day care provides supervision while preserving independence, unlike institutionalization (B) or passive referrals (A). Medications (C) don’t address safety. Why Other Options Are Wrong: A, B, and C are less supportive of caregiver and patient needs. 19. An older adult has sudden aggression and panic. After ruling out infection, what should the nurse assess next? A. Mental illness B. Cognitive function C. Delirium risk factors D. Drug use Answer: D Explanation: Drug abuse can mimic psychiatric symptoms; this assessment prioritizes reversible causes over chronic conditions (A, B) or delirium (C). Why Other Options Are Wrong: A, B, and C are less likely than substance use to cause acute behavioral changes. MULTIPLE RESPONSE QUESTIONS 1. Which statements characterize young adults? (Select all that apply.) A. Declining college enrollment B. Over 88% high school completion C. More married males aged 20–24 D. 9% hold advanced degrees E. Diverse adult roles Answer: B, E Explanation: Most young adults complete high school (B), and their roles vary widely (E). College attendance is rising (A), more females marry young (C), and few have advanced degrees (D). Why Other Options Are Wrong: A and C are factually incorrect. D is true but not a defining characteristic. 2. Which topics are priorities for young adult health education? (Select all that apply.) A. STIs B. Falls C. Alcohol use D. Intimate partner violence E. Distracted driving Answer: A, C, D, E Explanation: STIs, alcohol, violence, and driving risks are prevalent in this group. Fall prevention (B) targets older adults. Why Other Options Are Wrong: B is irrelevant to young adults’ primary risks. 3. Which conditions should nurses prioritize in middle-aged adults? (Select all that apply.) A. Heart disease B. Cancer C. STIs D. Stroke E. Functional decline Answer: A, B, D Explanation: Cardiovascular disease and cancer are leading middle-aged risks. STIs (C) are more relevant to younger adults, and functional decline (E) to older adults. Why Other Options Are Wrong: C and E are less critical for this age group. 4. Which conditions are linked to free radicals? (Select all that apply.) A. Cancer B. Cataracts C. Glaucoma D. Arthritis E. Liver disease Answer: A, B, D Explanation: Free radicals contribute to cancer, cataracts, and arthritis but not glaucoma (C) or liver disease (E). Why Other Options Are Wrong: C and E lack evidence of free radical involvement. 5. What enhances young adults’ cognitive abilities? (Select all that apply.) A. Brain growth B. Formal education C. Job training D. Life experiences E. Career choice Answer: B, C, D Explanation: Education, training, and experiences refine cognition. Brain growth (A) plateaus by adulthood, and career choice (E) is less influential than skill development. Why Other Options Are Wrong: A and E have minimal impact on cognitive refinement. 6. Which hospitalized older adults are at highest delirium risk? (Select all that apply.) A. Age 95 B. On multiple pain medications C. Blind D. Postoperative day 2 E. Severe pain Answer: A, B, D, E Explanation: Advanced age, polypharmacy, surgery, and pain increase delirium risk. Blindness (C) does not. Why Other Options Are Wrong: C is unrelated to delirium etiology.