Chapter 02: Theories Related to Care of the lder
Adult Meiner: Gerontologic Nursing, 6th Edition
MULTIPLE CHOICE
1. The practitioner who believes in the free radical theory of aging is likely to recommend
that the older adults
a. avoid excessive intake of zinc or magnesium.
b. supplement his or her diet with vitamins C and E.
c. increase intake of complex carbohydrates.
d. avoid the use of alcohol or tobacco.
ANS: B
Vitamins C and E are two naturally occurring antioxidants that appear to inhibit the
functioning of the free radicals or possibly decrease their production in the body. The free
radical theory of aging is not related to zinc, magnesium, carbohydrates, or alcohol and
tobacco.
DIF: Applying OBJ: 2-5 TOP: Nursing Process:Planning
MSC: Health Promotion and Maintenance
2. To provide effective care to the older adult, the nurse must understand which of
the following?
a. Older adults are not a homogeneous sociologic group.
b. Little variation exists in cohort groups of olderadults.
c. Health problems are much tWhWe Wsa.mTeBfoSrMsi.mWilSar age groups of older
adults.
d. Withdrawal by an older adult is a normal physiologic response to aging.
ANS: A
Older adults are not a homogenous sociological group, having four distinct cohort groups
and many individual variations within these cohorts. Nurses must take to not treat older
adults as if they were all the same. Health needs will vary among the cohorts and among
individuals. Withdrawal is not a normal part of aging and may signify depression.
DIF: Understanding OBJ: 2-2
TOP: Nursing Process: Planning MSC: Health Promotion and Maintenance
3. The nurse is using the eight stages of life theory to help an older adult patient assess the
developmental stage of personal ego differentiation. The nurse does this by assisting the
patient to do which of the following?
a. Determine feelings regarding the effects of aging on the physical being.
b. Describe feelings regarding what he or she expects the future to hold.
c. Identify aspects of work, recreation, and family life that provide self-worth and
pleasure.
d. Elaborate on feelings about the prospect of his or her personal death.
ANS: C
During the stage of ego differentiation versus work role preoccupation, the task for older
adults is to achieve identity and feelings of worth from sources other than the work role. The
onset of retirement and termination of the work role may reduce feelings of self-worth. In
contrast, a person with a well-differentiated ego, who is defined by many dimensions, can
replace the work role as the major defining source for self-esteem. Determining feelings
related to the effects of aging, future death, or what the future may hold is not part of this
theory.
DIF: Applying OBJ: 2-5 TOP: Nursing Process:
Implementation MSC: Psychosocial Integrity
4. A patient is recovering from a mild cerebral vascular accident (CVA). The home care
nurse notes that the patient is talking about updating a will and planning funeral
arrangements. Which of the following responses is most appropriate for the nurse to
make?
a. “You seem to be preoccupied with dying.”
b. “Is there anything I can do to help you?”
c. “Are you worried about dying before you get your affairs in order?”
d. “Let’s focus on how you are recovering rather than on your dying.”
ANS: B
According to Peck’s expansion of Erikson’s theory, the older adult who has successfully
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achieved ego integrity and ego transcendence accepts death with a sense of satisfaction
regarding the life led and without dwelling on its inevitability. The patient’s action reflects a
healthy transition and should be supported. Using the word “preoccupied” sounds
judgmental. Asking if the patient is worried is a yes/no question and is not likely to lead to
further conversation. Saying “Let’s focus on you how are recovering” discounts the
patient’s decisions and actions WanWdWi.s pTaBtrSonMiz.inWgS.
DIF: Applying OBJ: 2-4 TOP: Nursing Process:
Implementation MSC: Psychosocial Integrity
5. A nurse is caring for a patient whose spouse died recently from a sudden illness after 45
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years of marriage. The patient was the primary caregiver for the spouse during this
time. The patient is now depressed and withdrawn and has verbalized feelings of
uselessness. Which action by the nurse is best?
a. Encourage the patient take up a hobby that will occupy some time.
b. Explain that volunteering would be an excellent way to stay useful.
c. Assure the patient that these feelings of sadness will pass withtime.
d. Ask the patient to share some cherished memories of the spouse.
ANS: B
Volunteering will help the patient to interact with people and feel productive and valued for
the ability to help others as stated in the activity theory. A hobby does not offer the chance
to help others and may create more isolation. Assuring the patient that feelings will pass is
false reassurance and does nothing to help the patient to be proactive. Reminiscing is a
valued activity, but it is not the best choice for regaining a sense of usefulness.
DIF: Applying OBJ: 2-4 TOP: Nursing Process:
Implementation MSC: Psychosocial Integrity
6. A patient has recently been diagnosed with end-stage renal disease. The patient has cried
often throughout the day and finally confides in the nurse that “I am going home to be
with my Lord.” The nurse’s best response is
a. “There is no reason to believe the end is near.”
b. “Do you want me to call your family?”
c. “We have a wonderful chaplain if you’d like me to call him.”
d. “I think this is the time for us to pray together.”
ANS: C
It is important for the nurse to acknowledge the spiritual dimension of a person and support
spiritual expression and growth while addressing spirituality as a component in holistic care
without imposing upon the patient. Because the patient has made reference to the Lord, the
nurse can safely offer religion-oriented spiritual care. Telling the patient there is no reason
to believe that death is near does not help the patient work through emotions and is
providing false reassurance. Asking about calling the family is a yes/no question and is not
therapeutic. The nurse is assuming too much by saying it is time to pray.
DIF: Applying OBJ: 2-4 TOP: Nursing Process:
Implementation MSC: Psychosocial Integrity
7. A nurse is responsible for the care of 20 older adults in a unit of an assisted living facility.
In order to best address the needs and wants of the entire unit’s population, the nurse
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a. strictly adheres to facility policies so that all patients will be treated equally.
b. encourages specific age cohorts to gather in the dayroom because they
share similar interests.
c. has the unit vote on which television programs will be watched each evening.
d. schedules the patients’ bathWinWgWti.mTeBs aScMco.rdWiSng to their individual
preferences.
ANS: D
Older adults continue to feel valued and viewed as active members of society when allowed
to maintain a sense of control over their living environment by attention to personal choices
and rituals. Adhering strictly to policies does not allow for individualized care. Not all in the
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same age cohort will have similar interests. Voting on television programs does not ensure
each individual feels a sense of worth.
DIF: Applying OBJ: 2-5 TOP: Nursing Process:Planning
MSC: Psychosocial Integrity
8. In planning the care for an older adult patient, the nurse will best promote health
and wellness by
a. encouraging independent living and self-care.
b. scheduling regular cardiac and respiratory health screenings.
c. effectively delivering health-related educational information.
d. promoting a nutritious diet and an age-appropriate exercise routine.
ANS: C
Providing well-prepared and effectively delivered health-related educational information
will provide the best means of promoting a patient’s ability to impact his or her wellness
and general health. Increased health literacy is related to improved wellness activities. Each
of the other options is too narrow to be the most effective way to promote health and
wellness.
DIF: Applying OBJ: 2-5 TOP: Nursing Process:Planning
MSC: Health Promotion and Maintenance
9. Which theory of aging does the student learn is related to problems with DNA transcription?
a. Free radical theory
b. Limit theory
c. Cross-linkage theory
d. Wear-and-tear theory
ANS: A
The free radical theory poses that mutations in DNA/RNA transcription from the action of
free radicals lead to aging. The Limit theory states that cells are not immortal and do not
undergo unending replication. The cross-linkage theory states that normally separated
molecular structures are bound together through chemical reactions and that this interferes
with metabolic processes. The wear-and-tear theory postulates that normal activity causes
wear and tear on the body, leading to aging.
DIF: Remembering OBJ: 2-
1 TOP: Integrated Process: Teaching-Learning
MSC: Physiologic Integrity: Physiologic Adaptation
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10. According to which theory does cancer occur as a possible result of aging?
a. Free radical theory
b. Limit theory
c. Immunity theory
d. Cross-linkage theory
ANS: C
Immunosenescence is the term used in immunity theory to describe an age-related decrease
in immune functioning. According to this theory, as people age, they are more prone to
getting cancer or autoimmune diseases because of this phenomenon. The error free radical
theory poses that mutations in DNA/RNA transcription from the action of free radicals lead
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to aging. The Limit theory states that cells are not immortal and do not undergo unending
replication. The cross-linkage theory states that normally separated molecular structures are
bound together through chemical reactions and that this interferes with metabolic processes.
DIF: Remembering OBJ: 2-
1 TOP: Integrated Process: Teaching-Learning
MSC: Physiologic Integrity: Physiologic Adaptation
11. A nurse is caring for an older patient who is sedentary and does not want to participate
in any activities. What action by the nurse is best?
a. Inform the patient about the consequences of immobility.
b. Promote activity by explaining the “use it or lose it” concept.
c. Tell the patient he or she will feel better by being more active.
d. Explain the relationship of being active and being
independent. ANS: D
https://www.stuvia.com/doc/4742870/test-bank-for-gerontologic-nursing-6th-edition-by-sue
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