Nokea
The nurse is caring for the hospitalized 60-year-old client of Korean American ethnicity. Which statement, if made by the client, correctly reflects the Korean American culture and should alert the nurse that intervention is needed?
- A. Since 60 is considered old age, I retired as expected. I’m now worried about insurance.'
- B. Value is on youth and beauty; so little attention is paid to problems of the elderly.'
- C. Fathers are expected to continue to contribute financially even for their adult children.'
- D. Grandchildren are raised by the grandparents until school age, so we have a full house.'
Correct Answer: A
Rationale: In Korean American culture, 60 is considered old age, and retirement is expected, but this client’s concern about insurance requires a social worker consult for coverage options. Other statements reflect different cultural norms or lack specific cultural ties.
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The nurse assesses the 75-year-old client and concludes that some findings are not age-related changes and require further follow-up. Which report by the client represents a non-age-related finding that requires additional investigation?
- A. Reports a decreased ability to see at night
- B. Reports seeing halos around lights
- C. Reports difficulty distinguishing some colors
- D. Reports diminished visual acuity
Correct Answer: B
Rationale: Seeing halos is a symptom of glaucoma, not an age-related change, requiring investigation. Night vision, color distinction, and acuity changes are normal with aging.
The nurse is admitting the older adult client to a nursing home. Which is the nurse’s best approach when obtaining information during the admission interview?
- A. Direct questions to the family member accompanying the client
- B. Speak clearly and slowly to the client using high-pitched vocal tones
- C. Take the client and family members to a private room without distractions
- D. Speak to the client loudly about familiar topics before asking questions
Correct Answer: C
Rationale: A private, distraction-free room respects confidentiality and aids focus. Directing questions to family, high-pitched tones, or loud familiar topics are inappropriate.
The nurse is teaching a group of middle-aged female nurses about middle-aged moral development applicable only to women. Which point should the nurse most specifically address?
- A. Gilligan’s moral development theory includes responsibility and caring for self and others
- B. Kohlberg’s moral development theory includes living according to universally agreed-upon principles
- C. Westerhoff’s stages of faith include putting faith into personal and social action and standing up for beliefs
- D. Fowler’s stages of spiritual development include becoming aware of truth from a variety of viewpoints
Correct Answer: A
Rationale: Gilligan’s theory, specific to women, emphasizes morality as integrity in relationships and caring for others and self, unlike Kohlberg’s justice-based theory. Westerhoff and Fowler address spiritual, not moral, development.
The nurse is caring for the chronically ill middle-aged adult who has had numerous hospitalizations. Which behaviors may interfere with the client’s achievement of the developmental task associated with middle adulthood? Select all that apply.
- A. Writes thank-you notes to friends
- B. Stays at home and refuses visitors
- C. Self-absorbed in own psychological needs
- D. Attempts to perform own personal cares
- E. Continually relays feelings of inadequacy
Correct Answer: B;C;E
Rationale: Staying home, self-absorption, and feelings of inadequacy interfere with maintaining social relationships and generativity. Thank-you notes and self-care support generativity.
The 62-year-old client is diagnosed with osteoporosis. Which medication, if taken by the client, should the nurse identify as posing a secondary risk factor for the client’s osteoporosis?
- A. Baby aspirin daily for past 4 years
- B. Escitalopram 5 mg daily for past 7 months
- C. Multivitamin for many years
- D. 10-year use of budesonide nostril spray bid
Correct Answer: D
Rationale: Long-term corticosteroid use, like budesonide, is a risk factor for osteoporosis. Aspirin, escitalopram, and multivitamins (with calcium/vitamin D) do not contribute to bone loss.