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The nurse is caring for the middle-aged client. Which client behavior should indicate to the nurse that the client may have difficulty achieving Erikson’s developmental stage of generativity?
- A. Talks about accomplishments that made the workplace a better place
- B. Volunteers at the local nursing home reading to residents one day a week
- C. Focuses conversation on self and displays disinterest in the activities of others
- D. Shows pictures of the client’s grandchildren and the client at various sports events
Correct Answer: C
Rationale: Self-focus and disinterest in others suggest self-absorption and stagnation, indicating difficulty with generativity. Workplace accomplishments, volunteering, and involvement with grandchildren demonstrate generativity.
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The unsteady 20S-year-old client persists in ambulating to the bathroom alone despite being reminded to call for assistance. The nurse concludes that, according to Havighurst’s developmental tasks, this behavior reflects which need of the client?
- A. Adjusting to physiological changes
- B. Independence
- C. Industry
- D. Integrity
Correct Answer: B
Rationale: The client is attempting to perform self-care and to demonstrate the ability to be self-sufficient and independent from other adults. Adjusting to physiological changes is a developmental task of middle age. Industry and integrity are Erikson’s tasks, not Havighurst’s, and apply to different age groups.
The nurse is evaluating the older adult client’s hydration status. Which information should the nurse include? Select all that apply.
- A. Urine color
- B. Serum blood urea nitrogen (BUN) and creatinine
- C. Serum white blood cell (WBC) and differential count
- D. Urine specific gravity
- E. 24-hour fluid intake and urine output
Correct Answer: A;B;D;E
Rationale: Urine color, BUN/creatinine, specific gravity, and 24-hour intake/output assess hydration. WBC count evaluates infection, not hydration.
The 50-year-old asks the nurse how to calculate BM]. The client weighs 134 1b and is 5’3” tall. Together, the client and nurse calculate the client’s BMI rounded to the nearest tenth. What is the client’s BMI?
Correct Answer: 23.8
Rationale: BMI = [weight (lb) / height (in)²] × 703 = [134 / (63)²] × 703 = [134 / 3969] × 703 ≈ 23.75, rounded to 23.8.
The 70-year-old client, hospitalized with chest pain, has been functioning independently at home. During the night, the client is found wandering in the hallway and states, 'I can’t find my kitchen. I need a glass of milk.' What is the nurse’s best interpretation of the client’s behavior?
- A. The client most likely had a stroke
- B. The stress of being in unfamiliar surroundings has caused the client’s confusion
- C. The decline in mental status, especially at night, is a normal part of aging
- D. This is an insidious change, and it likely means the client has early dementia
Correct Answer: B
Rationale: Stress from unfamiliar surroundings can cause confusion in older adults. No stroke symptoms are noted, mental decline isn’t normal aging, and the change is abrupt, not insidious.
The 83-year-old tells the nurse, 'I’m not taking my medication because it’s too expensive and I really don’t need it anymore.' Before responding to the client, the nurse should consider that the most common reason for older clients to discontinue their medications is which of the following?
- A. Information about the medications is insufficient
- B. Medications alter the taste of foods that they enjoy
- C. Fear they will live longer than their resources will last
- D. They want the attention from others when they are sick
Correct Answer: C
Rationale: Fear of outliving resources is a common reason older adults stop medications, reflecting financial concerns. Lack of information, taste changes, and seeking attention are less common.