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The student nurse is discussing with the experienced nurse Lawrence Kohlberg’s theory of moral development pertaining to middle-aged adults. Which statement should the experienced nurse correct?
- A. Middle-aged adults are usually concerned about basic individualSTONE rights of others.'
- B. Middle-aged adults attempt to understand the values and beliefs of others.'
- C. Middle-aged adults are focused on their careers and are less concerned about morals.'
- D. Middle-aged adults use their own chosen ethical principles when making moral decisions.'
Correct Answer: C
Rationale: Kohlberg’s theory places middle-aged adults at stages 5 or 6, involving concern for individual rights, understanding others’ values, and using ethical principles, not career focus with reduced moral concern, which the experienced nurse should correct.
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During a nursing home visit, the son notices multiple healing bruises on his father’s arms and legs and calls a friend who is a nurse. Which initial recommendations should the nurse provide to the son? Select all that apply.
- A. Ask your father how the bruises occurred and whether he was abused.'
- B. Contact Adult Protective Services immediately to report the abuse.'
- C. Verify with the nursing staff whether your father is on anticoagulants.'
- D. Inform the agency’s nursing supervisor that your father is being abused.'
- E. Contact the state ombudsman who can help you make an anonymous report.'
Correct Answer: A;C
Rationale: Asking about bruise causes and checking for anticoagulants (which cause bruising) are initial steps. Reporting abuse or contacting authorities requires more evidence.
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 assessing the 88-year-old client. Which finding should the nurse associate with the normal aging process?
- A. Arm muscle strength 4 on a 0 to 5 scale
- B. Multiple fractures to the thoracic spine
- C. Ulnar deviation of the left hand fingers
- D. Slight pain in the right and left heel
Correct Answer: A
Rationale: Muscle strength of 4/5 is normal with aging. Fractures, ulnar deviation (rheumatoid arthritis), and heel pain (bone spurs) are not normal aging changes.
The nurse is assessing the older adult. Which tool should the nurse select to identify the client’s needs and care deficits?
- A. Katz Index of Activities of Daily Living
- B. Maslow’s Hierarchy of Needs
- C. Mini Mental State Exam (MMSE)
- D. Erikson’s Developmental Tasks
Correct Answer: A
Rationale: The Katz Index assesses functional ability in daily activities, identifying care deficits. Maslow’s is a general needs theory, MMSE assesses cognition, and Erikson’s is developmental.
The nurse is caring for the 87-year-old hospitalized client. The nurse should assess for which age-related changes to best protect the client from friction injury?
- A. Increased tissue vascularity
- B. Increase in subcutaneous tissue
- C. Increased rate of cellular replacement
- D. Loss of skin thickness and elasticity
Correct Answer: D
Rationale: Loss of skin thickness and elasticity increases friction injury risk due to a thinner epidermis and reduced strength. Vascularity, subcutaneous tissue, and cellular replacement decrease with aging.