Nokea
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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The nurse is interviewing a family member of the hospitalized 90-year-old client to assess for common problems associated with an increased risk for falling. Which questions should the nurse ask? Select all that apply.
- A. Has your mother fallen within the past year?'
- B. Has your mother had her annual influenza vaccine?'
- C. When was the last time your mother took a pain pill?'
- D. Does your mother have any problems with urination?'
- E. Does your mother have difficulty falling asleep at night?'
Correct Answer: A;C;D;E
Rationale: Questions about past falls, pain medication, urination issues, and sleep disorders assess fall risk factors. Influenza vaccine is unrelated.
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 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 client experiencing problems sleeping. Which statements, if made by the client, indicate that the client may benefit from teaching? Select all that apply.
- A. I am so tired that I need to take a nap in the middle of the day.'
- B. My routine includes a glass of warm chocolate milk at bedtime.'
- C. I installed room-darkening shades after my doctor advised these.'
- D. I’m in my bed a lot; it is the most comfortable place in my home.'
- E. I often take my pain pill for my leg pain just before going to bed.'
Correct Answer: A;B;D
Rationale: Daytime napping, chocolate milk (caffeine), and excessive bed time disrupt sleep, indicating teaching needs. Darkening shades and pain management are appropriate.
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.