1.
Which statement best demonstrates an older adult’s success at achieving self-actualization?
Correct Answer
A. A. “My father was an alcoholic but he did love us.”
Explanation
ANS: A
Self-actualization is the highest level of human functioning according to Maslow and would be reflected in the ability to see both the good and the bad in others. Biological or physiological integrity, safety and security, and self-esteem are all part of the hierarchy of human needs but they are not the highest level of human functioning.
2.
Which description would be most characteristic of a self-actualized individual?
Correct Answer
A. A. An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children
Explanation
ANS: A
The individual described here is displaying three of the characteristics of a self-actualized individual: altruism, courage, and self-renewal. This individual displays altruism in that he is helping others by reading to the children in the neighborhood and improving their literacy. Despite being economically disadvantaged, he displays courage by conquering despair and giving of himself. He is also displaying self-renewal in that he is connected to the world around him and is giving back to it. The other scenarios listed are all incorrect because the individuals described are all focused on their own personal problems despite having fewer challenges than the economically disadvantaged older black man.
3.
What is the role of the nurse in assisting older adults with travel interests?
Correct Answer
B. B. Addressing with arrangements to have medical care if needed during their travels
Explanation
ANS: B
The role of the nurse is to assist the older person with addressing potential problems and planning ahead for contingencies that would support the individual in continuing to experience and express their passions. Addressing potential health care needs would best meet this role. The remaining options are not as powerful in achieving their goal to travel.
4.
Which intervention best demonstrates that the nurse understands the spiritual needs of a terminally ill client?
Correct Answer
A. A. Arranging care so that the client’s prayer time is not interrupted.
Explanation
ANS: A
Private time for prayer, meditation, and reflection may be needed. Nurses may neglect to explore this issue with elders because religion and spirituality may not seem a high priority. The client should be assured that religious longings and rituals are important and that opportunities will be made and respected. The nurse should never assume a client’s desire or need to see clergy or to have family accompany them to services but respond only when asked to.
5.
An elder is experiencing severe chronic pain resulting from a terminal illness. Which intervention by the nurse would be most appropriate they verbalize a desire to find “some sort of meaning to all of this”?
Correct Answer
C. C. Listen and help them express their feelings about life and death.
Explanation
ANS: C
The most appropriate intervention at this time is to listen and facilitate expressions of feelings about life and death. The patient may have the need to talk; the role of the nurse is to assist the patient to find meaning and reconciliation. By attempting to distract the client, you are negating the patient’s feelings. It is not true that “everyone experiences it;” each person’s experience is different and the patient needs to be allowed room for expression. It is within the role of the nurse to listen to the patient and assist him in expressing concerns. A psychiatric consultation is not warranted at this time.
6.
When a terminally ill client expresses a need, “for something more to help me cope with the pain”, the nurse bases the recommendation of meditation on which principle concerning this alternative therapy?
Correct Answer
B. B. It has been shown to decrease anxiety and depression
Explanation
ANS: B
Meditation has been shown to produce calm, better health, and higher energy levels in its wake. Meditation usually lasts 20 minutes at a time. It does not cause changes in cognitive abilities nor does it eliminate emotional distress but rather helps manage it.
7.
When the daughter of a client diagnosed with moderate Alzheimer’s disease asks about the possible benefits of enrolling her mother in art classes, the nurse’s response is based on the knowledge that:
Correct Answer
A. A. creative activities are not limited to cognitively intact elders; even individuals with dementia can benefit from creative activities.
Explanation
ANS: A
Creative arts offer great value to individuals with dementia; the arts offer opportunities for individuals to express themselves and their vision of the world. Language skills are not required for individuals with dementia to participate in some of the arts. Individuals with dementia can benefit from creative activities. Not all individuals with dementia are agitated.
8.
Which statement best demonstrates the primary benefit of intergenerational partnering and the activities that it creates?
Correct Answer
B. B. Intergenerational activities can foster a sense of meaning and purpose.
Explanation
ANS: B
Intergenerational activities primarily focus on fostering a sense of meaning and purpose in those involved. Establishing new relationships, increasing self-esteem of younger people, and decreasing isolation in the elder are goals but will occur most often when the individual has a life with purpose and meaning.
9.
Which activity assures the nurse that the client’s wish to, “leave a living legacy” has been accomplished?
Correct Answer
A. A. Donating their body to the local teaching hospital for research purposes
Explanation
ANS: A
The purpose of a living legacy is to transcend death. Anatomical gifts are an example of a living legacy. Discussing war experiences is an example of a collective/group legacy. A written journal and a religious trip represent personal/self legacies.
10.
A 77-year-old client recently lost her husband to a chronic progressive neurological disease. She has a history of osteoarthritis and hypertension and was newly diagnosed with metastatic gastric cancer. She sold her home and moved to another state to be closer to her children, but she misses her many close friends. What makes her at risk for spiritual distress? Select all that apply.
Correct Answer(s)
A. A. Metastatic cancer
C. C. Moving far away from family and friends
D. D. Loss of a spouse
Explanation
ANS: A, C, D
Conditions that most predispose an individual to spiritual distress include those that are life threatening, such as a terminal illness, loss of interpersonal support, and those that affect the ability to participate in spiritual rituals. Metastatic cancer is a life-threatening illness and moving to another state and loss of husband result in the loss of interpersonal support. Spiritual distress is not directly associated with a specific age; that is, it is not true that the older a person is, the more spiritual distress she feels. Chronic conditions are usually not associated with spiritual distress unless they affect the ability to participate in spiritual rituals, which is not indicated in this scenario.
11.
The nurse managers of the geriatric and pediatric units arrange an intergenerational holiday party.
The rationale for arranging such a partnering is based on which principle? Select all that apply.
Correct Answer(s)
A. A. Intergenerational activities can help all participants establish new relationships.
D. D. Intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpose.
E. E. Intergenerational activities provide youngsters with an opportunity to interact with older adults.
Explanation
ANS: A, D, E
Intergenerational activities are not required by any regulatory agency nor is their purpose to foster inter-agency cooperation. The benefits are those that are client/individual based such as those identified in the correct options.