G24

1. Which description would be most characteristic of a self-actualized individual?

A. An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children

B. A wealthy white older woman who is constantly searching for a better laxative

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.

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.

2. 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:

A. creative activities are not limited to cognitively intact elders; even individuals with dementia can benefit from creative activities.

B. individuals with dementia who have rational language skills can benefit from creative activities

C. cognitively impaired elders cannot benefit from creative activities due to altered brain processes

D. cognitively impaired elders are usually too agitated to participate in creative arts.

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.

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.

3. Which intervention best demonstrates that the nurse understands the spiritual needs of a terminally ill client?

A. Arranging care so that the client’s prayer time is not interrupted.

B. Assuming the responsibility of notifying the hospital chaplain of the client’s admission

C. Providing the client with the schedule of religious services offered in the chapel

D. Suggesting that the family attend worship services with the client whenever possible.

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.

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.

4. Which activity assures the nurse that the client's wish to, "leave a living legacy" has been accomplished?

A. Donating their body to the local teaching hospital for research purposes

B. Discussing their experiences as a World War II veteran in Europe to a reporter

C. Keeping a journal to be passed on to their great-grandchildren

D. Making a pilgrimage to a location with personal religious significance

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.

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.

5. Which statement best demonstrates an older adult's success at achieving self-actualization?

A. “My father was an alcoholic but he did love us.”

B. “I always feel safe when my son is visiting.”

C. “My heart problems are better since I had the surgery.”

D. “I’ve been elected president of my service organization again.”

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.

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.

6. What is the role of the nurse in assisting older adults with travel interests?

A. Suggesting that they travel with a seniors group

B. Addressing with arrangements to have medical care if needed during their travels

C. Providing information regarding pet care services for their beloved dog

D. Reassuring the client that their concerns about safety are unfounded

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.

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.

7. 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?

A. It is efficient and usually takes less than 5 minutes to implement.

B. It has been shown to decrease anxiety and depression

C. It improves cognitive abilities.

D. It has been known to eliminate emotional distress

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.

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.

8. 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"?

A. Introduce a sensory distraction, such as television.

B. Reassure them that this is normal phase that everyone experiences.

C. Listen and help them express their feelings about life and death.

D. Ask the doctor to order a psychiatric consult for possible depression.

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.

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.

9. Which statement best demonstrates the primary benefit of intergenerational partnering and the activities that it creates?

A. These types of activities can help establish new relationships.

B. Intergenerational activities can foster a sense of meaning and purpose.

C. Such partnering can increase the self-esteem of the younger people.

D. These activities can decrease social isolation in the older people.

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.

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.

10. 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.

A. Intergenerational activities can help all participants establish new relationships.

B. Intergenerational activities are required by state and local geriatric regulatory agencies.

C. Intergenerational activities provide the units with an opportunity to improve inter-agency cooperation.

D. Intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpose.

E. Intergenerational activities provide youngsters with an opportunity to interact with older adults.

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.

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.

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11. 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.

A. Metastatic cancer

B. Age 77

C. Moving far away from family and friends

D. Loss of a spouse

E. Chronic conditions: hypertension and arthritis

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.

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.

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1. Which description would be most characteristic of a self-actualized individual?

2.

What first name or nickname would you like us to use?

2. 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:

3. Which intervention best demonstrates that the nurse understands the spiritual needs of a terminally ill client?

4. Which activity assures the nurse that the client's wish to, "leave a living legacy" has been accomplished?

5. Which statement best demonstrates an older adult's success at achieving self-actualization?

6. What is the role of the nurse in assisting older adults with travel interests?

7. 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?

8. 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"?

9. Which statement best demonstrates the primary benefit of intergenerational partnering and the activities that it creates?

10. 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.