Promoting Health in Young and Middle-Aged Adults (22)

Question 1

Because a 45-year-old woman is worried that she still has regular menstrual periods, she asks about menopause. Which answer by the nurse is most appropriate?

1. ) “Regular menses in a 45-year-old woman should be promptly evaluated by a gynecologist.”
2. ) “Although you continue to have menstrual periods, you are unlikely to become pregnant.”
3. ) “It is common for women to experience menopause in their late 40s.”
4. ) “Many women dread menopause because it is an unpleasant experience.”

Answer 1

3.) “It is common for women to experience menopause in their late 40s.”

The average age for the onset of menopause in American women is 47 years. Therefore, there is nothing abnormal about ongoing menses in a 45-year-old woman, and gynecologic care is not warranted (option 1). As a woman nears menopause, ovulation may become irregular and difficult to predict. Conception remains a possibility, and the lack of predictable ovulation may actually increase the likelihood of unintended pregnancy (option 2). Many women have no negative symptoms of menopause, and the experience of meno- pause is highly culturally determined (option 4).

Question 2

A nurse is planning a teaching session on a wellness topic. Which adult generation group would be most likely to be skeptical about health teaching by the nurse?

1. ) Baby boomer
2. ) Generation X
3. ) Generation Y
4. ) Millennial

Answer 2

2.) Generation X

Generation X is characterized by both skepticism and resentment of people in authority (such as a nurse). Baby boomers tend to be interested in improving themselves, and health teaching may be viewed as self-improvement (option 1). Generation Y and Millennials are the same cohort, and are most likely to receive their health information from technologic sources, such as the Internet (options 3 and 4).

Question 3

A woman is seen at her primary care provider’s office. She has been losing weight and not feeling well. She is 44 years old. What is the leading cancer death in female clients between the ages of 25 and 64?

1. Breast cancer
2. Lymphoma
3. Lung cancer
4. Colon cancer

Answer 3

3. Lung cancer

Lung cancer is the most common cause of cancer death in women age 24 to 65 years. Breast cancer is common, but deaths related to breast cancer have declined. Lymphoma and colon cancer are significant diseases for both men and women (options 2, 3, and 4).

Question 4

The nurse is planning an educational program on sexually transmitted infections (STIs) for young adults. Which topic should be given priority?

1. ) Syphilis
2. ) HIV
3. ) Gonorrhea
4. ) Chlamydia

Answer 4

4.) Chlamydia

Although HIV and syphilis may have more disastrous health effects, chlamydia is the most prevalent infectious disease in the United States. Gonorrhea is still common, and its prevalence may vary geographically, but chlamydia is more common and therefore the most likely contracted STI (option 3).

Question 5

Which statement about moral development in adults is the most correct?

1. ) Moral development is completed during adolescence.
2. ) Moral development continues throughout adulthood.
3. ) Moral development is highly individualized.
4. ) Moral development correlates to spiritual development.

Answer 5

2.) Moral development continues throughout adulthood.

Kohlberg’s initial work indicated that moral de- velopment was completed by adulthood, but more recent research has demonstrated that moral development continues throughout adulthood. Moral development refers to a decision-making process of right and wrong, and proceeds in a series of predictable stages (option 3). Moral development and spirituality are unrelated, and represent very different spheres of human thought and behavior (option 4).

Question 6

If the nurse were assessing the status of a middle-aged client’s psychosocial development, which activity should be the focus?

1. ) Selecting a life partner
2. ) Balancing the needs of others
3. ) Reviewing one’s life course
4. ) Establishing a sense of self

Answer 6

2.) Balancing the needs of others

The middle-aged person is generally attempting to relate to adult children and grandchildren as well as assisting aging parents. Hence, continuous efforts to meet the needs of others occur. Selecting a life partner is the developmental task for young adults. Reviewing one’s life course is the task for older adulthood (option 3). Establishing a sense of self is usually achieved during adolescence (option 4).

Question 7

The nurse is developing a health promotion teaching plan for a community group of middle-aged adults. Information about which immunizations should be included?

1. Pneumococcal, meningococcal
2. Pertussis, influenza, meningococcal
3. Influenza, pneumococcal
4. Meningococcal, pertussis

Answer 7

3. Influenza, pneumococcal

Because individuals over 50 years of age tend to have multiple chronic illnesses as well as an aging immune system, the influenza vaccine is highly recommended. Influenza can lead to serious complications in older adults. The pneumococcal vaccine protects against the most common pathogens that cause pneumonia. The vaccine must be given every 10 years. Immunization for pertussis is only appropriate in children, and meningococcal vaccine is appropriate in adolescents and young adults living in congregate housing.

Question 8

When planning a screening program for cardiovascular disease in the middle-aged adult, the nurse has limited funds and decides to address which significant elements? Select all that apply.

1. Blood pressure measurement
2. Electrocardiogram
3. Cholesterol measurement
4. Sexual performance
5. Activity level

Answer 8

1. Blood pressure measurement

2. Electrocardiogram

3. Cholesterol measurement

5. Activity level

Hypertension (elevated blood pressure) forces the heart to work harder, resulting in decreased function of the heart; the electrocardiogram assesses cardiac rhythm and rate; high cholesterol levels are directly related to a decrease in arterial size, which decreases circulation blood to the cardiac tissue; activity level (e.g., dyspnea on exertion) can indicate cardiovascular disease. While cardiac impairment may decrease sexual performance, which is important to assess, the others would have priority given the limitations for the screening program (option 4).

Question 9

A woman comes into the emergency department with multiple bruises about the face and head. The nurse suspects that IPV may be related to the injuries. What is the most appropriate action for the nurse to take at this time?

1. ) Ask the person if she is afraid of someone at home who is hurting her.
2. ) Refer the person to a shelter for battered women.
3. ) Call a social worker to assess the person for IPV.
4. ) Document the concern in the chart, but do nothing else.

Answer 9

1.) Ask the person if she is afraid of someone at home who is hurting her.

Asking the individual if she or he is afraid of someone at home, or if someone hurt her or him, is a critical step in a comprehensive assessment. Intimate partner violence is a serious problem for women and men of all ages, cultures, and socioeconomic levels. The nurse should suspect it in people whose injuries are not consistent with the history they give. Referring the individual to a shelter without completing a thorough assessment may lead to inappropriate care (option 2); the nursing process requires assessment before intervention. Collaboration with other health care professionals may be very helpful but an assessment needs to be done first (option 3). Documentation of the assessment does not directly address, reduce, nor solve the concern (option 4).

Question 10

The nurse is completing a health history on a 24-year-old male. Which activity is the best indicator of appropriate psychosocial development?

1. ) Creating a scrapbook of his life experiences
2. ) Joining the board of directors for three charities
3. ) Decorating his new apartment
4. ) Attending seminars on choosing a career

Answer 10

3.) Decorating his new apartment

Each of these activities indicates achievement of a developmental task, but the nurse must know which task is appropriate for the client’s chronological age. Obtaining and decorating a place to live is an activity that establishes independence from parents, a task for young adults. Creating a scrapbook is an important strategy to enhance ego integrity, a developmental task for older adults (option 1). Working with philanthropic groups is a hallmark of generativity, a developmental task for those in midlife (option 2). Considering career paths is more appropriate to the identity task of adolescence (option 4).