Chapter 1: Seeing Older Adults Through the Eyes of Wellness
1. A nurse is discussing an older adult client's recent diagnosis of rheumatoid arthritis
with a colleague. Which of the nurse's statements reflects an accurate view of the
relationship between aging and wellness?
A. "We need to ensure that the client's expectations of continuing to live alone are
realistic."
B. "We need to make sure our teaching is not too detailed for a client of this age."
C. "It is important that the client knows this is an expected part of growing older."
D. "We need to teach the client to increase functional activities."
Answer: D
Rationale: Teaching the client about a need for functional activities reflects a desire to
foster a fulfilling and productive life for the older adult client despite the diagnosis and
reflects an understanding of wellness and aging. Ensuring the client's expectations of
living alone implies that illness is an inevitability of aging. Similarly, dumbing down
information for older adult clients suggests that older adults have a limited capacity to
learn by virtue of their age. Informing the client that this diagnosis is an expected part
of aging is incorrect and implies pessimism about the health and functioning of the
older adult client.
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Integrated Process: Communication and Documentation
Reference: p. 3
2. A nurse cares for an older adult client with type 1 diabetes mellitus and
scleroderma, whose current hospital admission is prompted by an exacerbation of
chronic renal failure. Which action by the nurse emphasizes the goal of client
wellness?
A. Discuss the possibility of a kidney transplant with the client.
B. Explore the client's abilities and strengths.
C. Discuss with the client that the exacerbation occurs because of lack of adherence to
diet.
D. Teach the client that health problems do not have to affect daily routines.
Answer: B
Rationale: A focus on existing strengths and abilities can foster wellness in older
adults, even when they are experiencing health challenges. It is inaccurate to claim
that health problems do not affect daily routines. It is unlikely that the client will meet
the criteria for a kidney transplant due to the age of the client as well as comorbid
factors. The nurse should not assume that the client is nonadherent to the diet and
should reinforce education rather than take an accusatory approach.
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process
Reference: p. 3
,3. An 85-year-old client takes meals on wheels around the community. The client
states, "All those old people really need me, you know how older people are. They
cannot get out and are a burden to their family, and I just want to help." Which
characterizes this scenario?
A. ageism
B. aging anxiety
C. aging attribution
D. antiaging
Answer: A
Rationale: Ageism is a way of pigeonholing people and not allowing them to be
individuals with unique ways of living their lives. The antiaging movement views aging
as a process able to be stopped and the life span as something that can be extended
for up to 200 years. Aging anxiety is having fears about detrimental effects associated
with older adulthood. Age attribution is the tendency to attribute problems to the
aging process rather than to pathologic and potentially treatable conditions.
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Understand
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process
Reference: p. 12
4. An older adult has recently displayed unprecedented lapses in short-term memory.
The nurse overhears a colleague reassuring the person by saying, "Try not to worry; it
is just a part of growing older." This is an example of which phenomenon?
A. multiple jeopardy
B. gerontophobia
C. age attribution
D. aging anxiety
Answer: C
Rationale: Age attribution is the act of attributing a problem to age rather than to a
pathology, as in the colleague's statement. Multiple jeopardy is the compounding of
discrimination based on factors such as race and gender, whereas gerontophobia is
the fear or hatred of older people. Aging anxiety is fears and excess concern about
one's future aging and detrimental effects associated with older adulthood (e.g., social
losses, financial insecurity, changes in appearance, and declines in health and
functioning).
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Integrated Process: Caring
Reference: p. 8
5. A nurse hears a colleague make the statement, "The majority of older adults have
nothing to worry about financially." Which response is most appropriate?
A. "Adults aged 85 and older are more likely to live in poverty than the younger older
adult ages, 65 through 74 years."
B. "The number of older adults living below the poverty line is increasing, not
decreasing."
,C. "This is not really true now, but it is true that the gaps that disadvantaged groups
live with are expected to shrink."
D. "This is true for some groups but not for minorities, who are less likely to be living
with their relatives."
Answer: A
Rationale: An important consideration with regard to economic conditions of older
adults is the tremendous range in financial status, which varies significantly according
to race, gender, and living arrangements. The number of adults living below the
poverty line, however, has decreased in recent years. The disparities that separate
disadvantaged groups from more economically secure older adults will persist.
Minorities are more likely, not less likely, to be living with their relatives. Adults older
than 85 years of age are more likely to live in poverty than those aged 65 to 74 years.
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Reference: p. 11
6. A nurse who provides care to many older adults identifies the importance of
implementing a wellness approach to care. Which principle underlies this approach to
the health care of older adults?
A. Older adults have decreasing expectations for wellness as they move through the
aging process.
B. There is a decreased focus on the overall health needs of the client as well as on
health prevention.
C. Most older adults are optimistic regarding the ability to improve their health and
functioning.
D. A holistic approach to caring for older adults can foster their well-being at every
stage of life.
Answer: D
Rationale: An integral part of the wellness approach to the health care of older adults
is a holistic approach to care that considers mind, body, and spirit. Health problems
are an inevitable reality, but a decrease in wellness does not necessarily accompany
the aging process. Older adults may be pessimistic or even hopeless about their ability
to improve their health and functioning and not optimistic as more comorbid factors
arise in their life. There is an increased focus on the overall health of the older adult
client.
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Understand
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process
Reference: p. 3-4
7. A diabetes educator is providing care for an older adult client who is a regular client
of the hospital's outpatient diabetes clinic. Which assessment question most clearly
addresses this client's potential for optimal function?
A. "What are some goals that you have for maximizing your level of wellness?"
B. "How can we help you to take ownership of your own health?"
C. "Is there anything that you are doing that might be exacerbating your diabetes?"
, D. "How long do you think that you will be able to live independently?"
Answer: A
Rationale: Eliciting an older adult client's goals for wellness and high functioning can
help promote these desired outcomes. Questions about a client's living situation,
disease management, and personal responsibility may or may not promote wellness.
Asking the client about taking ownership of their own health implies that the client is
not responsible and can be viewed as offensive, which will place a barrier on the
nurse–client relationship. Implying that the client is exacerbating their own illness,
indicates a lack of nurse–client trust. Asking a client how long they will be able to live
independently is irrelevant and does not add anything to the history. The client is likely
unable to answer the question.
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Integrated Process: Communication and Documentation
Reference: p. 5
8. A nurse administrator is involved in strategic planning for a large long-term care
facility that has locations in numerous regions of the country. What trend should the
nurse administrator anticipate?
A. There will be a decrease in the proportion of older adults who are members of
minority groups.
B. Residents in assisted living facilities will not require assistance with any daily
activities.
C. Clients affected by dementia will not be admitted to assisted living facilities.
D. An increasing number of older adults will reside in assisted living facilities.
Answer: D
Rationale: Assisted living facilities have become a common option for older adults; this
trend is to continue. Life expectancy is continuing to increase, with women usually
outliving men. An increasing proportion of the older adult population will be members
of minority groups. People living in assisted living facilities usually need help with
three or more daily activities. Many clients that have mild or moderate dementia may
live successfully in assisted living facilities.
Question format: Multiple Choice
Chapter 1: Seeing Older Adults Through the Eyes of Wellness
Cognitive Level: Remember
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process
Reference: p. 14
9. A nurse interviews a centenarian while gathering data for a large study. In the
interview, the centenarian says, "You re only as old as you feel; some days I feel like I
am 50." To which definition of aging does this response correspond?
A. chronologic aging
B. functional aging
C. successful aging
D. subjective aging
Answer: D
