Chapter 15: Problems of Adulthood Nursing School Test Banks

Chapter 15: Problems of Adulthood
Test Bank

MULTIPLE CHOICE

1. The nurse is caring for an adult male client who lacks a strong sense of personal identity. With which area of development will this client most likely struggle the most?
a. Social
b. Intellectual
c. Emotional
d. Vocational
ANS: A
If an individual has little or no sense of identity, it is difficult to establish relationships with others. Lack of personal identity will not affect the other areas of development as strongly as it does social development. Vocation is not one of the areas of development; choosing a vocation or career is a core task of young adulthood.

DIF: Cognitive Level: Comprehension REF: p. 170 OBJ: 2
TOP: Adult Growth and Development KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

2. __________ is a major challenge for adults because energies are not concentrated on the self, and the demands can create feelings of anxiety, isolation, inadequacy, and helplessness.
a. Adulthood
b. Adolescence
c. Childhood
d. Parenting
ANS: D
Most of a parents energy is focused on the child or children every minute of every day. The responsibility is immense and can cause various emotions, especially if the parent works outside the home. Adulthood, adolescence, and childhood do not have a primary focus on others as parenting does.

DIF: Cognitive Level: Comprehension REF: p. 170 OBJ: 3
TOP: Adult Growth and Development KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

3. An adult male client is admitted to a mental health facility with the diagnosis of depression following the breakup of a long-term engagement. He states that he couldnt commit to marriage. In conducting his admission assessment, the nurse learns that during his childhood he did not feel guided, nurtured, or accepted by his parents. One of the goals for this client is to help him develop a positive personal identity. Which intervention should the nurse implement to meet this goal?
a. Improve his strength in the ability to adapt to new situations.
b. Develop the ability to establish and maintain an intimate relationship.
c. Discern his feelings about relationship choices and level of commitment.
d. Outline his lifes dream.
ANS: C
Discerning his feelings about relationship choices and commitment best meets the needs of this client at this time in his life. Improving his ability to adapt and developing his ability to establish and maintain an intimate relationship are not indicated in the scenario as an issue. Outlining his lifes dream assists in building a positive personal identity but is too broad a task for this client at this time.

DIF: Cognitive Level: Analysis REF: p. 171 OBJ: 4
TOP: Personal Identity
KEY: Nursing Process Step: Planning | Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

4. The term sandwich generation best describes adults:
a. Caught between adulthood and late adulthood
b. Caring for their children and aging parents
c. Caring for their children and grandchildren
d. Caught between young adulthood and adulthood
ANS: B
This generation situation can be a problem for many adults in that they face multiple responsibilities, resulting in increased levels of stress.

DIF: Cognitive Level: Knowledge REF: p. 172 OBJ: 5
TOP: Guiding the Next Generation KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

5. An increasing number of are the head of the household of families in the United States.
a. Married couples
b. Single women
c. Single men
d. Relatives
ANS: B
This statistic sometimes can lead to stress-related mental health disorders caused by the pressure of multiple responsibilities.

DIF: Cognitive Level: Knowledge REF: p. 173 OBJ: 5
TOP: Guiding the Next Generation KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

6. The nurse is caring for a client who is a single mother of two young children, has no financial or parental support from her ex-husband, is troubled by her financial circumstances and future, and works at a local fast-food restaurant. She is seeking help for depression. What is the nurses best action?
a. Assist the client in seeking educational and/or vocational programs for single parents.
b. Encourage the client to explore her feelings related to the reasons for her divorce.
c. Persuade the client to contact her ex-husband for financial and parental support.
d. Share information with the client regarding support groups for single mothers.
ANS: A
Assisting the client in finding programs for single parents helps the client by giving her support as she tries to better her financial situation in a way that will improve her self-esteem, independence, and personal identity and will help her to secure her financial future. Exploring feelings related to the divorce and having the client contact her ex-husband are not going to help her depression at this time. Sharing information about support groups will be helpful in the future but does not meet her immediate need.

DIF: Cognitive Level: Application REF: p. 173 OBJ: 6
TOP: Education KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

7. An adult female calls a crisis hotline stating that she moved a few months ago to seek a new job in a big city. She is crying and says that she doesnt think she can stand being so lonely anymore but doesnt want to move back to her small home town and face her family and friends as a failure. What is the nurses first response?
a. Would you like me to call your family to assist you in deciding what is best for you to do?
b. I am sure you will make friends once you find a steady job that you like.
c. Can you tell me what you mean by your statement that you dont think you can stand being lonely anymore?
d. Let me give you a list of some social groups that might be of interest to you.
ANS: C
The nurse must first clarify what the clients statement is referring to so as to eliminate the possibility that the client is thinking of harming herself. Once this is clarified, and if it is not what the client is indicating, a list of social groups might be supplied later in the conversation. Offering to call the clients family and assuring her that she will make friends are disregarding what the client is telling the nurse she feels. Social isolation is not a healthy state for an individual.

DIF: Cognitive Level: Analysis REF: p. 174 OBJ: 7
TOP: Lack of Social Support KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

8. AFRAIDS is a condition that most likely would be seen in:
a. The homosexual population
b. Sexually promiscuous heterosexuals
c. Individuals in a heterosexual monogamous relationship
d. Persons who have a chemical dependency on illegal intravenous drugs
ANS: C
This term stands for acute fear regarding acquired immunodeficiency syndrome (AIDS). It is seen in individuals whose behaviors based on their lifestyle put them at very little risk of contracting HIV/AIDS. Individuals in a heterosexual monogamous relationship most likely would demonstrate AFRAIDS. The other populations are at higher risk for contracting the disease based on the behaviors associated with their lifestyle.

DIF: Cognitive Level: Comprehension REF: p. 175 OBJ: 8
TOP: Acquired Immunodeficiency Syndrome
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

9. How many people in the United States have a severe mental illness?
a. 500,000
b. 1.3 million
c. 5.4 million
d. 10 million
ANS: C
It is important for the nurse to realize that the number of individuals needing care for mental health issues is growing.

DIF: Cognitive Level: Knowledge REF: p. 175 OBJ: N/A
TOP: Mental Health Problems of Adults KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

10. When the nursing care plan for a client with a mental health disorder is developed, what is the most likely reason that interventions are ineffective and goals are not met?
a. The client sees his goals as less important.
b. The clients family is not supportive.
c. The clients disorder is difficult to treat.
d. The clients medications are being adjusted.
ANS: A
Unrealistic goals set the client up for failure. Even the best interventions will not be successful in this circumstance. The nurse must be sure to accurately assess the clients life situation when working with the client to set realistic goals. The other options must be considered when a care plan is being developed, but if taken into consideration, they do not hinder the outcome as much as the client not seeing importance in his goals. Therapeutic actions will have greater results if goals are as important to the client.

DIF: Cognitive Level: Application REF: p. 175 OBJ: 9
TOP: Health Care Interventions KEY: Nursing Process Step: Planning
MSC: Client Needs: Psychosocial Integrity

11. A 42-year-old male client continues to enter into business deals that cause him to lose large amounts of money. He subsequently seeks mental health care for stress-related disorders. Which characteristic of a successful adult is this client lacking?
a. Acceptance of self
b. Finding a balance between giving and taking
c. Making sound decisions
d. Learning from past decisions
ANS: D
Making sound decisions and learning from past decisions describe this clients situation, but learning from past decisions applies the most in that he has made the wrong decision numerous other times in the past. Acceptance of self is not addressed in this scenario, and finding a balance between giving and taking refers to maintaining a balance between caring for others and taking care of oneself.

DIF: Cognitive Level: Synthesis REF: p. 171 OBJ: 3
TOP: Adult Growth and Development KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

12. A 68-year-old woman tells the nurse that since she retired a few months ago, she has been taking it easy by sleeping later and staying around the house to rest. She has recently noticed that she is having a little trouble with remembering things. The nurse is aware that intellectual development is continuous and suggests to the client:
a. You might think about volunteering somewhere to keep your mind sharp.
b. You are probably just tired from all those years at work.
c. After you have gotten used to being at home, I am sure your memory will improve.
d. Sometimes we must accept the fact that as we get older, we sometimes become more forgetful.
ANS: A
To maintain intellectual development, individuals must engage in productive activities at all ages.

DIF: Cognitive Level: Application REF: p. 170 OBJ: 3
TOP: Adult Growth and Development KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

13. A 49-year-old woman who has been the owner of a successful large business for several years decides to sell her business and move to a remote island to open a small dress shop. She most likely has made this decision based on her need to:
a. Avoid becoming stagnant in her life.
b. Earn more money.
c. Prevent another company from taking over her business.
d. Improve her social development.
ANS: A
Making a dramatic change in ones adult life prevents an individual from becoming dormant in his or her daily life. People who are unhappy tend to develop mental health disorders.

DIF: Cognitive Level: Application REF: p. 171 OBJ: 3
TOP: Adult Growth and Development KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

14. A 37-year-old client who has been divorced for several years recently lost joint custody of a 10-year-old daughter because of drug and alcohol use, along with nonpayment of child support. The client is referred to the clinic as the result of a court order. When arriving at the clinic, the client has been on a drinking binge for 2 days. What is the most appropriate nursing diagnosis for this client?
a. Health-seeking behaviors
b. Family processes, readiness for enhanced
c. Coping, ineffective
d. Hopelessness
ANS: C
This client is using drugs and alcohol as coping mechanisms. It is unlikely that the client is choosing these actions as a health-seeking mechanism. The client is not ready to work on family processes, and there is not enough evidence to suggest hopelessness.

DIF: Cognitive Level: Analysis REF: p. 172 OBJ: 4
TOP: Internal (Development) Problems KEY: Nursing Process Step: Nursing Diagnosis
MSC: Client Needs: Psychosocial Integrity

15. A 45-year-old woman is admitted to an inpatient mental health facility with the diagnosis of severe depression. She lives by herself and has been very active in her community for many years. During the past 6 months, she has become increasingly withdrawn from her family and friends and was terminated from her job because of excessive absenteeism. When she arrives on the unit, she makes little eye contact with the nurse, has a flat affect, and answers with one or two words. What is the most appropriate nursing diagnosis for this patient?
a. Diversional activity, deficient
b. Coping, ineffective
c. Fatigue
d. Hopelessness
ANS: D
The complete picture of this client indicates hopelessness as the most accurate nursing diagnosis at this time. The other three options may apply to her at a later time after further evaluation.

DIF: Cognitive Level: Analysis REF: p. 175 OBJ: 9
TOP: Mental Health Problems of Adults KEY: Nursing Process Step: Nursing Diagnosis
MSC: Client Needs: Psychosocial Integrity

16. _____% of the adult population in the United States has a mental health disorder.
a. Five
b. Eleven
c. Twenty five
d. Thirty nine
ANS: C
This percentage refers to diagnosable mental health disorders.

DIF: Cognitive Level: Knowledge REF: p. 175 OBJ: N/A
TOP: Mental Health Problems of Adults KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

17. A 35-year-old woman in a managerial position has had a number of employees under her supervision resign or transfer to other departments over the past year. In addition, she has rarely had a close personal relationship for more than a few months. She feels other people just dont measure up to my expectations. Her situation is the result of a possible _____ disorder.
a. Cognitive
b. Somatoform
c. Anxiety
d. Personality
ANS: D
Problems with interpersonal relationships can extend to work and social environments. Individuals who have little or no ability to see how their attitudes and behaviors affect other people often have difficulties with long-term relationships. They become superficial and unwilling to consider the feelings of others. Small problems with social relationships can balloon into serious mental health problems.

DIF: Cognitive Level: Knowledge REF: p. 172 OBJ: 4
TOP: Internal (Development) Problems KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

18. A newly married couple residing in a large city is expecting the birth of their first child in 3 months. The wife wishes to maintain her career and remain in their apartment. The husband has expressed the desire to relocate to a more suburban setting to raise their child. Their ability to successfully face this challenge depends upon their ability to:
a. Negotiate a mutually satisfying solution.
b. Employ appropriate coping mechanisms.
c. Avoid conflict by dealing with the issue at a later time.
d. Maintain a firm sense of individuality.
ANS: A
Compromise involves a willingness to negotiate and enter into interactions in which neither person wins or loses. Conflicts are resolved by defining and solving the problem. The focus is kept on the issue. Couples who compromise, communicate openly, listen carefully, and try to understand their partners point of view find that their relationship is respected and cherished.

DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 3
TOP: Adult Growth and Development KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

19. An obese woman is seen in the emergency department complaining of headaches. Her blood pressure is 150/92. Also present are her 4-year-old son and 2-year-old daughter. When the nurse offers to call a family member to pick up the children, the woman states that they are living alone in a womens shelter. What is the most appropriate action for the nurse to take?
a. Instruct the client on proper nutrition and educate her regarding the dangers of hypertension.
b. Make a referral for the client to a weight loss center.
c. Assist the client to plan better coping strategies.
d. Assess the familys daily living needs and consult social work for community resources.
ANS: D
It is crucial to learn about the clients living conditions and work within the reality of their situation. Instruction on nutrition and health practices and development of coping strategies cannot be addressed until basic needs for food, clothing, and shelter are met.

DIF: Cognitive Level: Knowledge REF: p. 175 OBJ: 6
TOP: Health Care Interventions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

20. The parents of a 21-year-old college student who attended church services on a consistent basis are concerned when their child returns home from college and announces she is converting to another religion. This individual is most likely experiencing:
a. A personality disorder
b. The need to challenge a value and belief system
c. Instability due to dysfunctional parenting
d. Regression to an unresolved developmental task
ANS: B
Development within the spiritual dimension focuses on defining ones value system and belief system. Young adults often challenge their current religious practices by changing churches or refusing to attend services. This is not seen as a personality disorder or a result of dysfunctional parenting. This task is expected during this phase of development.

DIF: Cognitive Level: Knowledge REF: p. 171 OBJ: 6
TOP: Health Care Interventions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

21. Which statements describe the adult who has achieved the successful emotional development of adulthood? (Select all that apply.)
a. The adult is able to function effectively in a stressful environment.
b. The adult possesses effective intellectual and abstract problem-solving skills.
c. The adult is able to adapt to growing older.
d. The adult sets realistic personal and professional goals.
ANS: A, C, D
These are characteristics of an individual who has achieved the expected emotional development of adulthood. Possessing effective intellectual and abstract problem-solving skills refers to intellectual development of adulthood.

DIF: Cognitive Level: Application REF: p. 170 OBJ: 3
TOP: Adult Growth and Development KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

22. One of the ways in which the social development of adults can be assessed is by observing the individuals ability to effectively communicate with whom? (Select all that apply.)
a. His or her significant other
b. His or her physician
c. His or her children
d. His or her co-workers
ANS: A, C, D
These are people with whom the adult interacts on a daily basis so effective communication will confirm that one aspect of the social task of adulthood is achieved. It would be unfair to base this on how effectively the client communicates with his or her physician because this interaction does not occur on a daily basis and often occurs during stressful times.

DIF: Cognitive Level: Application REF: p. 170 OBJ: 1
TOP: Adult Growth and Development KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

23. Therapeutic interventions are effective in the prevention of mental and emotional disorders and assisting the client to cope. Which of the following interventions assist in providing for a positive personal identity? (Select all that apply.)
a. Continue to define identity in terms of role in nuclear family.
b. Develop career path and goals.
c. Recognize how emotions influence achievement of goals and relationships.
d. Maintain personal distance in relationships.
ANS: B, C
The individual is assisted to develop a positive personal identity by differentiating self from the nuclear family, developing occupational goals, assessing how emotions influence achievement and relationships, and deciding on relationship choices and level of commitment.

DIF: Cognitive Level: Application REF: p. 172 OBJ: 2
TOP: Therapeutic Interventions for a Positive Personal Identity
KEY: Nursing Process Step: Evaluation MSC: Client Needs: Psychosocial Integrity

COMPLETION

24. Adulthood is defined as beginning at age ____ years and ending at age ____ years.

ANS:
18, 65
These are the age ranges of the beginning and end of adulthood.

DIF: Cognitive Level: Knowledge REF: p. 169 OBJ: 1
TOP: Adulthood KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

25. The __________ environment defines stressful or anxious situations.

ANS:
internal
Problems with the internal and external environment can lead to physical and psychological problems in adults who are unable to cope effectively. The external environment includes jobs, education, and living conditions.

DIF: Cognitive Level: Knowledge REF: p. 171 OBJ: 4
TOP: Common Problems of Adulthood KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

Leave a Reply