Chapter 6: Social, Psychological, Spiritual, and Cognitive Aspects of AgingTest BankMULTIPLE CHOICE1.Which of the following is a true statement about the theories of aging?a.Research data support the disengagement theory, activity theory, and continuity theory.b.Everyone should be able to achieve the three tasks of Pecks model of integrity.c.The exercise of rights is not a task of aging in Kellys model.d.A person may choose to avoid pursuing inner discovery in older age.ANS:DSome persons do not value inner psychological exploration and remain action oriented even in an older age, and others are still subject to the same demands of daily living as they were in middle age. None of these theories is clearly supported by data. Pecks tasks of ego differentiation, body transcendence, and ego transcendence demand a great deal of courage and energy that not everyone possesses. Tasks of aging in Kellys model are accepting reality, fulfilling responsibility, and exercising rights.PTS:1DIF:UnderstandREF:4-12TOP:Nursing Process: AssessmentMSC:Psychosocial Integrity2.Which of the following is a true statement about neuropsychiatric function in older adults?a.Overall cognitive abilities are progressively degraded by neuron loss in the cerebral cortex with aging.b.Improving cognitive functions in an older person calls for sporadic mental activity around ideas the person finds significant and interesting.c.Nerve cells regenerate in the hippocampus.d.Mood does not influence an older person ability to remember verbal instructions.ANS:CNerve cells regenerate in the hippocampus; this is a true statement. Although neurons can regenerate in the hippocampus, regeneration is impeded by stress. Overall cognitive abilities are progressively degraded by neuron loss in the cerebral cortex with aging; this statement is not true. Neuron loss does not harm overall cognitive ability, although it makes neural processes run more slowly. Improving cognitive functions in an older person calls for sporadic mental activity around ideas the person finds significant and interesting; this is not a true statement. Neural functions can be retrained, but exercising the brain on a regular basis is necessary. Older adults learn best when new information is relevant to what is already familiar. Mood does not influence whether an older person remembers verbal instructions; this is a not a true statement. Recalling events, including communication, is impaired by a crisis situation or anxiety.PTS:1DIF:RememberREF:16TOP:Nursing Process: AssessmentMSC:Psychosocial Integrity3.Which of the following statements is true about social and emotional health of older adults?a.Contemporary society has strong norms for the behavior of adults older than 80 years.b.The transition to old age entails a declining level of contribution to others as one becomes increasingly dependent on them.c.Computers and the Internet have little to contribute to older adults in their need for social support.d.Nurses are often significant sources of social and emotional support for older adults.ANS:DNurses are often important confidants and providers of social support in the lives of older adults. The diversity of cultures and individuals in a society such as the United States means that norms are almost nonexistent for those older than 80 years. Older adults have a great deal to contribute in wisdom and by example. E-mail and online chat rooms are a means of contact and social support for many older adults.PTS:1DIF:UnderstandREF:12-20| 29 Box 6-1| 33 Box 6-5| 34 Box 6-6TOP:Nursing Process: AssessmentMSC:Psychosocial Integrity4.Which role is most likely to have a significant effect on the type of aging process experienced by the older adult?a.Grandparentc.Friendb.Spoused.ParentANS:BThe loss of a spouse is likely to be devastating for an older adult for economic and biopsychosocial reasons. When an older adult loses a spouse, the loss can include economic security, especially for a woman, and societal roles. Alterations in these roles are not usually as challenging as the loss of a spouse. Grandparenting can offer the potential for enhanced social experiences for an older adult; however, adults can age well without them when more basic needs are met. Alterations in these roles are not always as acutely demanding as the loss of a spouse. Alterations in these roles usually call for little or a gradual adjustment.PTS:1DIF:UnderstandREF:12-13TOP:Nursing Process: AssessmentMSC:Psychosocial Integrity5.The children in an African-American family attended college because their mother worked two jobs as they were growing up. She never finished high school, the children are grown, and she lives alone in retirement. Which noted weakness of sociological theories on aging explains why the social exchange theory is not applicable to this older adult?a.Genderc.Ethnicityb.Cultured.OpportunityANS:DSocial exchange theory ignores the effect that opportunity can have on aging because, according to this theory, the mother should be living with one of the children. They had the opportunities that she never had. Gender is not as relevant to this theory of the value of youth as being a period where social credits are earned for old age. Culture is not as relevant to this theory as the value of youth. Ethnicity is not as relevant to this theory as the value of youth.PTS:1DIF:AnalyzeREF:7TOP:Nursing Process: AssessmentMSC:Psychosocial Integrity6.In which context are members of a cohort described when using the age-stratification theory to explain the effect of similar events, conditions, and circumstances?a.Historicalc.Sociologicalb.Biologicald.ChronologicalANS:AIn the age-stratification model, historical context is used to understand members of a cohort in terms of similar events, conditions, and circumstances and the effect these have on the group as a whole. A good example of such a cohort is older adults who lived through World War II. Biological context is not important in considering the age-stratification theory. The age-stratification theory is a sociological theory of aging that uses historical context to describe cohorts. Chronological context of a cohort will span a range, but historical context is what describes the cohort.PTS:1DIF:KnowledgeREF:6TOP:Nursing Process: AssessmentMSC:Psychosocial Integrity7.An older patient who was just diagnosed with a terminal disease states, All my life I attended church, but I am still worried about what will happen after death. The nurses best response is which of the following?a.The unknown may be frightening. Do you want to talk about this?b.Religious people know that God is a good God.c.People that have had near death experiences say it is peaceful.d.You must feel good about attending church most of your life.ANS:AOften the unknown is very frightening, uses the reflective technique to identify the patients feelings regarding the fear of the unknown. Religious people know that God is a good God, denies the patients feelings. People that have had near death experiences say it is peaceful, focuses on the experience of others. You must feel good about attending church most of your life, ignores the patients concern about death.PTS:1DIF:ApplyREF:12-16| 32 Box 6-4| 33 Box 6-5| 34 Box 6-6TOP:Nursing Process: ImplementationMSC:Psychosocial Integrity8.An older man with severe knee pain tells the nurse how he lost his job and his home after starting a new business when he was 48 years old. Now he lives alone and relies on Social Security. Using Jungs theory, what in this individuals life is the most pivotal in his personality development?a.Living alonec.Severe knee painb.Meager incomed.Job and home lossANS:DJungs theorizes that the personality forms, in part, after a crisis, as an individual moves from extroversion to introversion in aging. Living alone is a situation that is the result of many factors coalescing in an individuals life. A meager income can be a result of the individuals life work and other individual choices and events. His personality can affect how an individual deals with pain, and the pain can affect an individuals personality. However, whether the pain is old or new is not known; thus a determination cannot be made.PTS:1DIF:AnalyzeREF:9-10TOP:Nursing Process: AssessmentMSC:Health Promotion and Maintenance9.The nurse plans care for older adults who are in good health but isolated from their families. If the nurses goal is to move the adults toward gerotranscendence, which intervention should the nurse use in the plan of care?a.Give a daily tea party for the group.b.Call each family to encourage visiting.c.Assist them to resume midlife patterns.d.Help each person with individual activities.ANS:DIn Tornstams theory, aging offers the potential for gerotranscendence, a culmination of an individuals life, wisdom, and spiritual growth that allows the older adult to live contentedly with and without social activities. An older adult spends more time on meditation and solitude, and less time on materialism and self-consciousness about body image. Individual activities or self-selected activities are satisfactory. Solitude is satisfactory. Midlife patterns are no longer relevant to contentment.PTS:1DIF:ApplyREF:12TOP:Nursing Process: PlanningMSC:Psychosocial Integrity10.The nurse observes older female adults learning advanced knitting techniques. The nurse concludes that this learning activity is suitable for these women because it accomplishes which of the following?a.Helps maintain joint flexibilityb.Improves the groups cohesivenessc.Provides a needed social opportunityd.Adds to their existing knowledge baseANS:DLearning advanced techniques is a suitable activity for older adults because it builds on knowledge they already have; further, this activity is suitable because it is concrete and practical for experienced knitters to develop advanced skills. Joint flexibility is a physical activity and not necessarily a learning activity. The members share enjoyment of knitting; other than being women and older, the group has no special bond on which to build. The need for socializing is not evident.PTS:1DIF:ApplyREF:19-20TOP:Nursing Process: EvaluationMSC:Psychosocial Integrity11.The nurse at a nursing home wants to help decrease the risk of Alzheimer disease in the residents. Which should the nurse do to implement this goal?a.Keep the curtains open in their rooms.b.Offer beads for them to string on yarn.c.Show movies that the residents choose.d.Assist residents with ambulation to meals.ANS:DEngaging in physical activity and social interaction are associated with a lower risk for Alzheimer disease. Keeping the curtains open can make a residents room more pleasant but is likely to be counterproductive in lowering the risk; brightening the room can entice the resident to stay in the room and decrease social interaction. Stringing beads is a passive and sedentary activity and therefore unlikely to decrease the risk for Alzheimer disease; physical activity is associated with a lower risk for Alzheimer disease. Watching movies is a sedentary but not a mentally stimulating activity for an adult with a normal intelligence.PTS:1DIF:ApplyREF:15-18TOP:Nursing Process: PlanningMSC:Health Promotion and Maintenance12.Which physiological change in the brain is the reason the nurse allows more time for answering questions with older adults?a.Increased secretion of cholinesteraseb.Decreased secretion of neurotransmittersc.Loss of spinal cord and brainstem neuronsd.Atrophy of dendrites in the cerebral cortexANS:DDendrites are the receiving end of neurons (receiving electrochemical signals) and the branched ends extending from the cell body. The atrophy of dendrites contributes to slower thought processes with aging because the synapses are impaired; this changes the transmission of neurotransmitters that are vital in the transmission of an electrical impulse from neuron to neuron. The secretion of cholinesterase, the enzyme that inactivates acetylcholine in the synapse, does not increase with aging. Changes in the transmission of neurotransmitters are associated with the atrophy of dendrites. The spinal cord and the cerebral cortex lose neurons with age, the cerebral cortex more than the spinal cord.PTS:1DIF:UnderstandREF:16TOP:Nursing Process: AssessmentMSC:Safe, Effective Care Environment13.The nurse provides opportunities for nursing home residents to read aloud to others. Which cognitive skill is this nursing intervention most likely to improve?a.Verbal fluencyc.Object namingb.Logical analysisd.Visuospatial skillsANS:AAllowing residents to read aloud helps improve and maintain verbal fluency because it provides an opportunity to practice these skills. Reading aloud does not usually require analysis. Reading is unlikely to improve object recall unless displaying objects is part of the reading. Visuospatial skills require the ability to perceive the relationship of objects in terms of the space each object occupies; reading is unlikely to improve this skill.PTS:1DIF:UnderstandREF:16TOP:Nursing Process: EvaluationMSC:Health Promotion and MaintenanceMULTIPLE RESPONSE1.Which statements are true about aging and the brain? (Select all that apply.)a.Most areas of the brain do not lose brain cells.b.Memory decline is inevitable as people age.c.Basic intelligence remains unchanged with age.d.The brain does not continue to make new brain cells.ANS:A, CMost areas of the brain do not lose brain cells. Although older adults may lose some nerve connections, it can be part of the reshaping of the brain that comes with experience. Basic intelligence remains unchanged with age, and older adults should be provided with opportunities for continued learning. Many people reach older age and have no memory problems. Participation in physical exercise, stimulating mental activity, socialization, health diet, and stress management help brain health.PTS:1DIF:UnderstandREF:12-AprTOP:Nursing Process: AssessmentMSC:Psychosocial Integrity2.The nurse is admitting a patient to a long-term care facility. During the admission, the patient verbalizes a concern about getting dementia now that he is in a nursing home. In what activity(ies) should the nurse encourage the patient to participate to maintain brain health? (Select all that apply.)a.Physical exercisec.Socializationb.Stimulating mental activityd.Increasing dietary intakeANS:A, B, CMany people reach older age and have no memory problems. Participation in physical exercise, stimulating mental activity, socialization, health diet, and stress management help brain health. An increase in dietary intake has not been shown to influence brain health.PTS:1DIF:ApplyREF:37TOP:Nursing Process: PlanningMSC:Health Promotion and Maintenance