e.Disengagement theory: Maintains that an older
adult withdraws from societal interactions
because it is mutually desired and satisfying for
both the individual and society
f. Activity theory: Successful aging involves the
ability to maintain high levels of activity and
functioning.
g.Identity-continuity theory: Assumes that healthy
aging is related to the ability of the older adult to
continue similar patterns of behavior that
existed in young to middle adulthood
4.Alzheimer’s disease affects brain cells and is charac-
terized by patchy areas of the brain that degenerate,
or break down. At first, forgetfulness and impaired
judgment may be evident; over a period of several
years, the person becomes progressively more con-
fused, forgetting family and becoming disoriented
in familiar surroundings.- a.Integumentary: Wrinkling and sagging of skin
occur with decreased skin elasticity; dryness and
scaling are common.
b.Musculoskeletal: Muscle mass and strength
decrease.
c. Neurologic: Temperature regulation and pain
perception become less efficient.
d.Cardiopulmonary: The body is less able to
increase heart rate and cardiac output with activ-
ity.
e.Gastrointestinal: Malnutrition and anemia
become more common.
f. Genitourinary: Blood flow to the kidneys
decreases with diminished cardiac output.
REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Sample Answers
1.How might the nurse use blended nursing skills to
provide holistic, developmentally sensitive care for
Mr. and Mrs. Jenkins?
The nurse should aim to facilitate the Jenkins’
achievement of the developmental tasks of older
adulthood, such as, adjusting to the changes of
older adulthood and retirement, relating to one’s
age group, maintaining social roles, and continuing
moral and spiritual development. The Jenkins
would benefit from a referral to community
services, such as physical fitness programs and
social clubs designed for older adults.
2.What would be a successful outcome for this
patient?
By next visit, Mr. Jenkins will report being involved
in social and physical activities and drinking less.
3.What intellectual, technical, interpersonal, and/or
ethical/legal competencies are most likely to bring
about the desired outcome?
Intellectual: knowledge of the theories of aging as
they relate to the changes faced by the aging adult
Technical: ability to adapt necessary skills and tech-
niques to address the changes associated with the
aging adult
Interpersonal: ability to establish trusting
professional relationships with adult patients of dif-
ferent ages, respecting their developmental needs
Ethical/Legal: ability to practice in an ethically and
legally defensible manner, maintaining the rights of
the aging adult
4.What resources might be helpful for Mr. and Mrs.
Jenkins?
Community services, social networks, physical
fitness programs, nutrition classesCHAPTER 21
PRACTICING FOR NCLEX
MULTIPLE CHOICE QUESTIONS
1.d 2.a 3.b 4.a 5.c
6.c 7.d 8.d 9.c 10.c
ALTERNATE-FORMAT QUESTIONS
Multiple Response Questions
1.a, b, d
2.b, c, f
3.b, d, f
4.c, e, f
5.a, c, f
6.c, e, f
7.a, c, f
8.c, d, eDEVELOPING YOUR KNOWLEDGE BASE
FILL-IN-THE-BLANKS
1.Stimulus
2.Channel
3.Feedback
4.Nonverbal
5.Helping
6.Orientation
7.Validating
8.Horizontal violence
MATCHING EXERCISES
1.b 2.d 3.g 4.a 5.c
6.e 7.b 8.c 9.a 10.a
11.c 12.b 13.c 14.a 15.b
16.b 17.c 18.a 19.e 20.d
21.c
SHORT ANSWER
1.Sample answers:
a.Touch: The nurse gently squeezes a patient’s
hand before surgery. The patient’s response to
this touch may express fear, gratitude,
acceptance, and so on.
b.Eye contact: A patient avoids eye contact. The
patient may be expressing defenselessness or
avoidance of communication.
c. Facial expressions: A patient grimaces when
looking at his surgical incision. The patientCopyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:358 ANSWER KEY
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