Chapter 6: Social, Psychological, Spiritual, and Cognitive Aspects of Aging

Test Bank
MULTIPLE CHOICE
1. 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: D

Some 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: 1
DIF: Understand
TOP: Nursing Process: Assessment

REF: 4-12
MSC: Psychosocial Integrity

2. 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: C

Nerve 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: 1
DIF: Remember
TOP: Nursing Process: Assessment

REF: 16
MSC: Psychosocial Integrity

3. 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: D

Nurses 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: 1
DIF: Understand
TOP: Nursing Process: Assessment

REF: 12-20| 29 Box 6-1| 33 Box 6-5| 34 Box 6-6

MSC: Psychosocial Integrity

4. Which role is most likely to have a significant effect on the type of aging process experienced

by the older adult?

a. Grandparent
b. Spouse

c. Friend
d. Parent

ANS: B

The 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: 1
DIF: Understand
TOP: Nursing Process: Assessment

REF: 12-13
MSC: Psychosocial Integrity

5. 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. Gender
c. Ethnicity
b. Culture
d. Opportunity
ANS: D

Social 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: 1
DIF: Analyze
TOP: Nursing Process: Assessment

REF: 7
MSC: Psychosocial Integrity

6. 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?

c. Sociological
d. Chronological

a. Historical
b. Biological
ANS: A

In 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 agestratification 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: 1
DIF: Knowledge
TOP: Nursing Process: Assessment

REF: 6
MSC: Psychosocial Integrity

7. 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: A

Often 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: 1
DIF: Apply
TOP: Nursing Process: Implementation

REF: 12-16| 32 Box 6-4| 33 Box 6-5| 34 Box 6-6

MSC: Psychosocial Integrity

8. 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 alone
c. Severe knee pain
b. Meager income
d. Job and home loss
ANS: D

Jungs 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: 1
DIF: Analyze
TOP: Nursing Process: Assessment

REF: 9-10
MSC: Health Promotion and Maintenance

9. 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: D

In 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: 1
DIF: Apply
MSC: Psychosocial Integrity

REF: 12

TOP: Nursing Process: Planning

10. 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 flexibility
b. Improves the groups cohesiveness
c. Provides a needed social opportunity
d. Adds to their existing knowledge base
ANS: D

Learning 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: 1
DIF: Apply
MSC: Psychosocial Integrity

REF: 19-20

TOP: Nursing Process: Evaluation

11. 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?

Keep the curtains open in their rooms.
Offer beads for them to string on yarn.
Show movies that the residents choose.
Assist residents with ambulation to meals.

a.
b.
c.
d.

ANS: D

Engaging 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: 1
DIF: Apply
REF: 15-18
MSC: Health Promotion and Maintenance

TOP: Nursing Process: Planning

12. Which physiological change in the brain is the reason the nurse allows more time for

answering questions with older adults?

Increased secretion of cholinesterase
Decreased secretion of neurotransmitters
Loss of spinal cord and brainstem neurons
Atrophy of dendrites in the cerebral cortex

a.
b.
c.
d.

ANS: D

Dendrites 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: 1
DIF: Understand
TOP: Nursing Process: Assessment

REF: 16
MSC: Safe, Effective Care Environment

13. The nurse provides opportunities for nursing home residents to read aloud to others. Which

cognitive skill is this nursing intervention most likely to improve?

c. Object naming
d. Visuospatial skills

a. Verbal fluency
b. Logical analysis
ANS: A

Allowing 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: 1
DIF: Understand REF: 16
MSC: Health Promotion and Maintenance

TOP: Nursing Process: Evaluation

MULTIPLE RESPONSE
1. 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, C

Most 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: 1
DIF: Understand
TOP: Nursing Process: Assessment

REF: 12-Apr
MSC: Psychosocial Integrity

2. 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 exercise
c. Socialization
b. Stimulating mental activity
d. Increasing dietary intake
ANS: A, B, C

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. An increase in dietary intake has not been shown to influence brain health.
PTS: 1
DIF: Apply
REF: 37
MSC: Health Promotion and Maintenance

TOP: Nursing Process: Planning