Chapter 01: Health and Wellness in an Aging Society
Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition

MULTIPLE CHOICE

	1.	When asked by new parents what the life expectancy is for their African American newborn, the nurse replies that, “2010 statistics indicate that your son:
a.	will have a life expectancy of approximately 65 years.”	
b.	can realistically expect to live into his late 80s.”	
c.	has a good chance of celebrating his 75th birthday.”	
d.	is likely to live into his late 90s.”	

ANS:	C
In 2010, men in the United States at age 60 can expect to live another 22 years. The life expectancy of African American men is about 4.7 years less than white men. Of the options above, C is the only response that fits into those parameters. The other options are not supported by reliable research.

DIF:	Cognitive Level: Understanding	REF:	p. 3	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

	2.	A nurse is planning care for a group of super-centenarians in an assisted living facility. The nurse considers which of the following?
a.	Most super-centenarians are functionally independent or require minimal assistance with activities of daily living	
b.	The majority of super-centenarians have cognitive impairment	
c.	The number of super-centenarians is expected to decrease in coming years as a result of heart disease and stroke	
d.	It is theorized that super-centenarians survived as long as they have due to genetic mutations that made them less susceptible to common diseases	

ANS:	A
Research supports that most super-centenarians are functionally and cognitively intact, requiring minimal assistance with ADLs. The number of super-centenarians is expected to increase in coming years as the number of older adults increases. The reason why individuals survived as long as they have is not known.

DIF:	Cognitive Level: Remembering	REF:	p. 4	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

	3.	One reason why many “baby boomers” have multiple chronic conditions such as heart disease, diabetes, and arthritis is that:
a.	they have less access to medication and other treatment regimens.	
b.	there was a lack of importance placed on healthy living as they were growing up.	
c.	they did not have access to immunizations against communicable disease when they were children.	
d.	they grew up in an era of rampant poverty and malnutrition.	

ANS:	B
The baby boomers, individuals born between 1946 and 1964, post-WWII, have better access to medication and treatment regimens than other cohorts. They have had the benefit of the development of immunizations against communicable diseases. They grew up in an era of prosperity post-WWII. However, there was a lack of importance placed on what we now consider healthy living when they were younger. Smoking, for example, was not condoned, but was considered a symbol of status. Candy in the shape of cigarettes was popular, and there was much secondhand smoke.

DIF:	Cognitive Level: Remembering	REF:	p. 6	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

	4.	A nurse is planning an education program on wellness in a local senior citizen center. The nurse plans to provide education on the importance of immunizations, annual physical examinations, screening for diabetes, and vision and hearing screening. It is important for the nurse to understand which of the following?
a.	Approximately 40% of older adults (ages 65 and older) utilize available preventive services	
b.	Preventive strategies are more widely used in the 40-64 age group than in the 65 and over age group	
c.	The research on health promotion strategies in older adults demonstrates that they have low efficacy	
d.	There is an abundance of research specific to health promotion and aging	

ANS:	A
Approximately 40% of individuals, ages 65 and older, utilize the preventive services that are available to them. However, only 24% of those between the ages of 40 and 64 do so. There is a paucity of research specific to health promotion and aging; however, the research that exists demonstrates that health promotion strategies are highly effective.

DIF:	Cognitive Level: Understanding	REF:	p. 7	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

	5.	A nurse is caring for an 85-year-old male client with diabetes in a community setting. The nurse promotes functional wellness by which of the following activities?
a.	Encouraging the client maintains current levels of physical activity	
b.	Assisting the client to receive all the recommended preventive screenings that are appropriate for his age group	
c.	Teaching the patient how to use a rolling walker so that he can ambulate for longer distances	
d.	Encouraging the client to attend his weekly chess games	

ANS:	A
Maintaining existing levels of physical activity is consistent with functional wellness. Teaching the client how to use a rolling walker enables the client to remain active at the highest level possible, which is an example of promoting functional wellness. Receiving recommended screening is an example of promoting biological wellness. The use of a rolling walker should be based on assessment of physical ability. Encouraging the client to attend weekly chess games is an example of promoting social wellness.

DIF:	Cognitive Level: Applying	REF:	p. 10	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

	6.	Based on the census reports of 2010, the typical profile of a centenarian in the United States includes which of the following characteristics?
a.	A Caucasian woman who lives in an urban area of a Southern state	
b.	An African American woman who lives in a rural area of a Southern state	
c.	A Hispanic man who lives in an urban area of a Midwestern state	
d.	A Caucasian man who lives in a rural area of a Midwestern state	

ANS:	A
Based on the 2010 U.S. Census data, centenarians were overwhelmingly white (82.5%), women (82.8%), and living in urban areas of the Southern states.

DIF:	Cognitive Level: Applying	REF:	p. 5	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

	1.	Primary prevention strategies for older adults include which of the following? (Select all that apply.)
a.	An annual influenza immunization clinic	
b.	A smoking cessation program	
c.	A prostate screening program	
d.	A cardiac rehabilitation program	
e.	A meal planning education program for type 2 diabetics	

ANS:	A, B
Primary prevention refers to strategies that are used to prevent an illness before it occurs and maintaining wellness across the continuum of care. Immunizations and smoking cessation are examples of primary prevention. Secondary prevention is the early detection of a disease or a health problem that has already developed. Prostate screening is an example of secondary prevention. Tertiary prevention addresses the needs of individuals who already have their wellness challenged. Cardiac rehabilitation and meal planning for diabetics are examples of tertiary prevention.

DIF:	Cognitive Level: Applying	REF:	pp. 8–9	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Management of Care		

	2.	A nurse organizes a health fair for older adults. The nurse’s goal is to focus on the six priority areas identified by the National Prevention Council. Which of the following activities should the nurse include? (Select all that apply.)
a.	Smoking cessation	
b.	Depression screening	
c.	Recognizing elder abuse	
d.	Cholesterol screening	
e.	Fitness training	

ANS:	A, B, C
The six priority areas of the National Prevention Council include tobacco-free living, preventing drug abuse and excessive alcohol use, healthy eating, injury- and violence-free living, reproductive and sexual health, and mental and emotional well-being. Smoking cessation, depression screening, and recognizing elder abuse all directly address these areas. While cholesterol screening and fitness training are important for older adults, they do not address these six priority areas.

DIF:	Cognitive Level: Analyzing	REF:	p. 8	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

	3.	The “in-between” generation (individuals born between 1915 and 1945) were subject to which of the following health challenges during their childhood? (Select all that apply.)
a.	Polio	
b.	Lack of fluoride in the water causing teeth to be soft and cavity prone	
c.	“Pigeon Chest,” a malformation of the rib cage due to a lack of vitamin D	
d.	Smallpox	
e.	HIV/AIDS	

ANS:	A, B, C
Polio was a major fear of this group; the polio vaccine was not available in the United States until 1955. In many areas water was not fluoridated. “Pigeon Chest” was common. Smallpox was a concern for the centenarians, not this generation. HIV/AIDS had not been identified in the early years of 1915-1945.

DIF:	Cognitive Level: Remembering	REF:	p. 5	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance

	4.	A nursing student is preparing a presentation on the Wellness-Based Model for Healthy Aging. Which of the following concepts should the student include in the presentation? (Select all that apply.)
a.	Healthy aging is defined by the absence of physical illness alone	
b.	Healthy aging is individually defined and can change over time	
c.	There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them	
d.	Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process	
e.	According to this model, an individual with a chronic disease would not be considered healthy	

ANS:	B, C, D
Healthy aging is a lifelong process that begins with birth and ends with death. The concept of healthy aging from a wellness perspective is uniquely defined by each individual and can change over time. There are challenges to implementing evidence-based practices on healthy aging because there is a paucity of research on this area. Therefore, there are many strategies that have been used and determined to be effective but do not have research evidence supporting them. The subcomponents with the wellness model are functional independence, self-care management of illness, personal growth, positive outlook, and social contribution and activities that promote one’s health.

DIF:	Cognitive Level: Applying	REF:	p. 7	
TOP:	Integrated Process: Teaching/Learning		
MSC:	Client Needs: Health Promotion and Maintenance