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Chapter 3 Nursing Model for Promoting Health in Older Adults
Terms in this set (15)
1. A nurse is using the Functional Consequences Theory as a lens for planning client care in a
health care facility. Which of the following is a key element of this nursing theory?
A) Most problems affecting older adults may be
attributed to age-related changes.
B) Most functional consequences cannot be addressed
through nursing interventions.
C) Wellness is a concept that is broader than just
D) The Functional Consequences Theory is an
alternative to holistic nursing care.
Within the Functional Consequences Theory, wellness is a central concept that encompasses
more than the older adult's level of physiologic function. Most problems affecting older adults
are attributable to risk factors, even though age-related changes are indeed relevant and
inevitable. Functional consequences can usually be addressed by nursing interventions, and
holistic care is not an alternative to Functional Consequences Theory, but rather a component of
2. A nurse is working with a 79-year-old client newly diagnosed with osteoporosis. Which of the
following interactions promotes achievement of wellness outcomes?
A) The nurse performs strength and mobility training
appropriate to the client's age and diagnosis.
B) The nurse teaches the client about bone density in
older women and the role of vitamin D and calcium
C) The nurse plans interventions in light of the body-
mind-spirit interconnectedness of the client.
D) The nurse teaches the client about how her risk
factors are a consequence of age.
Teaching about bone density and the role of vitamin D reflects an acknowledgment that the
client's diagnosis is attributable to both the client's age-related changes and risk factors such as
inadequate nutrient and mineral intake. Strength and mobility training may well be an
appropriate intervention, but it does not necessarily acknowledge the interplay of risk factors and
age in the client's diagnosis. The body-mind-spirit interconnectedness is a component of the
Functional Consequences Theory, but it does not address the relationship between risk factors
and age per se. Teaching about risk factors as a consequence of age implies that these factors are
an inevitable consequence of age, which is not the case.
3. A nurse is teaching a colleague about the difference between age-related changes and risk
factors. Which of the following examples should the nurse use when discussing age-related
A) An older adult with a diagnosis of diabetes mellitus
B) An older adult who is obese
C) An older adult with obstructive lung disease
D) An older adult with decreased bowel motility
Decreased bowel motility is an example of a phenomenon that is a normal consequence of the
aging process. Diabetes, obesity, and obstructive lung disease are all phenomena that may
constitute or exacerbate health problems for older adults, but they are not age-related changes.
4. A nurse determines risk factors for an 81-year-old client's plan of care. Which of the following
characteristics of the client would the nurse consider as a risk factor? (Select all that apply.)
A) Chronic bronchitis
B) Loss of bone density
C) Decreased vital lung capacity
D) Delayed gastric emptying
E) Digoxin (Lanoxin) toxicity
Ans: A, E
Chronic bronchitis would be considered a pathologic process and risk factor for disease, rather
than an expected or inevitable age-related change. Adverse medication effects are also
considered risk factors. Loss of bone density, decreased vital lung capacity, and delayed gastric
emptying are all examples of normal, age-related changes.
5. A nurse is identifying positive functional consequences as part of the development of an older
client's care plan. Which of the following outcomes exemplifies the concept of positive
functional consequences for an older adult? (Select all that apply.)
A) The older adult with arthritis can walk 1 mile
B) The older adult who is overweight develops a plan
to lose 2 lb a month.
C) The older adult has constipation from pain
D) The older adult schedules cataract surgery.
Ans: A, B, D
Positive functional consequences can result from automatic actions or purposeful interventions.
Older adults bring about positive functional consequences (also called wellness outcomes) when
they compensate for age-related changes and risk factors, such as cataracts and chronic
conditions. Nurses help older adults achieve positive functional consequences by teaching about
health promotion interventions to improve functioning and quality of life.
6. A nurse uses the Functional Consequences Theory to assess older adults. Which of the following
situations best demonstrates the effect of physical environment on the older adult?
A) A resident of a care facility experiences a fall
because there are not grab bars outside his bathtub.
B) A hospital client develops Clostridium difficile-
related diarrhea because a care provider did not
perform adequate handwashing.
C) An older adult cannot afford a wheeled walker and
suffers a fall while trying to ambulate using a cane.
D) An assisted living resident requires care for
emphysema that resulted from a 70 pack-year
history of cigarette smoking.
An adverse health effect that results from the inadequacy of one's surroundings (such as the lack
of safety devices) is an example of the domain of environment. Although the use of incorrect
equipment, health problems caused by lifestyle factors, and infections that result from caregiver
negligence create risk factors for older adults, these problems are not situated within the domain
7. A nurse plans interventions to promote wellness in older adults. Which of the following
interventions is most appropriate to meet this goal?
A) Talking with the physician about available
treatment options for an older adult with an acute
B) Facilitating early mobilization to prevent muscle
wasting and loss of function in an older hospital
C) Deferring the final decision regarding an older
adult's choice of assisted living facility to the
person's son and daughter
D) Placing a 76-year-old on the waitlist for a kidney
Goals of the Functional Consequences Theory include improving or preventing declines in
functioning and addressing quality-of-life concerns. Discussing treatment options, having family
members make an older adult's decisions, and placing an individual on a waitlist for a transplant
are not direct manifestations of this principle.
8. A nurse in the long-term care facility plans care to improve quality of life. Which of the
following actions is most likely to enhance the older adult's connectedness?
A) Teaching a client who has had a below-the-knee
amputation how to care for his stump
B) Organizing a client's intravenous antibiotic therapy
on an outpatient basis
C) Performing a focused respiratory assessment on a
client who has a diagnosis of lung cancer
D) Advocating for a husband and wife to remain in the
same room of a long-term care facility, as is their
Advocating for a husband and wife to remain in the same room of a long-term care facility, as is
their preference fosters connectedness, a component of the older adult's quality of life. Teaching
wound care, organizing treatment, and adequately assessing a client are aspects of good care, but
none is a direct contributor to connectedness.
9. A nurse plans the care of older adults in a long-term care setting. Which of the following
interventions incorporates the residents' connectedness to society?
A) Ensuring that there are multiple television sets
available to residents of the facility
B) Arranging regular visits by schoolchildren to the
C) Conducting reminiscence therapy
D) Allowing residents to have input into the meal
planning at the facility
Social connectedness can be fostered by arranging meaningful contact between older adults and
other members of society. TV, reminiscence, and input into routines may all have benefits, but
none is likely to create a sense of connectedness with society.
10. An 89-year-old adult is dismayed that his primary care provider referred him for a driving
evaluation because he experiences vision problems and slower reaction time. Which of the
following concepts is illustrated in this example?
A) Risk factors
B) Age-related changes
C) Positive functional consequences
D) Wellness outcomes
Changes in vision and response time are considered to be age-related changes. These are not
necessarily risk factors and they would not be considered positive functional consequences or
11. A nurse in a community setting plans wellness outcomes with a 68-year-old female client who
desires to participate in a half-marathon run. Which of the following outcomes should the nurse
A) The client will remain free of disease.
B) The client will participate in daily aerobic activity
class without falls.
C) The client will increase activity until able to run 30
D) The client will participate in the half marathon that
is scheduled in 6 months.
Health is individually determined, based on the functional capacities that are perceived as
important by that person, in this case, participating in a half marathon. Remaining free from
disease and expecting the older adult to participate in daily aerobic activity class may not be
pertinent to this client. Increasing activity by only 30 minutes at time minimizes the client's goal.
12. A nurse assesses a 71-year-old person who has smoked for 43 years. Which of the following is a
negative functional consequence of smoking for this person? (Select all that apply.)
A) Children are exposed to secondhand smoke
B) Low oxygen-carrying capacity
C) Abnormal breath sounds
D) The ability to run a 5-K race
E) Pulmonary disease
Functional consequences are the observable effects of actions, risk factors, and age-related
changes that influence the quality of life or day-to-day activities of older adults. Low oxygen-
carrying capacity, abnormal breath sounds, and pulmonary disease are negative functional
consequences of smoking. The ability to run a 5-K race is lost with smoking. Children may be
exposed to secondhand smoke. These are not functional consequences of smoking for this
13. A home health nurse performs an admission on a 90-year-old client who has a small dog. The
client states that the most important problem is urinary incontinence. The client's blood pressure
is 135/90 mm Hg, with last bowel movement 3 days ago. Which of the following areas addresses
the person's goals?
C) Blood pressure
Although nurses address safety, blood pressure, and constipation as part of a comprehensive care
plan, it is imperative to begin by addressing the older adult's priority.
14. A nurse cares for an older adult at risk for a venous stasis ulcer. Which interventions should the
nurse include in the teaching with this older adult? (Select all that apply.)
A) Health promotion interventions
B) Functional consequences
C) Wellness outcomes
D) Environmental modifications
Ans: A, D
The nurse should include health promotion interventions and environmental modifications to
create wellness outcomes for this client. Functional consequences and wellness outcomes are not
15. An older adult reflects, "Why should I go to the gym, I'm going to get fat anyway." Which
response by the nurse is most appropriate?
A) "Age-related changes are inevitable; however,
most problems affecting older adults are related to
risk factors, so it's important to do what you can to
maintain a high level of functioning."
B) "Older adults experience positive or negative
functional consequences because of age-related
C) "Risk factors do impact consequences, but you can
D) "Many problems affecting older adults are based
Although age-related changes are inevitable, most problems affecting older adults are related to
risk factors. Older adults experience positive or negative functional consequences because of a
combination of age-related changes and additional risk factors. Interventions can be directed
toward alleviating or modifying the negative functional consequences of risk factors.
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