AGE SPECIFIC COMPETENCY TEST 1) A 17 year-old female survives a motor vehicle accident and has several facial sutures and a kidney contusion. Considering the special needs of the adolescent, which of the following interventions would be important to consider? a) involving a parent in every aspect of care b) putting a sign on the door saying "No Visitors" c) offering privacy as appropriate, encouraging socialization with peers, and being sensitive to her concerns about body image Answer: C 2) True or False? Adolescents are generally in good health. Eighty percent of deaths in this age group are due to accidents, homicide, and suicide. However, health problems such as anorexia and bulimia, drug and alcohol abuse, and sexually transmitted diseases affect a sizable number of adolescents. Answer: TRUE 3) True or False? When obtaining a history from an adolescent, always have the patient's parents present. Answer: FALSE The adolescent has a right to privacy and may prefer to reveal some information in confidence. 4) True or False? It is best to communicate with adolescents by telling them exactly what to do, instead of giving them choices, and by speaking in concrete and factual manner. Answer: FALSE Adolescents are abstract thinkers who consider many options and need to be involved in decision making. 5) True or False? Pain perception in the elderly is less acute than for younger people; therefore pain medication should be given only if they complain. Answer: FALSE The elderly may complain less, but it is important to adequately control their pain. Their failure to complain may be because they are less able to distinguish the difference between intensities of pain or because they have trouble communicating. Small doses of pain medication given around the clock may are more effective for them than PRN doses. Remember that severe pain for them might inhibit breathing, increase blood pressure, precipitate arrhythmias, or worsen confusion. 6) True or False? It is important to encourage the elderly to keep their glasses or hearing aids on or close by and to keep a bathroom light on at night. Answer: TRUE Changes in their sight or hearing can affect their safety. Inner ear changes cause an inability to hear high frequency tones and can cause many words to sound alike. (Speak in clear, normal tones for best comprehension). Also, the elderly may have a decreased ability to see "greens and blues", resulting in a longer adjustment between dark and light rooms. Be careful not to interpret behaviors caused by sensory changes as the result of confusion. 7) True or False? There is no reason to be concerned about the nutritional needs of an elderly person. Answer: FALSE Particular attention needs to be given to the diet of the elderly who limit their intake due to difficulty swallowing (if saliva production is diminished), poorly fitting dentures or absent teeth, a decreased sense of thirst or taste, difficulty in preparing meals, or monetary concerns. 8) Mr. Greene, a 75 year old is two days post total hip replacement, appears to be having difficulty understanding or remembering anything you teach. The best teaching approach should include: a) encourage him to wear his glasses and hearing aids b) providing a quiet, non-distracting environment and encouraging participation c) keeping teaching periods short, pacing learning tasks to his stamina d) teaching what is really important for him to know and reinforcing learning e) all the above Answer: (E) all the above 9) True or False? By age 12, children should be able to take total responsibility for their own self-care needs such as insulin injections. Answer: FALSE School age children are at an ideal age to begin taking some responsibility for their own care. However, it is important to implement changes gradually, frequently assessing both the child's knowledge and skills in order to determine readiness to perform self-care tasks. 10) True or False? It is important to provide rules and boundaries to a hospitalized seven-year-old. Answer: TRUE Children between the ages of 6 and 11 have a very rigid behavior style. They follow rules closely and use rituals; rules reduce anxiety, give specific boundaries, and provide an external standard against which to measure them. 11) True or False? School age children (ages 7-12) need to feel included in groups or club activities. Answer: TRUE Feeling included in groups helps them explore their roles in society. Maintaining contact with a group or club when they are sick is important in improving their self-esteem. 12) True or False? Since toddlers (13 mos.- 3 years) are unable to make choices, all choices should be made for them. Answer: FALSE Toddlers can choose between 2 things on a basic level. The adult role is to offer good choices: "do you want juice or water with your medication?" The child is not given the choice of whether to take the medication or not. 13) True or False? It is normal for a child to regress under stress. Answer: TRUE A child will regress under stress to previous developmental stages such as bed-wetting, or wanting a bottle or pacifier. The child will return to a "pre-stress" level when feeling better. Try not to say, "be a big boy (girl)." Children will do the best they can. 14) True or False? Be honest. Don't hide the truth from children. Answer: TRUE If you don't tell the truth to children, even though your intentions are good, the failure to be honest causes a loss of trust. If something is going to hurt, tell them it will hurt. Acknowledge their feelings. 15) True or False? Relationships with peers are unimportant in the preschool years (ages 4- 6) Answer: FALSE Children learn and seek comfort in relationships with peers. Isolation from these relationships can cause anxiety, fear, and behavioral changes. 16) True or False? When children in the preschool age (4-6) are sick, they don't want to play. Answer: FALSE Preschool children always need to play, even when hospitalized. Through play they learn what no one can teach the. They learn about their world and how they operate in it - what they can do, how to relate to things, how to adapt. 17) True or False? Preschoolers ask a lot of "why" and "what" questions, but they really don't want explanations. Answer: FALSE Preschoolers are very inquisitive and explanations should be simple, concrete, and honest. 18) True or False? Infants below the age of 6 months are not able to communicate their needs. Answer: FALSE Infants can communicate clearly with different cries, cooing, postures, or pulling, patting painful areas, such as ears. They can communicate their needs for food, diaper changes, sleep, and being held, as well as pain, boredom, and illness. Talk to them while you care for them. 19) True or False? Separation and stranger anxiety may occur during the second half of the baby's first year. Answer: True All babies become fearful of strangers and want to cling to parents, turning their faces away from strangers or non-family members. Actual separation, even for short periods, can increase this anxiety. 20) The middle-aged adult who is hospitalized may be concerned about his employment status. Occupational stress affects physical and emotional well being. Answer: TRUE Middle adults are striving to live up to the highest potential and assuring security for later years, both financially and emotionally.