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Chapter 07: Social, Psychological, Spiritual, and Cognitive Aspects of Aging
Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 2nd
Canadian Edition

MULTIPLE CHOICE

1. Which of the following statements is true about sociological theories of aging?

a. Disengagement theory, activity theory, and continuity theory are supported by
data.
b. Everyone should be able to achieve the three tasks of Peck’s model of integrity.
c. The exercising of rights is not a task of aging in Kelly’s model.
d. A person may choose to avoid pursuing inner discovery in old age.
ANS: D

Feedback
A Incorrect. None of these theories is clearly supported by data.
B Incorrect. Peck’s tasks of ego differentiation, body transcendence, and ego
transcendence demand a great deal of courage and energy that not everyone
possesses.
C Incorrect. Tasks of aging in Kelly’s model are accepting reality, fulfilling
responsibility, and exercising rights.
D Correct. Some persons do not value inner psychological exploration and remain
action oriented even in old age, while others are still subject to the same
demands of daily living as they were in middle age.

DIF: Comprehension REF: 94 OBJ: 1

TOP: NCLEX: Psychosocial Integrity

2. Which statement is true about the social, emotional, and spiritual well-being of older
persons?
a. Contemporary society has strong norms for the behaviour 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 persons in their need
for social support.
d. Nurses are often significant sources of social and emotional support for older
persons.
ANS: D

Feedback
A Incorrect. The diversity of cultures and individuals in a society like Canada’s
means that norms are almost nonexistent for persons older than 80 years.
B Incorrect. Older persons have a great deal to contribute in wisdom and by
example.
C Incorrect. E-mail and social networking sites are a means of contact and social
support for many older persons.
 D Correct. Nurses are often important confidants and providers of social support in
the lives of older persons.

DIF: Comprehension REF: 100 OBJ: 1

TOP: NCLEX: Psychosocial Integrity

3. Which alterations in roles are most likely to have a significant effect on the type of aging
process experienced by the older person?
a. Being a grandparent and church member
b. Losing employment or a spouse
c. Being a friend and patient
d. Being a parent and volunteer
ANS: B

Feedback
A Incorrect. Alterations in these roles are not usually as challenging as loss of
employment and loss of a spouse. Grandparenting and church membership can
offer the potential for enhanced social experiences for an older person; however,
adults can age well without them when more basic needs are met.
B Correct. The loss of employment or a spouse are likely to be devastating for an
older person for economic and biopsychosocial reasons. Losing a job not only
includes the loss of income and benefits, most notably health insurance, but can
include the loss of lifestyle, identity, and sense of importance or purpose in life.
When an older person loses a spouse, the loss can include economic security,
especially for women, and societal roles.
C Incorrect. Alterations in these roles are not always as acutely demanding as loss
of a spouse or retirement.
D Incorrect. Alterations in these roles usually call for little or gradual adjustment.

DIF: Comprehension REF: 95 (Box 7-2) OBJ: 2

TOP: NCLEX: Psychosocial Integrity

4. 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?
a. Historical context
b. Biological context
c. Sociological context
d. Chronological context
ANS: A

Feedback
A Correct. In the age-stratification theory, historical context is used to understand
members of a cohort in terms of similar events, conditions, and circumstances
and the effect these things have on the group as a whole. A good example of
such a cohort is older persons who lived through World War II.
B Incorrect. Biological context is not important in considering the age-stratification
theory.
C Incorrect. The age-stratification theory is a sociological theory of aging that uses
historical context to describe cohorts.
 D Incorrect. Chronological context of a cohort will span a range, but historical
context is what describes the cohort.

DIF: Knowledge REF: 92 OBJ: 2

TOP: NCLEX: Psychosocial Integrity

5. An older male adult 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
welfare. Using Jung’s theory, what in this individual’s life is the most pivotal in his
personality development?
a. Living alone
b. Meagre income
c. Severe knee pain
d. Job loss and home loss
ANS: D

Feedback
A Incorrect. Living alone is a situation that is the result of many factors coalescing
in an individual’s life.
B Incorrect. A meagre income can be a result of the individual’s life work and
other individual choices and events.
C Incorrect. Personality can affect how an individual deals with pain, and the pain
can affect an individual’s personality; however, the reader does not know if the
pain is old or new and thus cannot make the determination.
D Correct. Jung theorizes that the personality forms, in part, after crisis, as an
individual moves from extroversion to introversion in aging.

DIF: Analysis REF: 94 OBJ: 1

TOP: NCLEX: Psychosocial Integrity

6. The nurse plans care for older persons who are in good health but isolated from their
families. If the nurse’s goal is to move the adults toward gerotranscendence, which of the
following interventions 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. Encourage each person to focus on individual activities.
d. Assist them to resume midlife patterns.
ANS: C

Feedback
A Incorrect. Individual activities or self-selected activities are satisfactory.
B Incorrect. Solitude is satisfactory.
C Correct. In Tornstam’s theory, aging offers the potential for gerotranscendence,
a culmination of an individual’s life, wisdom, and spiritual growth that allows
the older person to live contentedly with and without social activities. An older
person spends more time on meditation and solitude, and less time on
materialism and self-consciousness about body image.
D Incorrect. Midlife patterns are no longer relevant to contentment.
 DIF: Application REF: 95 OBJ: 1
TOP: NCLEX: Psychosocial Integrity

7. The nurse observes older female adults learning advanced knitting techniques. The nurse
concludes that this is a suitable learning activity for these women because it accomplishes
which goal?
a. It helps to maintain joint flexibility.
b. It improves the group’s cohesiveness.
c. It provides a needed social opportunity.
d. It adds to their existing knowledge base.
ANS: D

Feedback
A Incorrect. Joint flexibility is a physical activity and not necessarily a learning
activity.
B Incorrect. The members share enjoyment of knitting; other than being female
and older, the group does not necessarily have a special bond on which to build.
C Incorrect. The need for socializing is not evident.
D Correct. Learning advanced techniques is a suitable activity for older persons
because it builds on knowledge they have already; further, it is suitable because
it is concrete and practical for experienced knitters to develop advanced skills.

DIF: Application REF: 100-101 OBJ: 5

TOP: NCLEX: Health Promotion and Maintenance

8. The nurse at a nursing home wants to help decrease the risk of Alzheimer’s disease among
the residents. Which of the following should the nurse do to implement this goal?
a. Assist residents with ambulation to meals.
b. Offer beads for the residents to string on yarn.
c. Show movies that the residents choose.
d. Keep the curtains open in the residents’ rooms.
ANS: A

Feedback
A Correct. Engaging in physical activity and social interaction are associated with
a lower risk for Alzheimer’s disease.
B Incorrect. This is unlikely to decrease the risk for Alzheimer’s disease because
stringing beads is a passive, sedentary activity; physical activity is associated
with a lower risk for Alzheimer’s disease.
C Incorrect. Watching movies is a sedentary but not mentally stimulating activity
for an adult with normal intelligence.
D Incorrect. Social interaction is associated with a lower risk for Alzheimer’s
disease. Keeping the curtains open can make the resident’s room more pleasant
but is likely to be counterproductive in lowering the risk because brightening the
room can entice the resident to stay in the room and decrease social interaction.

DIF: Application REF: 91 OBJ: 4

TOP: NCLEX: Health Promotion and Maintenance
 9. Which physiological change in the brain is the reason the nurse allows more time for older
persons to answer questions?
a. Increased secretion of acetylcholine
b. Decreased secretion of neurotransmitters such as dopamine
c. Loss of brainstem neurons
d. Atrophy of dendrites in the cerebral cortex
ANS: D

Feedback
A Incorrect. The secretion of cholinesterase, the enzyme that inactivates
acetylcholine in the synapse, does not increase with aging.
B Incorrect. Changes in the transmission of neurotransmitters are associated with
the atrophy of dendrites.
C Incorrect. It is the cerebral cortex that loses neurons with age.
D Correct. 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.

DIF: Comprehension REF: 98 OBJ: 4

TOP: NCLEX: Physiological Integrity

10. The nurse provides opportunities for nursing home residents to read aloud to others.
Which cognitive skill is this nursing intervention most likely to improve?
a. Verbal fluency
b. Logical analysis
c. Object naming
d. Visuospatial skills
ANS: A

Feedback
A Correct. Allowing residents to read aloud helps to improve and maintain verbal
fluency because it provides an opportunity to practise those skills.
B Incorrect. Reading aloud does not usually require analysis.
C Incorrect. Reading aloud is unlikely to improve object recall unless displaying
objects is part of the reading.
D Incorrect. Visuospatial skill is the ability to perceive the relationship of objects
in terms of the space each object occupies; reading aloud is unlikely to improve
this skill.

DIF: Comprehension REF: 99 OBJ: 5

TOP: NCLEX: Psychosocial Integrity

11. Crystallized intelligence consists of:

a. Memories created more than 20 years ago.
b. Knowledge and abilities that the person acquires through education and life.
c. Skills that are biologically determined.
d. Education acquired through post-secondary education.
ANS: B

Feedback
A Incorrect. Memory is not the sole factor in types of intelligence.
B Correct. Crystallized intelligence is developed throughout life and consists of
both formal education and life experience.
C Incorrect. This is the definition of fluid intelligence.
D Incorrect. Although formal education plays a part in crystallized intelligence, it
does not have to be post-secondary.

DIF: Knowledge REF: 99 OBJ: 5

TOP: NCLEX: Physiological Integrity
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