Chapter 22: Young Adult


Chapter 22: Young Adult
Edelman: Health Promotion Throughout the Life Span, 8th Edition


1. A nurse is planning a community health education program for young adults. Which of the following considerations should be made by the nurse?
a. The age span encompassing young adulthood is between 20 to 30 years of age.
b. The number one cause of death for young adults is injury.
c. The number of young adults in the United States is increasing.
d. The maternal mortality rate is at its lowest point since 1980.
Young adulthood spans the years between ages 18 to 35. The number of young adults in the United States is declining, and the maternal mortality rate is at its highest level since 1980.

DIF: Cognitive Level: Apply (Application) REF: p. 536

2. A nurse is completing a health counseling session with a 25-year-old woman. Which of the following statements should be made by the nurse during this session?
a. “A yearly Pap test is recommended for detection of ovarian cancer.”
b. “Research supports that breast self-exams reduce breast cancer mortality.”
c. “The incidence of cervical cancer is very low in your age group.”
d. “Daily physical activity and weight control is one way to stay healthy.”
Screening is strongly recommended for cervical cancer in women who have been sexually active (Papanicolaou [Pap] smears). The incidence of carcinoma in situ is high in young adults. The US Preventative Services Task Force recommends against teaching breast self-examination and concludes that the current evidence is insufficient to assess the additional benefits and harm of clinical breast examination beyond screening mammography for women 40 and older. After age 25, the preventive emphasis is on modifying coronary disease risk factors, which would be accomplished by discussing activity and weight control.

DIF: Cognitive Level: Apply (Application) REF: pp. 538-539

3. A 26-year-old client has a total cholesterol of 206 mg/dL and an LDL of 110. Which of the following conclusions can be drawn by the nurse?
a. The client has achieved the target levels for cholesterol in young adults.
b. The client has a very low risk of developing heart disease.
c. The client requires counseling about cardiac disease risk factors.
d. The client has early-onset cardiac disease.
Cardiovascular assessment of the young adult includes determining the presences of hyperlipemia, hypertension, diabetes, chest pain, or heart disease. This client has an elevated cholesterol levels and requires additional education about risk factors that may lead to cardiac disease. The Healthy People 2020 target is to reduce the mean total blood cholesterol levels among adults to 177.9 mg/dL. A diagnosis of heart disease cannot be made on the basis of these lab values.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 538-539

4. The public health nurse is conducting a screening of young adults for metabolic syndrome. When asked about the syndrome, which of the following responses should be made by the nurse?
a. “Anyone who has low blood sugar, high cholesterol, and high blood pressure has this syndrome and is at risk for cardiac disease.”
b. “This syndrome helps predict heart disease. Once it is diagnosed, the correct medication can be prescribed and heart disease avoided.”
c. “This syndrome is a warning sign that the person could develop heart disease. When someone has metabolic syndrome, dietary and activity level changes are recommended.”
d. “Anyone who has high cholesterol, high blood pressure, and high blood sugar has coronary artery disease. Once we make the diagnosis, we can begin to treat the disease.”
Metabolic syndrome is diagnosed when a person has high cholesterol, high blood pressure, and high blood sugar. A person with this syndrome is at risk for coronary artery disease. Lifestyle changes are tried before medication is used.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 541

5. The university health services nurse is preparing a disease prevention program for college students. Which of the following information should the nurse include in the program?
a. Living in the dorm increases one’s risk of developing meningococcal disease.
b. The mortality rate from meningococcal disease is very low.
c. There are no antiviral medications that can treat meningococcal outbreaks.
d. A vaccine for meningococcal disease has not been developed.
Although most outbreaks of meningococcal disease are sporadic, young adults living in dormitories or crowded conditions may be more susceptible than young adults not living in close settings. Meningococcal disease has a high mortality rate. It is caused by a bacterium, not a virus, and antibiotics to treat the disease are readily available. A preventive vaccine is available.

DIF: Cognitive Level: Apply (Application) REF: p. 543

6. A 30-year-old woman with a BMI of 36 is counseled by the nurse regarding interventions to assist with weight reduction. In which order would the nurse discuss the implementation of these interventions?

1. Gastric stapling
2. Medication to reduce appetite
3. Nutrition and exercise education
4. Assessment of lipid profile and blood pressure
a. 4, 3, 2, 1
b. 4, 2, 3, 1
c. 3, 4, 2, 1
d. 3, 2, 1, 4
Assessment data must be complete before intervention. Diet and exercise are used first, and then pharmaceutical agents to reduce appetite. Bariatric surgery is used when all other options have failed.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 544

7. A nurse is discussing optimal activity for young adults. Which of the following information should be stressed?
a. Forty-five minutes of moderate exercise per day are required to maximize health benefits.
b. An increase in heart rate from 70 to 200 beats/min during exercise is optimal.
c. Moderately brisk walking is an appropriate aerobic exercise.
d. Sixty minutes of exercise three times a week is recommended.
The Healthy People 2020 goal is to increase the proportion of adults who engage in moderate physical activity for 150 minutes a week (30 minutes five times per week) to 47.9% from 43.5%. Aerobic conditioning achieves cardiovascular fitness through five periods of moderately intense exercise weekly for about 30 minutes or more at a heart rate of approximately 220 minus the age of the person multiplied by 65% to 85%. Young adults are encouraged to engage in fitness activities that increase the heart rate to approximately 150 beats or more per minute. Moderately brisk walking that increases the heart rate is an appropriate aerobic exercise.

DIF: Cognitive Level: Apply (Application) REF: p. 545

8. The nurse working in the college health center is asked about a safe way to obtain a tan. Which of the following would be the best response by the nurse?
a. “There is no safe way. Be sure to stay out of the sun as much as possible.”
b. “Tanning beds are much safer than exposure to actual sunlight.”
c. “Be sure to use sunblock agents and do not sunbathe between 10 AM and 2 PM.”
d. “Once you apply sunblock, you are protected all day, so be sure to use it before any outdoor activity.”
Young adults should avoid sunbathing during the 2-hour period before and after noon because two-thirds of the day’s ultraviolet light comes through the earth’s atmosphere during this time. There is no need to stay completely out of the sun. Tanning beds are not a safe way to tan. Sunblock should be reapplied if certain outdoor activities are part of the day, such as swimming.

DIF: Cognitive Level: Apply (Application) REF: p. 545

9. A nurse is working in the community to prevent bicycle and motorcycle fatalities. Which of the following measures would be most effective for the nurse to promote?
a. Use of helmets
b. Increasing the minimum age for motorcycle licensure
c. Construction of bike paths along busy roads
d. Right-of-way laws for bicyclists
Head injury is the major cause of death related to bicycle or motorcycle accidents. Bicycle helmets are believed to be the single most effective preventive measure available to decrease the incidence of brain and head injury.

DIF: Cognitive Level: Apply (Application) REF: p. 545

10. Which of the following reflects Piaget’s theory as applied to young adults?
a. Voting for a candidate based on popularity
b. Voting for a candidate based on media advertisements
c. Voting for a candidate based on support of the candidate by peers
d. Voting for a candidate based on analysis of views about various issues
Young adults are in Piaget’s formal operational thinking stage during which they analyze issues objectively and insightfully.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 546

11. Which of the following adults has transitioned to Erikson’s intimacy versus isolation and loneliness stage of development?
a. A 21-year-old man who has a part-time job, spends most of his leisure time with his buddies, and has numerous short-term intimate relationships
b. A 25-year-old woman who is very concerned with how she is perceived by her coworkers and friends
c. A 30-year-old man who just graduated with a PhD and is looking for his first full-time job
d. A 26-year-old woman who has a long-term relationship with a female companion
Erikson’s intimacy versus isolation and loneliness stage of development involves reciprocal expressions of affection and trust. Promiscuous behavior is not characteristic of this stage of development. Reliance on a positive perception by friends and coworkers for self-esteem is not characteristic of this stage of development.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 546

12. Which of the following young adults exemplifies Kohlberg’s postconventional level of moral reasoning?
a. 28-year-old person who calls in sick so as to help a friend move to a new location
b. 22-year-old man who uses marijuana on the weekends with friends
c. 30-year-old woman who volunteers at a soup kitchen one day a month
d. 35-year-old who works long hours so as to be considered for a promotion
Someone in Kohlberg’s postconventional level of moral reasoning is able to do what is beneficial or “right” regardless of peer pressure to take another course of action.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 546

13. Which of the following statements should be considered by a nurse working in occupational health who organizes a stress reduction workshop?
a. Women generally experience less workplace stress than do men.
b. One’s first job is exciting and leads to numerous opportunities, and therefore causes little stress.
c. Young adults adapt easily to changing job demands such as telecommuting and long work hours.
d. Work is of primary importance to young adults and helps form their self-image.
Employment is more than a source of income to young adults; it provides self-esteem and social interaction. Women experience as much, and sometimes more, stress than do men because of child care issues. The demands of work are stressful and sometimes lead to unhealthy behavior.

DIF: Cognitive Level: Apply (Application) REF: p. 547

14. The parents of a young adult female have recently divorced. Which of the following is the young adult most likely to experience?
a. Relief
b. Depression
c. Unemployment
d. Inability to sustain own relationships
Although dissatisfaction and unhappiness are frequent precursors to separation and divorce, the decision to dissolve a marriage is not easy. Divorced young adults frequently suffer severe emotional strain and depression. Some young adults are unable to adjust to role and status changes and to threats of self-concept. Young adults whose parents divorce have an increased rate of divorce, but that does not mean that they are unable to sustain their own relationships.

DIF: Cognitive Level: Apply (Application) REF: p. 548

15. A 19-year-old college student is seen by the health services nurse. The young woman is distraught that she had unprotected sex 4 days ago and is afraid she may have become pregnant. Which of the following statements should be made by the nurse?
a. “Let’s talk about your options because you must be 21 years of age to purchase emergency contraception.”
b. “Don’t worry; you can purchase Plan B, an emergency contraception drug, without a prescription and it will terminate the pregnancy.”
c. “I know you are upset, but we are in one of the 40 states that allow drugstores to carry Plan B, an emergency contraception drug. Let’s talk about how to use the medication.”
d. “You have several options. Let’s discuss what would be the best thing for you to do next.”
Emergency contraception can reduce the number of unintended pregnancies. There is a generic two-dose form Next Choice, and a one-dose form, Plan B One-Step. Both require a prescription for girls under 17. Emergency contraception must be used within three days of unprotected sex. It works by either altering tubal transport of either sperm or ova, inhibiting implantation. It will not terminate an existing pregnancy and does not provide protection against sexually transmitted diseases.

DIF: Cognitive Level: Apply (Application) REF: pp. 550-551

16. The nurse working in the college health center is planning a program about sexually transmitted diseases (STDs). Which of the following information should the nurse include in the program?
a. STDs are the third most common infection in young adults.
b. STDs can be transmitted by any intimate contact, not just sexual intercourse.
c. STDs usually occur as a single infection.
d. STDs are the most common reason for a visit to the health center.
STDs can be transmitted from oral and anal sex, not just vaginal intercourse, and many young adults do not understand this. STDs are the most common infection in persons age 15 to 24. A person may have multiple STDs. STDs are generally unreported and not treated.

DIF: Cognitive Level: Apply (Application) REF: pp. 551-552

17. A 32-year-old woman visits the occupational health nurse because of malaise. Which of the following assessment data indicates that the client may be experiencing achievement-oriented stress?
a. Sleeping 10 hours per day
b. Unintentional loss of 10 pounds in the past 3 weeks
c. Expressed fear of company layoffs
d. Calling in sick once every 2 weeks for the past month
Achievement-oriented stress is characterized by lack of sleep, skipping meals, and workaholic habits. It differs from situational stress, which would be caused by changes in job function for example.

DIF: Cognitive Level: Apply (Application) REF: p. 553

18. A nurse volunteered to work at a natural disaster site. Which of the following questions should the nurse ask to determine if the 26-year-old individual being screened is depressed or has suicide ideation?
a. “Tell me about your pets.”
b. “What do you do for work? How has your work been affected by this disaster?”
c. “Have you thought of harming yourself?”
d. “Have you seen your friends since the disaster?”
Direct questioning about the intent to harm oneself is appropriate for the nurse to ask during screening/counseling sessions.

DIF: Cognitive Level: Apply (Application) REF: pp. 553-554

19. A nurse is planning health care for young adults. Which of the following factors about the interventions should be recognized by the nurse as having the greatest impact on whether they are effective?
a. Culturally sensitive
b. Match the person’s health care beliefs
c. Cost effective
d. Gender neutral
Unless the interventions are culturally sensitive, they are not likely to be successful. Although the other factors are important, the priority consideration is cultural sensitivity.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 554-555

20. Which of the following circumstances accounts for one of the leading cause of death in young adults?
a. Tobacco use
b. Binge drinking and driving
c. Illegal drug use
d. HIV infection
Alcohol-related accidents among individuals ages 15 to 24 continue to be a leading cause of preventable morbidity, disability, and death.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 556

21. A nurse is counseling a 23-year-old woman about oral, transdermal, injectable, vaginal ring, and implant contraceptive methods. Which of the following risks of using these methods should be stressed by the nurse?
a. Toxic shock syndrome
b. Nausea
c. Blood clots
d. Ectopic pregnancy
Blood clots are a potential risk with using all of these contraceptive methods. Ectopic pregnancy is a possible complication of IUDs. Nausea may occur with the use of Plan B, and toxic shock syndrome may occur with use of a diaphragm.

DIF: Cognitive Level: Apply (Application) REF: p. 551 (Table 22-2)

22. Which of the following interventions are appropriate relative to the nursing diagnosis: Health-Seeking Behaviors Related to Preconceptual Assessment and Preparation for Childbearing?
a. Encouraging the consumption of a moderate-fat diet to prepare for pregnancy
b. Referral to genetic counseling based on family history
c. Counseling to avoid “hard” liquor
d. Substituting a nutritional supplement for a meal so as to assure adequate vitamin intake
Assessment of biophysical risk factor is an important intervention, which includes review of genetic disorders, nutrition problems, and current medical problems. Before and during pregnancy, the diet should be well-balanced, low in fat and sodium, and high in calcium and iron. Nutritional supplements are not required unless the woman is malnourished. Alcohol in all forms including beer and wine should be avoided.

DIF: Cognitive Level: Apply (Application) REF: p. 559 (Care Plan)


1. An occupational health nurse is conducting a blood pressure screening. Which of the following clients is at greatest risk of mortality from cardiac disease? (select all that apply)
a. Black man with a blood pressure of 130/80
b. Mexican American man with a blood pressure of 110/60
c. White woman with a bold pressure of 120/80
d. Black woman with a blood pressure of 128/78
According to the JNC VII, the risk for cardiovascular events rises when blood pressure is greater than 115/75. Blacks have a higher death rate from heart disease than do Whites. Mexican Americans have the lowest rate of hypertension.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 538-539

2. A public health nurse is interested in writing a grant to improve vaccination rates of young adults. His focus should be on trying to obtain funding to support which of the following vaccination initiatives? (select all that apply)
a. Rubella prevention
b. Lyme disease prevention
c. Hepatitis B prevention
d. Human papilloma virus (HPV) prevention
Rubella in young adults is generally a minor disease; the population at risk is women of childbearing age. There is not a vaccine available for Lyme disease. Hepatitis B and HPV can both be prevented through immunization and young adults are at high risk for contracting these diseases.

DIF: Cognitive Level: Apply (Application) REF: p. 543

3. A nurse is conducting a community health education program for Hispanic women ages 18 to 35. Which of the following items should the nurse recommend that they increase in their diet on a daily basis? (select all that apply)
a. Calcium
b. Folic acid
c. Iron
d. Sodium
ANS: A, B, C
Women of childbearing age frequently consume a diet deficient in calcium, iron, and folic acid.

DIF: Cognitive Level: Apply (Application) REF: p. 544

4. A community health nurse has received a grant to present a program about violence prevention. Which of the following individuals has a higher than average risk of homicide? (select all that apply)
a. 33-year-old woman who served 5 years in prison
b. 20-year-old homeless man
c. 28-year-old man with a history of bipolar disorder
d. 24-year-old woman who has a female partner
ANS: A, B, C
Homicide is closely associated with alcohol and drug abuse and frequently is related to other violent acts, such as robbery. Other risk factors for homicide include a history of loss of employment, detention or prison experience, access to firearms, abuse in the home, mental illness, social isolation, and homelessness.

DIF: Cognitive Level: Apply (Application) REF: p. 549

5. A nurse is working in a domestic violence shelter. Which of the following individuals would the nurse expect to encounter? (select all that apply)
a. 34-year-old White woman who is vice president of a communications company
b. 26-year-old Black woman who has a live-in boyfriend
c. 29-year-old Hispanic man who has been married for 2 years
d. 21-year-old unemployed White woman who has been with her boyfriend for 3 years
ANS: A, B, C, D
Abusive behavior victims come from all racial, ethnic, and socioeconomic levels.

DIF: Cognitive Level: Apply (Application) REF: p. 549

6. A nurse is planning community health programming for young adults. Based on the objectives for Healthy People 2020, which of the following topics would be priority areas for programming? (select all that apply)
a. Prenatal care
b. Physical activity
c. HIV
d. Suicide
Healthy People 2020 objectives targeted for the young adult include increasing the proportion of adults who engage in regular aerobic activity of moderate intensity and increasing the proportion of women who receive early and adequate prenatal care. HIV and suicide rates are not mentioned in the target areas for young adults.

DIF: Cognitive Level: Apply (Application) REF: p. 537 (Box 22-2)