Fundamentals · chapter 40 · Young and Middle-Aged Adults
Growth and Development Stages
The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.
Key points
Adult lifestyle effects
Physical changes during this time are more subtle than the visible changes of growth during adolescence and are directly related to lifestyle choices such as physical activity level, nutrition choices, and substance use (Lawrence et al., 2017; Zheng et al., 2017).
Nursing health promotion
Nurses can encourage patients to maintain healthy lifestyle practices in young adulthood to reduce health risks as they move into middle adulthood.
Young adult physical peak
During the young adult stage, ages 18 to 35 years, individuals experience stabilization in physical growth, particularly changes in height and weight. While young adults may continue to increase muscle mass and bone strength, this stage is often considered the peak in physical development.
Peak organ function
In healthy young adults, many organ systems are at peak function. These physical attributes allow young adults to perform at maximum ability and are directly tied to their physiological development.
Young adult brain development
Young adults experience significant brain development, which continues up to age 30 years (Hochberg Konner, 2020). This ongoing brain development in early young adulthood significantly affects the psychological and social development of the individual.
Young adult lifestyle risks
Lifestyle choices, such as unhealthy eating habits, lack of exercise, or substance use disorders, can have significant negative short- and long-term effects on health (Zheng et al., 2017). While young adults may have a certain level of resilience, chronic poor lifestyle choices can increase the risk of developing various health issues later in life, such as obesity, cardiovascular disease, and diabetes.
Early aging signs
In the later part of young adulthood, organ systems start a slow, gradual decline. By the mid to late 30s, young adults start noticing signs of aging.
Emerging adulthood maturation
Significant brain development continues throughout this stage of adulthood, which occurs immediately after adolescence and typically lasts until around the age of 25 years (Wood et al., 2017). Young adults experience significant behavioral and social maturation during this time, during which they are expected to perform as adults.
Improving executive functions
As individuals progress through young adulthood, they typically experience significant improvement in executive functions that are based on both life experiences and the completion of brain development.
Emerging adulthood tasks
However, by the end of early adulthood, most individuals will have accomplished the core developmental tasks of becoming more autonomous, taking care of themselves and others, committing to relationships and jobs/careers, getting married, raising families, and integrating into their chosen communities.
Middle adulthood timing
Around the time individuals reach their 40s, they enter middle adulthood, which extends to the mid-60s.
Middle adulthood aging changes
During middle adulthood, individuals continue to notice signs of aging, although these may be more subtle or more pronounced depending on individual characteristics and life choices.
Middle adult muscle loss
One of the primary musculoskeletal physiological changes that occurs during middle adulthood, regardless of health status, is the loss of muscle mass.
Cardiovascular aging changes
Some common cardiovascular changes during this stage include increased blood pressure due to blood vessels losing elasticity, decreased cardiac output, plaque buildup in the arteries, and thickening of the heart muscle.
Terms to know
- Physical changes
- Physical changes refer to alterations in the body’s structure or appearance, such as body shape, skin texture, or muscle mass, while physiological changes involve modifications in bodily functions or processes, such as metabolism, kidney function, and blood pressure.
- physiological changes
- Physical changes refer to alterations in the body’s structure or appearance, such as body shape, skin texture, or muscle mass, while physiological changes involve modifications in bodily functions or processes, such as metabolism, kidney function, and blood pressure.
- psychological change
- Changes relating to the mind and emotions are called a psychological change.
- psychosocial factor
- A psychosocial factor is related to interpersonal interactions, such as relationships, work communication, and cooperation in living situations.
- executive functioning
- Many of these psychological changes occur in response to the development of the frontal cortex, which controls executive functioning —the ability to develop plans, focus attention, perform from working memory, maintain self-awareness, initiate and execute complicated tasks, control impulses, and manage emotions.
- Variable reward systems
- Variable reward systems are unpredictable psychological rewards that provide a dopamine surge in the brain and encourage individuals to pursue additional gratification (Haynes, 2018).
- osteosarcopenia
- Sarcopenia and associated osteosarcopenia, the decline of muscle and bone tissue, pose significant physical change during middle adulthood.
- achlorhydria
- The disorder achlorhydria, in which the stomach produces insufficient acid, may also occur.
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
The graded version needs JavaScript. Every question is below anyway, with the answer and why.
Every question here, with the answer
A 23-year-old patient says, “I’m young, so I can worry about exercise and nutrition later.” Which nursing response best supports health as the patient moves into middle adulthood?
- Explain that physical changes in young adulthood are as visible and rapid as in adolescence.
- Encourage adequate nutrition, exercise, positive social interaction, and moderating digital and social media use now.
- Reassure the patient that peak organ function will compensate for chronic poor lifestyle choices.
- Delay lifestyle teaching until the patient notices signs of aging in the mid to late 30s.
Answer: Encourage adequate nutrition, exercise, positive social interaction, and moderating digital and social media use now.
Healthy habits in young adulthood affect health in the next stage and can reduce later risks. The other responses minimize the long-term effects of lifestyle choices or misrepresent the subtle nature of adult physical changes.
A 24-year-old student reports insomnia, trouble concentrating, and heavy evening device use. Which effects should the nurse include when teaching about excessive screen use and sleep quality? Select all that apply.
- Trouble concentrating
- Disruption in circadian rhythm
- Improved quality of REM sleep
- Altered sleep patterns
- Reduced bladder capacity
- Hyperarousal
Answer: Trouble concentrating, Disruption in circadian rhythm, Altered sleep patterns, Hyperarousal
The section identifies hyperarousal, circadian rhythm disruption, altered sleep patterns, and trouble concentrating as effects of excessive screen use on sleep quality. Reduced bladder capacity is a urinary change in middle adulthood, and improved REM sleep is the opposite of the sleep-quality concern described.
A 21-year-old patient is working on better impulse control, planning, and managing emotions in a new job. Which developmental explanation is most appropriate for the nurse to provide?
- These abilities primarily reflect the beginning of sarcopenia in early adulthood.
- These abilities are expected because GI motility increases during emerging adulthood.
- These abilities occur because lung compliance starts to decline during young adulthood.
- These abilities are related to ongoing frontal cortex development and improving executive functioning.
Answer: These abilities are related to ongoing frontal cortex development and improving executive functioning.
The section links planning, attention, impulse control, and emotion management to executive functioning controlled by the frontal cortex. Sarcopenia, lung compliance, and GI motility are not the developmental explanation for these psychological changes.
A 50-year-old patient asks which skin changes can occur during middle adulthood. Which findings should the nurse include? Select all that apply.
- Delayed wound healing
- Increased subcutaneous tissue thickness
- Dry skin
- Dark spots
- Increased skin elasticity
- Skin tags
Answer: Delayed wound healing, Dry skin, Dark spots, Skin tags
Dry skin, skin tags, dark spots, and delayed wound healing are listed as integumentary changes middle-aged adults may notice. Increased skin elasticity and increased subcutaneous tissue thickness are not correct because the section describes reduced skin elasticity and decreased subcutaneous tissue thickness.
A middle-aged adult has elevated blood pressure and asks what actions may reduce long-term effects on cardiovascular and kidney health. Which response is most consistent with the section?
- Focus on lifestyle changes such as limited alcohol intake and daily physical activity, along with treatment of high blood pressure with medications.
- Wait until older adulthood, because negative cardiovascular changes do not start in middle adulthood.
- Focus only on skin changes, because cardiovascular changes are not affected by lifestyle choices.
- Avoid daily physical activity because reduced cardiac output makes exercise unsafe in middle adulthood.
Answer: Focus on lifestyle changes such as limited alcohol intake and daily physical activity, along with treatment of high blood pressure with medications.
The section states that lifestyle changes and treatment of high blood pressure can reduce long-term cardiovascular and kidney impacts. The other options conflict with the section’s emphasis on physical movement, early middle-adult cardiovascular changes, and lifestyle management.
A nurse is teaching a middle-aged person assigned male at birth about urinary symptoms that may occur with prostate enlargement. Which symptoms should the nurse include? Select all that apply.
- Increased bladder capacity
- Urinary urgency
- Urinary retention
- Urinary frequency
- Incontinence
- Weak urinary stream
Answer: Urinary urgency, Urinary retention, Urinary frequency, Incontinence, Weak urinary stream
The section lists urinary frequency, urgency, incontinence, weak urinary stream, and urinary retention as symptoms persons AMAB may notice with prostate enlargement. Increased bladder capacity is incorrect because the section describes reduced bladder capacity as a urinary change.
Where every quote comes from
Section 40.1 Growth and Development Stages of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.