Question 1

You are questioning your elderly resident about meal choices.He reluctantly answers your questions,and when pressed,states,"Why are you asking me? You guys always do what you want anyway!" Although surprised by his outburst,you recognize that he is exhibiting:

A) denial.
B) dementia.
C) powerlessness.
D) delirium.

powerlessness.

Accepted Answer

Uncertainty of illness can lead to feelings of powerlessness and decreased coping skills.The nurse needs to make efforts to reinstate control to the patient.He is not exhibiting denial or signs of dementia.There is no evidence of delirium.

Question 2

A 68-year-old man recently suffered a left-sided cerebrovascular accident (CVA)and is now in an acute rehabilitation setting.He is easily frustrated due to his physical deficits.During his morning bath,the nurse instructs the certified nursing assistant (CNA)to give the patient a washcloth and let him wash his face and as much of his upper body as possible.The primary reason for this is to:

A) allow the patient to establish some control and preserve self-esteem.
B) exercise the patient's left arm.
C) save time so the CNA can assist other patients.
D) allow the CNA to establish control over the situation.

Accepted Answer

The role of the nurse is to preserve the self-esteem of the individual,which can be done by allowing the individual to establish some control over the situation.Although exercising the left arm might occur during this activity,it is not the primary reason for the activity.Having the patient participate in his own care may in fact be more time-consuming for the CNA.The patient is the one who is in control in this situation.

Question 3

A 76-year-old woman was recently admitted to a nursing home.She was transferred directly from the hospital after a hospitalization for a fall and subsequent hip replacement.Her daughter was not able to accompany her on the transfer to the nursing home.She is not eating well,refuses to take her medications,and prefers to sit in her room.Her daughter visits and expresses concern to the nurse.What suggestion is most appropriate for the nurse to suggest to the daughter?

A) Visit often and bring familiar objects from the patient's home to decorate her room.
B) Do not visit for a few weeks in order to give the patient time to get used to the facility.
C) Speak with the primary physician and request a psychiatric evaluation to rule out dementia.
D) Transfer the patient to a different facility because she is not adjusting to this one.

Accepted Answer

The patient is most likely experiencing relocation stress,and family visits and familiar objects from home are useful.There is no evidence that the resident has signs of dementia.The resident is most likely exhibiting relocation stress,which will likely intensify if she is subjected to another move.

Question 4

What is a true statement regarding crises and stress?&#10;A) Stress always precipitates a crisis.&#10;B) Crises always create stress.&#10;C) Personal perception of an event is less significant than the event's magnitude.&#10;D) Stress is time limited.

Accepted Answer

Crises are temporary disruptions in coping capacity that create stress.In a stressful situation,an individual may display either effectual or ineffectual coping strategies,but coping strategies are in use.Stress response exists when there is a discrepancy between what the individual expects and that which requires change or recognition of uncertainty.The individual's perception of an event is far more important than the actual magnitude of the event.Stress may be ongoing.

Question 5

What is a true statement about coping strategies in older adults?&#10;A) Older adults are often less able to cope with stress due to decreased adaptive capacity.&#10;B) Older adults are less able to cope with stress due to cognitive declines.&#10;C) Coping strategies used in earlier life are ineffective in later life.&#10;D) Older adults use coping strategies directed at avoiding the problem.

Accepted Answer

Older adults frequently have a decreased adaptive capacity and decreased energy.Cognitive declines are not part of normal aging.Coping strategies,which were successful earlier in life,are frequently successful as the individual ages.Older adults use a variety of coping strategies,including those directed at the problem and those that avoid the problem.

Question 6

A 90-year-old client in an adult day care program tells the nurse that she is very stressed because her neighbor passed away.The most therapeutic response is:&#10;A) &#34;Let's think of happy things.&#34;&#10;B) &#34;Tell me what you did and how you managed when your other neighbor passed away last year.&#34;&#10;C) &#34;You should count your blessings and not dwell on sad things.&#34;&#10;D) &#34;Let's get involved in some activities and not think about sad things.&#34;

Accepted Answer

Application of what one has learned from previous situations can help dissipate the intensity of stress.Options A,C,and D are all incorrect; the nurse is not dealing with the issue.Denial of the stressful event will not lessen the stress and may in turn intensify it.

Question 7

An older adult woman has recently experienced a number of stressful life events,including the loss of her brother,the burden of caring for her ailing husband,and now an impending move to an apartment across town,because an earthquake has structurally devastated her home of 35 years.She comes to the ambulatory clinic because,in her words,"On top of all of that,now I've got this flu!" In rendering care for this elderly woman,you recognize that:

A) she is exhibiting attention-seeking behaviors.
B) crisis and stressful situations may produce emotions that erode the health of the elderly.
C) she is exhibiting "learned helplessness."
D) a period of crisis will ultimately lead to a lower level of functioning.

Accepted Answer

Sustained stress can lead to physical consequences,particularly in older adults who have less reserve than younger individuals.The client has experienced some major life stressors.Learned helplessness occurs when an individual has a perceived lack of control,which erodes the person's personality.A period of crisis can in fact lead to a higher level of functioning.

Deck 24: Stress,Crises,and Health in Aging