Question 1

A community health nurse visits an older adult whose spouse died 6 months ago and notes several vodka bottles are in the trash. The person says, "I get lonely and drink a little to help me forget." What is the nurse's most therapeutic intervention?

A) Teach the person about alcoholism, and suggest other coping strategies.
B) Request a mental health consultation to assess for alcohol dependency.
C) Advise the person not to drink alone, because the risks for injury increase.
D) Arrange for the person to attend an Alcoholics Anonymous (AA) meeting for older adults.

Accepted Answer

The most therapeutic intervention would be to arrange for the person to attend an Alcoholics Anonymous (AA) meeting for older adults. This will provide the person with a support system of peers who can empathize with their struggles with alcohol and offer coping strategies in a non-judgmental setting. It also allows the person to take ownership of their behavior and openly address their struggles with alcohol. Teaching the person about alcoholism and suggesting coping strategies may be helpful, but it does not address the immediate concern of the person's alcohol use. Requesting a mental health consultation would be appropriate if the person showed signs of alcohol dependency or other mental health concerns. Advising the person not to drink alone may be a temporary solution but does not address the root cause of their drinking.

Question 2

What assessment question asked by the nurse planning care for an older client best minimizes the risk for ineffective medication administration by the client and impaired medication effectiveness?&#10;A) &#34;What do you expect this medication will do for you?&#34;&#10;B) &#34;Can you explain how and when you should take your medication?&#34;&#10;C) &#34;How many medications do you take each day?&#34;&#10;D) &#34;Will you be able to easily get your medication prescriptions refilled?&#34;

Accepted Answer

Asking the client to explain how and when they should take their medication will assess their understanding and ability to correctly administer their medication, thus minimizing the risk for ineffective medication administration and impaired medication effectiveness. The other options do not specifically address this concern.

Question 3

Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? (Select all that apply.)&#10;A) &#34;Lately I have had a lot of aches and pains and just haven't felt very well.&#34;&#10;B) &#34;My appetite is better than usual, and I am sleeping about 9 hours a night.&#34;&#10;C) &#34;People are in and out of my room all day and all night taking my things.&#34;&#10;D) &#34;Don't ask me to eat. I can't because my stomach is upset all the time.&#34;&#10;E) &#34;Life is more organized now that I don't live in my own home.&#34;

Accepted Answer

Aches and pains, upset stomach, and delusions or paranoia (such as believing people are stealing from them) can be symptoms of depression, especially in older adults. Appetite changes and sleep disturbances are also common in depression, but in this case, the patient reports better appetite and adequate sleep, which are not typical depression symptoms. Feeling more organized might not directly indicate depression.

Question 4

A nurse demonstrates an understanding of milieu management associated with the care of older client's diagnosed with psychiatric disorders when implementing which interventions?&#10;A) Provide cognitive-behavior therapy (CBT) for all patients.&#10;B) Provide unconditional acceptance of all client behaviors.&#10;C) Prevent clients from self-isolating.&#10;D) Limit time clients spend reminiscing.

Accepted Answer

Milieu management involves creating a therapeutic environment for clients, which includes preventing self-isolation. This is important for older clients, who may be at increased risk of isolation due to physical limitations or loss of social relationships. Providing CBT or limiting reminiscing may be appropriate interventions for some clients, but they are not specific to milieu management. Unconditional acceptance of all behaviors may be challenging or even unsafe in certain situations.

Question 5

A nurse plans a staff education program for employees of a senior living community. Which topic has priority when considering client safety?&#10;A) Late-onset schizophrenia&#10;B) Depression and suicide&#10;C) Dementia&#10;D) Delirium

Accepted Answer

The answer of A nurse plans a staff education program...

Question 6

An older adult patient diagnosed with depression is prescribed a selective serotonin reuptake inhibitor (SSRI). Nursing assessment should include careful collection of what information to best assure patient safety?

A) Other prescribed medications and over-the-counter remedies used
B) Evidence of pseudo-parkinsonism or tardive dyskinesia
C) History of psoriasis and other skin disorders
D) History of diarrhea and electrolyte imbalances

Accepted Answer

When taking an SSRI, it is important to monitor for potential drug interactions with other prescribed medications and over-the-counter remedies used. This can help to prevent serious adverse reactions and ensure patient safety.

Question 7

Reducing aggressive outbursts on a unit for older adults with mental disorders can be best achieved by implementing which intervention?&#10;A) Administering antipsychotic medication when signs of aggression are first noted&#10;B) Redirecting a client who demonstrates verbal aggression&#10;C) Limiting diversional activities to manage stimuli&#10;D) Restricting the clients' personal space to help facilitate visual observation of the group.

Accepted Answer

Redirecting a client who demonstrates verbal aggression is a non-physical intervention that can effectively de-escalate aggressive behavior. Administering antipsychotic medication may be necessary, but it is not the best initial intervention in managing aggressive behavior. Limiting diversional activities may increase a client's frustration and lead to greater aggression. Restricting personal space may increase a client's disorientation and escalate aggression.

Question 8

Which interventions should the nurse implement to facilitate an effective assessment of an older adult? (Select all that apply.)&#10;A) Allow time for client to formulate answers.&#10;B) Use open-ended questions to encourage conversation.&#10;C) Ensure privacy to help minimize unwillingness to share information.&#10;D) Speak loudly to assure client's ability to hear the questions clearly.&#10;E) Explain the purpose of the assessment.

Accepted Answer

A) Allowing time for the client to formulate answers is important as older adults may have cognitive or physical limitations that may make it difficult for them to respond quickly. 
B) Using open-ended questions encourages conversation and allows the client to provide more detailed responses. 
C) Ensuring privacy helps the client feel more comfortable and may minimize their unwillingness to share personal information. 
D) Speaking loudly assumes that the client has hearing difficulties, which may not be the case, and can be perceived as disrespectful. 
E) Explaining the purpose of the assessment helps the client understand the importance of the questions being asked and may increase their willingness to provide accurate information.

Question 9

A 65-year-old patient is diagnosed with late-onset schizophrenia. Both positive and negative symptoms of the disorder are present. The patient has a history of atrial fibrillation. The nurse should prepare patient education materials related to what medication?

A) Chlorpromazine
B) Risperidone
C) Thioridazine
D) Haloperidol

Accepted Answer

Risperidone is an atypical antipsychotic medication that is commonly used to treat both positive and negative symptoms of schizophrenia. It has a lower risk of side effects compared to older, typical antipsychotics such as chlorpromazine, thioridazine, and haloperidol. Given the patient's history of atrial fibrillation, a medication with a lower risk of cardiac side effects may be preferable.

Question 10

Which information is most important to obtain during assessment of an older adult with a mental disorder?&#10;A) Functional ability and emotional status&#10;B) Chronologic age and sexual functioning&#10;C) Economic status and sources of income&#10;D) Developmental history, interests, and activities

Accepted Answer

Functional ability and emotional status are the most important information to obtain during assessment of an older adult with a mental disorder because they provide crucial information about the patient's day-to-day functioning and mood, which can guide treatment planning and intervention strategies. Chronologic age, sexual functioning, economic status, sources of income, developmental history, interests, and activities may also be important pieces of information, but they are secondary to functional ability and emotional status.

Question 11

What high priority assessment should a nurse caring for an older adult who self-administer medications preform?&#10;A) Use of stimulants&#10;B) Overuse of benzodiazepines&#10;C) Misuse of antihypertensive medications&#10;D) Trading medications with acquaintances

Accepted Answer

The answer of What high priority assessment should a nurse...

Question 12

When assessing older adults, the nurse should pay particular attention to which demographic group with the highest suicide risk?&#10;A) Hispanic men&#10;B) Caucasian men&#10;C) Caucasian women&#10;D) African-American women

Accepted Answer

The answer of When assessing older adults, the nurse should...

Question 13

An older adult patient is severely suicidal and the patient's physical condition is declining. When it is apparent that traditional interventions are ineffective, the nurse should prepare for which intervention?

A) Insertion of a feeding tube
B) Electroconvulsive therapy (ECT)
C) Behavior modification
D) Bright-light therapy

Accepted Answer

The answer of An older adult patient is severely suicidal...

Question 14

Which assessment findings related to a 68-year-old patient should be identified as risk factors for late-onset alcohol abuse and dependence? (Select all that apply.)&#10;A) Chronic obstructive pulmonary disease&#10;B) Insomnia&#10;C) Male gender&#10;D) Boredom and loneliness&#10;E) Recent loss of spouse

Accepted Answer

The answer of Which assessment findings related to a 68-year-old...

Question 15

A patient living in community housing for older adults says, "I don't go to the senior citizens club. They play cards and talk about the past, because that's all they can do." The nurse suspects that these remarks represent what personal behavior?

A) Failure to achieve developmental tasks
B) Thinking associated with ageism
C) Hypercritical behavior
D) Paranoid thinking

Accepted Answer

The answer of A patient living in community housing for...

Question 16

A resident in a senior community has lost weight, feels depressed, and has lost interest in former social activities. The nurse asks, "When you last saw your doctor, did you share these problems?" The resident replies, "Yes, but the doctor said I shouldn't expect to feel good every day." Which barrier to mental health care is evident?

A) Legislative failures to provide services for older adults
B) The physician's inadequate mental health assessment
C) The resident's inadequate description of symptoms
D) Economic obstacles to adequate programming

Accepted Answer

The answer of A resident in a senior community has...

Question 17

An 80-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the assessment, which initial action should be taken to maximize the effectiveness of the assessment?&#10;A) Move the interview to a darkened room to reduce stimulation.&#10;B) Ask if the patient can hear clearly as the nurse speaks.&#10;C) Ask the patient to rate the level of pain.&#10;D) Initiate a neurologic assessment.

Accepted Answer

The answer of An 80-year-old patient comes to the clinic...

Question 18

A community health nurse assesses four patients between ages 70 and 80. Which patient has the highest risk for alcohol dependence?&#10;A) Patient with no history of alcohol-related problems until retirement but now drinks alcohol daily to distract himself from arthritis pain.&#10;B) Patient who drank socially throughout adult life and continues this pattern, saying &#34;I'm old enough to drink if I want to.&#34;&#10;C) Patient who abused alcohol between ages 30 and 45 but now abstains and occasionally attends AA meetings.&#10;D) Patient with intermittent problems of alcohol misuse early in life. Now drinks one glass of wine nightly with dinner.

Accepted Answer

The answer of A community health nurse assesses four patients...

Deck 35: Older Adults