Deck 41: Common Psychosocial Care Problems of Older Adults

Question 1

The nurse is planning an instruction for an 84-year-old man relative to a significant change in his diet for diabetes. The nurse will plan her education around the idea that older adults:

A) need to have their family to hear the instruction.
B) cannot learn complex information or skills.
C) need more time to learn because of slower processing skills.
D) are fixed in their ideas and reject information that does not agree with them.

Answer 1

need more time to learn because of slower processing skills.

Question 2

The nurse would question a new order for a tricyclic antidepressant for a patient who has had a recent:

A) peptic ulcer.
B) myocardial infarct.
C) abdominal surgery.
D) diagnosis of diabetes.

Answer 2

myocardial infarct.

Question 3

When a patient with dementia exhibits increasing agitation, hostility, and paranoia, the nurse anticipates the health care provider will prescribe a(n):

A) anticonvulsant.
B) antidepressant.
C) minor tranquilizer.
D) major tranquilizer.

Answer 3

major tranquilizer.

Question 4

When a patient becomes violent and hits a table with his cane, the initial appropriate nursing approach is to:

A) medicate the patient to help control his anxiety.
B) call for assistance to apply restraints.
C) attempt to distract the patient.
D) direct the patient in a loud authoritarian voice to sit down.

Question 5

The behavior in a depressed older adult patient that would indicate that this patient is contemplating suicide is:

A) giving away personal belongings.
B) watching television in the activity room.
C) talking with other patients.
D) spending time sitting near the nurses' station.

Question 6

When the nurse plans to use reminiscence as a psychosocial approach to managing confusion with cognitively impaired patients, the nurse should:

A) use plants, pictures, and animals to encourage interactions in the group.
B) use memory aids such as television, radio, clock, and calendar.
C) encourage individual and group sharing of information about previous life experiences.
D) increase socialization roles in the group, such as serving each other refreshments.

Question 7

The family of a retired army veteran diagnosed with Alzheimer disease is concerned about obtaining care for the patient while away on vacation. The home health nurse informs the family that the Department of Veterans Affairs offers in facility care for patients with dementia for up to:

A) 10 days a year.
B) 15 days a year.
C) 20 days a year.
D) 30 days a year.

Question 8

The 64-year-old resident newly admitted to a long-term care facility refuses to sit down and eat, preferring to wander aimlessly through the facility. The initial intervention by the nursing staff should be to:

A) apply an alarm bracelet to monitor wandering.
B) offer high protein malts to drink on the go.
C) feed the resident in his room away from other residents.
D) feed the patient rapidly before he begins to wander.

Question 9

The nurse adds to the plan of care for a cognitively impaired resident who has begun to wander night and day throughout the long-term care facility. An appropriate intervention to add to the plan of care for the resident with wandering behavior would be to:

A) place the resident on a locked unit to prevent long-range wandering.
B) obtain an order for wrist restraints or a vest restraint.
C) apply a bracelet that alarms as the resident approaches an outside door.
D) discuss with the health care provider the need for stronger medication.

Question 10

When the nurse determines that an older adult patient has a reasonable risk of being physically abused by family members, it is the nurse's legal obligation to:

A) report the suspected abuse to the proper authority.
B) refer the family for counseling.
C) advise the patient to leave the family home.
D) tell the family to stop or face legal consequences.

Question 11

The older adults are vulnerable not only to crime, but also to scams. The best advice to give an older adult in avoiding scams is to:

A) travel with a group.
B) hang up when a timesharing agent calls.
C) lock windows at night.
D) consider getting a pet for protection.

Question 12

A depressed older adult patient was started on antidepressant drug therapy 3 weeks ago. The highest nursing priority when working with this patient at this time would be:

A) stimulating appetite.
B) providing reality orientation.
C) encouraging socialization.
D) protecting the patient from self-injury.

Question 13

The family of a patient with Alzheimer disease indicates that they want to keep the patient at home but are not sure how much longer they can care for the patient because of stress on family members. A helpful suggestion by the home health nurse would be to:

A) consider use of respite services.
B) face the reality of need for long-term care.
C) encourage the hiring of a full time caregiver.
D) encourage family counseling.

Question 14

The nurse in a long-term care facility emphasizes to the family of a resident recently admitted that one of the purposes of the creative behavioral therapies is to:

A) entertain the residents who have become bored.
B) stimulate an avid interest in music or art.
C) keep the residents out of their rooms.
D) slow the rate of deterioration.

Question 15

The nurse clarifies to a family of a resident with Alzheimer disease that dementia differs from confusion and delirium in that dementia is:

A) usually rapid in onset.
B) permanent.
C) caused by depression.
D) effectively treatable.

Question 16

A home health nurse working with an older adult patient assesses an early indication that this patient is developing Alzheimer disease. This early indication would be:

A) wandering behavior.
B) agitation.
C) difficulty learning new things.
D) deteriorating speech.

Question 17

An older female adult is most at risk for becoming a victim of a crime by:

A) having a peephole on the front door.
B) keeping doors locked with dead bolts.
C) having locks changed if keys are lost.
D) telling a stranger on the phone that she is alone at home.

Question 18

In order to minimize the risk of aspiration in a resident with advanced Alzheimer disease, the person feeding the patient should:

A) keep a suction machine available.
B) have the patient consume only liquids.
C) remind the patient to chew and swallow.
D) offer large amounts of water after each bite.

Question 19

A family member tells a hospitalized older adult patient to cooperate better with the treatment plan or placement in a long-term care facility will result. The nurse recognizes this statement is consistent with ___________ elder abuse.

A) physical
B) material
C) psychological
D) neglect

Question 20

An older adult patient with early Alzheimer disease is receiving the drug donepezil (Aricept). The nurse assesses the patient laboratory reports carefully for drug side effects because of the drug's potential toxicity to the:

A) kidneys.
B) liver.
C) spleen.
D) heart.

Question 21

The nurse frequently refers to "The _____________," a medication list that names drugs that are potentially harmful for use in elderly patients.

Question 22

The nurse is aware that the older adults of today face some functional psychosocial issues, which include: (Select all that apply.)

A) altered mobility.
B) becoming crime victims.
C) housing.
D) making provision for physical care.
E) cognitive impairments.

Question 23

A recently widowed 80-year-old man has been admitted to a long-term care facility for complaints of anorexia, loss of energy, and loss of sleep. The nurse learns that the patient is recently widowed. Prioritize the nursing actions that might be needed for this patient. (Separate letters by a comma and a space as follows: A, B, C, D.)

A) Provide a quiet environment.
B) Involve him in some activity.
C) Be alert to suicidal tendencies.
D) Spend time with the patient at mealtime.

Question 24

The nurse clarifies that the diagnosis of nocturnal delirium refers to a syndrome also called _______________.

Question 25

The home health nurse counsels the family of a cognitively impaired man that to best provide for his welfare, the family should: (Select all that apply.)

A) rearrange furniture and art to stimulate him.
B) use concise and direct communication.
C) enroll him in an Older Adult Activity Program.
D) monitor nutrition for adequacy.
E) install a door alarm that sounds when it is opened.

Question 26

The nurse instructs a family of an 87-year-old resident in a long-term care facility that his nocturnal delirium is most likely caused by: (Select all that apply.)

A) his schedule changing as a result of recent admission to the facility.
B) lack of adequate medication for anxiety.
C) increased shadows of the evening hours.
D) dehydration.
E) food allergy.

Question 27

When the nurse observes the ________ ________ warning on the label on a bottle of antipsychotics, the nurse is aware that it is a very strong advisory from the Food and Drug Administration (FDA) prior to pulling the drug off the market.