Question 1

A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include?

Accepted Answer

Pain is a common problem in elderly individuals, and it is often underreported and undertreated. Therefore, teaching staff about pain assessment techniques for older adults is essential to ensure that they receive appropriate pain management.

Question 2

A 79-year-old white male tells a nurse, "I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing." The nurse should analyze this comment as which of the following?

Accepted Answer

The patient's statement indicates feelings of hopelessness and worthlessness, which are risk factors for suicide, especially in the elderly population.

Question 3

What is considered the most common mental health disorder in the elderly?

Accepted Answer

B

Question 4

Select the best comment for a nurse to begin an interview with an elderly patient.

Accepted Answer

D is the best choice because it introduces the nurse and allows the patient to choose how they would like to be addressed, which is a respectful and person-centered approach. A is condescending and assumes the patient doesn't know what a nurse does. B is vague and doesn't give any indication of what the interview will entail. C assumes the patient is ready and willing to participate without checking in first.

Question 5

A 76-year-old is regressed, indifferent, and responds to others only when they initiate an interaction. What form of group therapy would be most useful to promote resocialization?

Accepted Answer

Remotivation therapy is specifically designed for individuals who are regressed and unresponsive, helping them regain their interest in life and social interaction. This approach may be particularly effective with an elderly person who has become indifferent and withdrawn. Activity groups and reminiscence therapy may also be helpful, but they are less focused on resocialization. Psychotherapy may also be useful, but it tends to be more individually focused and may not address the person's social withdrawal as effectively.

Question 6

A health-care provider writes these new orders for a resident in a nursing home: 2 G sodium diet, Restraint as needed, Limit fluids to 1800 mL daily, Continue antihypertensive medication, Milk of Magnesia 30 mL PO once if no bowel movement for 3 days. What should the nurse do?

Accepted Answer

The order for restraint should be questioned as restraints should only be used when absolutely necessary and after considering less restrictive alternatives.

Question 7

An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, "It's awful to be old. Every day is a struggle. No one cares about old people." Select the nurse's best response.

Accepted Answer

The nurse should acknowledge the patient's feelings and create a therapeutic relationship by asking the patient to share their concerns. This allows the patient to express their feelings and can lead to a more positive outcome. Options A and D do not address the patient's concerns or provide an opportunity for the patient to express their feelings. Option C dismisses the patient's concerns and shifts the focus away from the patient's feelings.

Question 8

In a sad voice, an elderly patient tells the nurse of the recent deaths of a spouse and close friend. The patient has no other family and only a few acquaintances in the community. The nurse's priority is to determine which nursing diagnosis applies to this patient?

Accepted Answer

The recent deaths of significant others and the lack of a support system may increase the risk of suicide, making it a priority for the nurse to assess.

Question 9

A nurse assesses an elderly patient. The nurse should complete the Geriatric Depression Scale if the patient answers which question affirmatively?

Accepted Answer

The Geriatric Depression Scale should be completed if the patient answers affirmatively to the question "Would you say your mood is often sad?" as this is an indicator of depressive symptoms.

Question 10

Which statement about aging provides the best rationale for focused assessment of elderly patients?

Accepted Answer

Focusing on the decline of the five senses with aging provides a rationale for assessment of elderly patients to ensure that their sensory needs are considered and addressed in their care plan.

Question 11

Which information is most important to obtain during assessment of an older adult diagnosed with a mental disorder?

Accepted Answer

Functional ability and emotional status are the most important information to obtain during assessment of an older adult diagnosed with a mental disorder, as it helps to determine the scope and severity of the disorder, the level of care needed, and the most appropriate treatment plan. Chronological age and sexual function, economic status, and developmental history, interests, and activities may also be important factors to consider, but they are not the most essential information to obtain for assessing a mental disorder in an older adult.

Question 12

A student nurse visiting a seniors centre says, "It's depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion." The student is expressing which of the following?

Accepted Answer

The student nurse is expressing ageism, which is a stereotype or prejudice against individuals based on their age, assuming that older people are weak, frail, and unable to engage in discussions.

Question 13

A 75-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important?

Accepted Answer

Before proceeding with any further assessment, the nurse should assess the patient's ability to hear questions. Impaired hearing could lead to inaccurate answers.

Question 14

When determining whether an elderly patient's confusion is related to delirium or another problem, what information would be of particular value?

Accepted Answer

Medications can often cause or contribute to delirium, so knowing what medications the patient has recently taken is crucial in determining if they are the cause of the confusion.

Question 15

A nurse assesses four patients between the ages of 70 and 80 years. Which patient has the highest risk for alcohol abuse?

Accepted Answer

The patient who began drinking daily after retirement to cope with arthritis pain is at the highest risk for alcohol abuse, as they are using alcohol as a means of self-medication and have recently increased their consumption.

Question 16

A new nurse says, "My elderly patient has Lewy body disease. What should I do about assessing for pain?" Select the best response from the nurse manager.

Accepted Answer

Patients with Lewy body disease may have difficulty communicating their pain due to cognitive impairments. Special scales designed for assessing pain in patients with dementia can help accurately evaluate their pain levels.

Question 17

A physically frail elderly patient with mild cognitive impairments needs the services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient's needs?

Accepted Answer

An adult day program provides supervision, safety, recreation, and social interaction during the day, allowing the family to care for the patient in the evening and night.

Question 18

A nurse wants to assess for suicidal ideation in an elderly patient. Select the best question to begin this assessment.

Accepted Answer

This question is clear, direct, and respectful. It will produce information relative to the acceptability of suicide as an option to the patient. If the patient deems suicide unacceptable, no further assessment is necessary. If the patient deems suicide as acceptable, the nurse can continue to assess intent, plan, means to carry out the plan, lethality of the chosen method, and so forth. The other options are less direct, may produce responses that may be unclear, or are appropriate for later in this discussion.

Question 19

An elderly patient must be physically restrained. Who is responsible for the patient's safety?

Accepted Answer

Although restraint is prescribed by a health care provider, the restraint is a measure carried out by nursing staff. The nurse caring for the patient is responsible for safe application of restraining devices and for providing safe care while the patient is restrained. Nurses may delegate the application of restraining devices and the care of the patient in restraint, but the nurse remains responsible for outcomes. Even when family agree to restraint, nurses are responsible for providing safe outcomes.

Question 20

For which of the following reasons is it difficult to diagnosis alcohol abuse in the older adult?

Accepted Answer

Older adults may experience personality changes due to alcohol abuse, but these changes are often attributed to aging or other health issues, making it difficult to recognize alcohol abuse as the underlying cause.

Quiz 28: Psychosocial Needs of the Older Adult