Question 1

A female older patient with early-onset Alzheimer's disease goes into male patients' rooms, crawls into bed with them, and fondles their genital areas. What does the nurse need to consider in developing nursing interventions to deal with this behavior?

Accepted Answer

The patient's behavior may indicate a need for affection and touch, which is common in individuals with Alzheimer's disease. Understanding this can help in developing appropriate interventions.

Question 2

The nurse says to an older patient, "Would you like to attend bingo or sit outside with the garden club?" What is the nurse doing?

Accepted Answer

The nurse is providing guided choices by offering specific activities to choose from, thereby facilitating decision-making for the patient.

Question 3

A resident in a long-term care facility has the right to have the least restrictive treatment to promote health. Which treatment would be questionable under these guidelines?

Accepted Answer

Applying a soft waist restraint on a resident who repeatedly falls after climbing over the side rails of the bed to go to the bathroom could be considered more restrictive than necessary, especially if alternative, less restrictive measures to prevent falls have not been explored or implemented.

Question 4

The nursing assistants refuse to care for a patient with Alzheimer's disease because he becomes very agitated at times during bathing. What is the best response by the licensed practical nurse?

Accepted Answer

Reviewing the plan of care with the interdisciplinary team to develop strategies to decrease the patient's agitation during bathing is the best response. It addresses the root cause of the problem (the patient's agitation) and seeks a solution that could improve the situation for both the patient and the nursing assistants.

Question 5

An older patient in a nursing facility tells the nurse that she knows she didn't commit any crimes and wants to see her attorney. What should the nurse suspect this patient is experiencing?

Accepted Answer

Delusions are fixed, false beliefs that are not based in reality. They are often seen in people with mental illness, such as schizophrenia. In this case, the patient believes that she has been accused of a crime, even though there is no evidence to support this belief.

Question 6

The family is upset because of the behaviors exhibited by an older patient experiencing delirium. What should the nurse instruct the family to do during this time? Select all that apply.

Accepted Answer

Reducing stress, limiting the number of visitors, and maintaining a quiet environment can help minimize confusion and agitation in a patient experiencing delirium.

Question 7

The nurse is visiting the home of an older patient who has just been forced to retire from a position at the local factory. Which statement would help draw the patient into a discussion about the job loss?

Accepted Answer

Option C, "How did you feel when the factory forced you to retire?" is an open-ended question that invites the patient to share their feelings and thoughts about the retirement, facilitating a discussion.

Question 8

An older patient calls for the nurse because there are alligators in the bathroom. What should the nurse do first?

Accepted Answer

The nurse should stay calm and assess the situation.

Question 9

An older patient who refuses food and medication is diagnosed with failure to thrive. What is this disorder associated with?

Accepted Answer

Failure to thrive in older adults is often associated with depression, which can lead to a refusal of food and medication.

Question 10

While making a routine visit to an older patient's home, the nurse notices a pile of digoxin and potassium wrapped in a napkin. For what should the nurse assess this patient?

Accepted Answer

The answer of While making a routine visit to an...

Question 11

An older patient who is disoriented believes that a fire has destroyed the city. What question should the nurse ask this patient?

Accepted Answer

The answer of An older patient who is disoriented believes...

Question 12

An older patient with a psychological problem is reluctant to speak to the nurse. Which technique should the nurse use to diffuse the older person's tension?

Accepted Answer

The answer of An older patient with a psychological problem...

Question 13

An older patient is fearful, crying out that birds are flying around her room. What psychological condition is this patient most likely demonstrating?

Accepted Answer

The patient is likely demonstrating hallucinations, which are perceptions in the absence of external stimuli. In this case, the patient perceives birds flying around her room, which are not actually present, indicating a hallucination.

Question 14

The nurse is caring for an older patient experiencing disorientation. What direction should the nurse provide when preparing the patient for bed?

Accepted Answer

Providing simple, one-step directions like "Unbutton your shirt" is most effective for patients experiencing disorientation, as it helps them focus on one task at a time without overwhelming them.

Question 15

An older patient grabs the nurse by the arm with one hand and begins to strike the nurse with the other hand. What should the nurse do?

Accepted Answer

The nurse should aim to safely release the patient's grip without causing harm to either party. Rotating away from the thumb is a technique that can help accomplish this, as the thumb is usually the weakest part of the grip. This method is preferred over aggressive actions that could escalate the situation or cause harm.

Quiz 18: Common Clinical Problems: Psychological