Deck 37: Geropsychiatric Nursing

Question 1

Which nursing intervention would be most important initially when evaluating the physiological health status of an older adult being admitted to an assisted living center?

A) Obtain a complete medication profile, including over-the-counter medications
B) Ask the patient, "How do you think your physical health has been overall?"
C) Observe the patient for indications of the degree of physical autonomy
D) Ask the patient's adult child, "Does your parent have any health problems?"

Answer 1

Obtain a complete medication profile, including over-the-counter medications

Question 2

Which older adult is at greatest risk for falls based on the medication profile? An older adult taking:

A) psyllium daily as a bulk-forming laxative.
B) calcium daily after hip replacement surgery.
C) an over-the-counter sleep aid an average of once per week.
D) an angiotensin-converting enzyme inhibitor daily for mild hypertension.

Answer 2

an angiotensin-converting enzyme inhibitor daily for mild hypertension.

Question 3

An older adult patient will be moved from a psychiatric inpatient unit to a nursing home.Which action should be given priority by the nurse to best facilitate the move?

A) Have the patient visit the nursing home before actually moving.
B) Administer a sedative-hypnotic to the patient before the patient moves.
C) Place the patient's belongings in the new room after they are inventoried.
D) Hold all of the patient's medications until after the move to minimize confusion.

Answer 3

Have the patient visit the nursing home before actually moving.

Question 4

An older adult is grieving the loss of a loved one.Which approach is most therapeutic for the nurse to apply when caring for this patient?

A) Assess past coping skills, the presence of support systems, and evidence of prolonged grieving.
B) Provide anticipatory guidance to the patient, explaining that prolonged grieving is not a normal part of loss regardless of the patient's age.
C) Plan activities for the patient that include increasing socialization with others who have experienced similar losses until mourning is over.
D) Intervene only when it becomes obvious that the patient's period of mourning has the potential to affect the patient negatively both physically and emotionally.

Question 5

Which nursing technique would be most effective when assessing an older adult patient's nutritional status?

A) Interact with the patient during meals.
B) Perform a comprehensive health assessment.
C) Supplement the patient's diet with preferred, nutritious snacks.
D) Ask the patient to complete a 7-day inclusive nutritional recall.

Question 6

A 68-year-old being treated for depression has a history of a suicide attempt at age 26.When the patient reports feelings of uselessness related to selling the family business and retiring,the nurse should initially:

A) notify the patient's health care provider of the intensified feelings of despair.
B) provide one-on-one time with the patient for the purpose of discussing the stated feelings.
C) alert other staff members of the need to increase the visual monitoring of this patient.
D) ask the patient if he is experiencing any suicidal ideations, including any plans to hurt himself.

Question 7

An older adult patient recently moved to a retirement community.Which behavior would prompt the nurse to suspect the patient is experiencing relocation stress syndrome?

A) Episodic dyspnea
B) Inappropriate affect
C) Increased withdrawal
D) Urinary incontinence

Question 8

Which scenario indicates to the nurse that an older adult is at risk for falls?

A) A 68-year-old retiree who moves in with family members to babysit their 3-year-old
B) A 75-year-old who lives alone and uses a cane at night and when going outside
C) An 80-year-old who marries and moves into the spouse's home after selling his home
D) A 92-year-old who moves to a retirement community after hip replacement surgery

Question 9

An older adult newly diagnosed with depression says,"Yesterday was such a busy day and with everything I had to remember I couldn't recall where I had parked my car.Am I getting Alzheimer disease?" An appropriate response from the nurse would be:

A) "Would you like me to have your health care provider discuss your concerns with you?"
B) "I do this all the time myself. It will get better after you've taken your antidepressant medication for a while."
C) "When people are very busy or depressed, it's not unusual for them to be forgetful. Nevertheless, let's talk about your concerns."
D) "It sounds as if you may have some memory deficit for recent events. When did you first begin to notice your problem with forgetfulness?"

Question 10

When planning discharge care for an older adult who is divorced,recently retired,and diagnosed with situational depression,the nurse learns that the patient's only child has moved 300 miles away.What is the nurse's best initial action?

A) Contact the child to discuss the parent's care needs.
B) Arrange for live-in help to provide for the patient's care needs.
C) Discuss the possibility of relocating to an assisted living center a reasonable distance from the child.
D) Assess availability of other family members and social support systems to assist the patient in meeting care needs.

Question 11

Based on a biological programming framework,which statement about aging is accurate?

A) "So you see, it's a matter of adding free radicals to your system through diet and supplements in order to stop the aging process."
B) "Although DNA programming isn't reversible, a healthy lifestyle and preventive health care can maximize cell function."
C) "Collagen delays aging. By increasing the collagen levels in the body, you improve flexibility and delay aging."
D) "The key is in the immune system, and once we solve the problem by gradually eliminating error cells, we extend youth."

Question 12

An older adult reports that "I know that I'm not the cheerful person I used to be but that's just a part of growing old." Using a psychological theoretical framework,the nurse might respond:

A) "When your life focuses on positive experiences from your adolescence, aging is reduced by that youthful mental status."
B) "There may be many causes for what you are feeling. I'd suggest seeing your health care provider to rule out any physical causes."
C) "The best way to prepare for a 'good death' is to systematically review your life and change any behaviors you feel might interfere with this process."
D) "You are in the last stage of development in your life, and it's important that you attempt to correct anything about your life that dissatisfies or saddens you."

Question 13

Which assessment finding best indicates that an older adult who resides at an assisted living center has functional mobility?

A) The patient spends most of the day interacting with others in the dayroom.
B) The patient spends weekends and holidays at the home of family members.
C) The patient shows an interest in having his hair professionally styled.
D) The patient dresses, bathes, and eats independently.

Question 14

An older adult who recently learned that his last surviving sibling has died refuses to take medication and is fearful of allowing anyone other than a specific staff member to assist with bathing and dressing.The patient is exhibiting signs of:

A) paranoia.
B) confusion.
C) depression.
D) disorientation.

Question 15

When the nurse asks an older adult,"Can you describe the events that led you to move to this assisted living center?" the patient looks perplexed and does not respond.Which response would the nurse make initially in order to be most therapeutic?

A) "Did you want to sell your house and move here?"
B) "We can talk about this at a later time if you wish."
C) "I can get this information from your medical record."
D) "Do you like living here at the assisted living center?"

Question 16

Which of these nursing communications would be most effective when teaching an older adult patient about aging through the disengagement theoretical framework?

A) "It's a natural result of growing older that your level of activity will decrease."
B) "It's important to maintain the same level of socialization throughout your lifetime, even though the type of activity may be changed to accommodate aging."
C) "It's important to maintain the familiarity of your environment to reflect your enduring competencies even though you're an older adult."
D) "Look to the ways in which your family of origin functions. If they are impaired it is more likely that you will be, too, as you age."

Question 17

Which older adult patient profile presents the highest risk for falls?

A) A widowed older adult who takes an antidepressant at bedtime
B) An older adult with diabetes who bicycles regularly as exercise
C) An older retired adult who provides in-home care for a spouse
D) An older single adult who wears corrective eyeglasses for myopia

Question 18

Which observation would be of greatest concern for an older adult patient who is taking several prescribed medications?

A) Experiencing early-morning confusion
B) Taking sugarless hard candy for dry mouth
C) Dangling feet at the bedside to avoid dizziness
D) Reporting frequent awakenings during the night

Question 19

A person who is the primary caregiver for a mother with Alzheimer disease says,"Sometimes I hate my mother for living this long and Dad for dying and not caring for her." Which response is most therapeutic?

A) "What do you do to cope with these negative feelings?"
B) "It's fairly common for a caregiver to feel such negative emotions."
C) "Have you ever felt angry enough to be abusive toward your mother?"
D) "Please consider discussing these feelings with other members of your family."

Question 20

Which would be the most effective approach for a nurse to take when assessing the self-care needs and activities of daily living (ADLs) for an older adult?

A) Observe the level of grooming and dress that the patient demonstrates on a daily basis.
B) Interview the patient with a focus on how daily toileting and bathing are typically achieved.
C) Offer to provide the patient with the typical activities involved with bathing and grooming.
D) Interact with the patient to determine his or her ability to bathe, toilet, eat, and dress independently.

Question 21

Which intervention by the nurse would be best when trying to create a therapeutic milieu for a group of older adult patients?

A) Use soothing music, nonglare lighting, and the patients' personal articles.
B) Use bright colors and the patient's personal articles, and plan frequent activities.
C) Periodically rearrange the furniture for variety, but remove environmental barriers.
D) Create a stable physical environment, but vary the daily routine to prevent boredom.

Question 22

Which strategy would be included in a nursing care plan for an older adult patient who has sundown syndrome? (Select all that apply.)

A) Minimizing daytime sleep
B) Increasing physical activity, such as walking
C) Protecting the patient from exposure to sunlight
D) Increasing social interaction with staff and others
E) Engaging the patient in mentally stimulating activities

Question 23

A nurse evaluates the outcomes of family education about expected age-related changes.Which statements indicate the teaching was effective? (Select all that apply.)

A) "It is normal for my parent to take longer to complete daily activities because of age."
B) "I should expect my parent's gait to change a little because of arthritis in the hips."
C) "Depression is to be expected because of losses associated with getting older."
D) "I shouldn't worry about my parent waking up at night once in a while."
E) "Problems remembering events and people occur often as one ages."

Question 24

A mildly confused older adult patient states,"I am in the Mojave desert." A nurse who is using validation therapy with the patient would make which response?

A) "Are you feeling hot or thirsty?"
B) "Can you tell me about a time in your past when you were in a desert?"
C) "You are in a rehabilitation nursing center because you need help caring for yourself."
D) "Your medical record shows that you have hyperthyroidism, which is probably responsible for the confusion you are experiencing."