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

Alcoholics Anonymous (AA) meetings provide peer support and can be helpful for individuals struggling with alcohol use, especially if they are feeling lonely or isolated. Additionally, suggesting that the person attend an AA meeting shows that the nurse is non-judgmental and supportive of the person's efforts to take control of their drinking habits. While teaching the person about alcoholism and suggesting other coping strategies may be beneficial in the long-term, attending an AA meeting provides immediate support and resources. Requesting a mental health consultation may also be beneficial if there are concerns about underlying mental health issues contributing to the person's drinking habits. Advising against drinking alone does not address the root cause of the problem and may not be feasible for the person if they do not have a support system.

Question 2

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

Thinking associated with ageism

Accepted Answer

The patient's remarks suggest ageist thinking, which is a prejudice against older adults based solely on their age. This type of stereotyping assumes that older adults are incapable of participating in activities outside of their past experiences and abilities, such as playing cards and reminiscing about the past.

Question 3

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

Electroconvulsive therapy (ECT) is a highly effective intervention for patients with severe depression or suicidal thoughts who have not responded to traditional therapies. It involves the use of electrical currents to stimulate the brain, which can improve symptoms quickly. Insertion of a feeding tube, behavior modification, and bright-light therapy are not appropriate interventions for severe suicidal ideation and declining physical condition.

Question 4

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 a second-generation antipsychotic that is effective for both positive and negative symptoms of schizophrenia. This medication has a lower risk of side effects such as extrapyramidal symptoms and tardive dyskinesia as compared to first-generation antipsychotics such as chlorpromazine, thioridazine, and haloperidol. Additionally, risperidone has a lower risk of interactions with medications used to treat atrial fibrillation. Therefore, risperidone would be the best choice of medication for this patient.

Question 5

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

Asking if the patient can hear clearly as the nurse speaks ensures that the patient is able to effectively communicate and understand the questions being asked during the assessment. This maximizes the effectiveness of the assessment.

Question 6

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 7

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 physician's response shows inadequate mental health assessment and lack of attention to the resident's symptoms. It is important for healthcare providers to take mental health concerns seriously and provide appropriate care and referrals to specialists when necessary.

Question 8

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 that supports the client's well-being. Preventing clients from self-isolating is a key intervention in milieu management, as social isolation can worsen symptoms of psychiatric disorders and impair the client's functioning. Providing CBT for all patients and limiting time spent reminiscing may be appropriate interventions for some clients, but they are not specific to milieu management. Unconditional acceptance of all client behaviors is not feasible or appropriate, as some behaviors may be harmful to the client or others. Instead, healthcare professionals should set clear boundaries and provide positive reinforcement for appropriate behaviors.

Question 9

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

Overuse of benzodiazepines is a high priority assessment in older adults who self-administer medications. Benzodiazepines can cause cognitive impairment, drowsiness, confusion, and falls in older adults. Therefore, it is important to assess the frequency and amount of benzodiazepine use and educate the patient on the potential risks associated with overuse. While the other choices are potential concerns, they are not as high of a priority as the overuse of benzodiazepines.

Question 10

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-invasive and immediate intervention that can help de-escalate the situation and prevent further aggressive behavior. It focuses on changing the client's focus and can be effective in managing aggression without the need for medication or restrictive measures.

Question 11

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 12

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 13

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

The answer of An older adult patient diagnosed with depression...

Question 14

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

The answer of Which remarks by a 72-year-old patient should...

Question 15

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

The answer of Which interventions should the nurse implement to...

Question 16

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

The answer of What assessment question asked by the nurse...

Question 17

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...

Question 18

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

The answer of Which information is most important to obtain...

Deck 35: Older Adults