Deck 35: Mental Disorders of Older Adults

Question 1

When assessing older adults, the nurse should pay particular attention to which demographic group with the highest suicide risk?

A) Hispanic men
B) Caucasian men
C) Caucasian women
D) African-American women

Answer 1

Caucasian men

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 analyzes that these remarks represent:

A) failure to achieve developmental tasks.
B) thinking associated with ageism.
C) hypercritical behavior.
D) paranoid thinking.

Answer 2

thinking associated with ageism.

Question 3

A community health nurse assesses four patients between ages 70 and 80. Which patient has the highest risk for alcohol dependence?

A) Patient with no history of alcohol-related problems until retirement but now drinks alcohol daily to distract himself from arthritis pain
B) Patient who drank socially throughout adult life and continues this pattern, saying "I'm old enough to drink if I want to"
C) Patient who abused alcohol between ages 30 and 45 but now abstains and occasionally attends AA meetings.
D) Patient with intermittent problems of alcohol misuse early in life. Now drinks one glass of wine nightly with dinner.

Answer 3

Patient with no history of alcohol-related problems until retirement but now drinks alcohol daily to distract himself from arthritis pain

Question 4

Reducing aggressive outbursts on a unit for older adults with mental disorders can be best achieved by:

A) liberal use of antipsychotic medication.
B) practicing redirection and diversion.
C) restricting diversional activities.
D) limiting personal space.

Question 5

Select the best plan for assessing an older adult.

A) Decrease anxiety by obtaining solves from the family whenever possible.
B) Ask direct questions, limit the focus on past events, and use a loud voice volume.
C) Ensure privacy, explain the purpose, use open-ended questions, and allow time for solves.
D) Speak loudly, keep the pace of the interview brisk, and politely interrupt to terminate long stories.

Question 6

A high priority for assessment by nurses caring for older adults who self-administer medications is:

A) use of stimulants.
B) overuse of benzodiazepines.
C) misuse of antihypertensive medications.
D) trading medications with acquaintances.

Question 7

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

A) Functional ability and emotional status
B) Chronologic age and sexual functioning
C) Economic status and sources of income
D) Developmental history, interests, and activities

Question 8

A major nursing responsibility in milieu management of a unit for older adults diagnosed with psychiatric disorders is to:

A) provide cognitive-behavior therapy (CBT) for all patients.
B) provide unconditional acceptance of all behavior.
C) prevent isolation, withdrawal, and deterioration.
D) limit time spent in reminiscence.

Question 9

A community health nurse visits an older adult whose spouse died 6 months ago. Three vodka bottles are in the trash. The person says, "I get lonely and drink a little to help me forget." Select 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.

Question 10

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

Question 11

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:

A) chlorpromazine (Thorazine).
B) risperidone (Risperdal).
C) thioridazine (Mellaril).
D) haloperidol (Haldol).

Question 12

An older adult patient is severely suicidal. The patient has not eaten for a week and today began refusing fluids. The patient's physical condition is declining. The nurse should prepare for which intervention?

A) Insertion of a feeding tube
B) Electroconvulsive therapy (ECT)
C) Behavior modification
D) Bright-light therapy

Question 13

An 80-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the assessment, which action should occur first?

A) Move the interview to a darkened room to reduce stimulation.
B) Ask if the patient can hear clearly as the nurse speaks.
C) Ask the patient to rate the level of pain.
D) Initiate a neurologic assessment.

Question 14

The health care provider prescribes buspirone (BuSpar) for an older adult patient with generalized anxiety disorder and alcohol abuse. What is the nurse's expectation about the effects of this drug?

A) Buspirone is associated with psychologic dependence.
B) Buspirone manages anxiety without causing sedation.
C) Buspirone is associated with physical dependence.
D) Buspirone has a rapid onset of action.

Question 15

Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? Select all that apply.

A) "Lately I have had a lot of aches and pains and just haven't felt very well."
B) "My appetite is better than usual, and I am sleeping about 9 hours a night."
C) "People are in and out of my room all day and all night taking my things."
D) "Don't ask me to eat. I can't because my stomach is upset all the time."
E) "Life is more organized now that I don't live in my own home."

Question 16

An older adult patient with depression is prescribed a selective serotonin reuptake inhibitor (SSRI). Nursing assessment should include careful collection of information regarding:

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.

Question 17

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.

A) Chronic obstructive pulmonary disease
B) Insomnia
C) Male gender
D) Boredom and loneliness
E) Recent loss of spouse

Question 18

A nurse plans a staff education program for employees of a senior living community. Which topic has priority?

A) Late-onset schizophrenia
B) Depression and suicide
C) Dementia
D) Delirium