Question 1

An older adult patient being treated for chronic obstructive pulmonary disease (COPD)is exhibiting signs of memory loss and confusion.What is the priority for the nurse when planning care for this patient?
A)Obtaining an order for a pulmonary function test (PFT)
B)Determining the potential of a possible adverse drug reaction
C)Reorienting the patient to time,place,and person frequently
D)Assessing for a family history of dementia

Accepted Answer

Memory loss and confusion may be symptoms of an adverse drug reaction in an older adult patient. Therefore, determining the potential for a possible adverse drug reaction is the priority for the nurse when planning care for this patient. Obtaining a pulmonary function test (PFT) may be important for managing COPD, but it is not the priority in this situation. Reorienting the patient to time, place, and person frequently may be helpful in managing confusion, but it does not address the underlying cause. Assessing for a family history of dementia may be important information to gather, but it is not the priority in this situation.

Question 2

An older patient is anxious about an upcoming diagnostic test and requests something to calm the nerves.What medication does the nurse prepare to administer?
A)Clonazepam
B)Diazepam
C)Chlordiazepoxide
D)Lorazepam

Accepted Answer

Lorazepam is the best choice as it has a shorter half-life, is fast-acting, and has a lower risk of accumulation in older adults. Clonazepam, Diazepam, and Chlordiazepoxide may have a higher risk of side effects and accumulation in older adults.

Question 3

A 65-year-old adult who recently lost his spouse is admitted to the hospital after a failed suicide attempt.He presents with a sad affect and is reluctant to interact within the milieu.The nursing diagnosis with priority is
A)ineffective coping related to recent loss.
B)hopelessness related to death of spouse.
C)risk for loneliness related to loss of spouse.
D)risk for self-directed violence related to depression.

Accepted Answer

The priority nursing diagnosis for this patient is risk for self-directed violence related to depression, as evidenced by the recent suicide attempt and the patient's current reluctance to interact with others. It is important to ensure the patient's safety and prevent any further attempts at self-harm before addressing other issues such as coping with the recent loss.

Question 4

An older adult has been recently diagnosed with type 2 diabetes and mild retinal deterioration.What action by the nurse is best in order to address the patient's potential for developing situation depression?
A)Assesses the patient's coping skills.
B)Encourages the patient to participate in a depression support group.
C)Assesses the patient's ability to manage the symptoms.
D)Educates the family on early signs of depression.

Accepted Answer

Assessing the patient's coping skills is the best course of action as it allows the nurse to identify any potential risk factors or barriers to adjustment and develop an individualized plan for the patient's care. Encouraging participation in a support group, assessing symptom management, and educating the family are all important interventions, but they are not the priority in addressing potential situation depression.

Question 5

An 80-year-old patient is exhibiting signs of dementia representative of Alzheimer's disease (AD).The nurse supports that possibility when determining that the patient
A)experienced a gastric resection several years ago.
B)traveled often to third world countries.
C)was employed as a steelworker for 40 years.
D)has a history of viral encephalitis.

Accepted Answer

A history of viral encephalitis has been linked to an increased risk of developing Alzheimer's disease.

Question 6

While collecting a health history for an older adult patient,the nurse learns that the patient had been prescribed Elavil 3 weeks ago and wants to stop taking it because "It didn't make me feel any better." What information does the nurse share with the patient?
A)Sudden withdrawal is likely to cause a hypertensive crisis.
B)Depression seldom improves without medication.
C)Realistically it will take longer for the patient to feel better.
D)In time,people adjust to the side effects.

Accepted Answer

Antidepressants often take several weeks to start working and sometimes require dose adjustments before producing a therapeutic effect. It is important for the patient to understand that stopping the medication abruptly is not recommended and may cause withdrawal symptoms. The nurse should also encourage the patient to speak with the prescribing provider before stopping any medication.

Question 7

The nurse is caring for an older adult patient admitted to the hospital.What assessment findings place the patient at risk for developing delirium during the hospitalization? (Select all that apply. )
A)The patent takes medications to manage several chronic illnesses.
B)The patent has a history of urinary tract infections.
C)The patent is in cancer remission.
D)The patent has recently been eating poorly.
E)The patent experienced a mild heart attack 2 years ago.

Accepted Answer

Taking multiple medications, a history of urinary tract infections, and poor nutrition are all risk factors for delirium in older adults. The patient's cancer remission and past heart attack are not specific risk factors for delirium in the hospital setting.

Question 8

The son of a patient with possible Alzheimer's disease (AD)asks the nurse if there is a diagnostic test that can confirm the diagnosis.Which response by the nurse is best?
A)An electroencephalogram is often very useful in diagnosing AD.
B)A positron emission tomography (PET)scan is a cheap but dependable tool.
C)Magnetic resonance imaging (MRI)is often ordered for that purpose.
D)Postmortem autopsy is the only definitive diagnostic tool.

Accepted Answer

Postmortem autopsy is currently the only definitive diagnostic tool for AD as it provides a thorough examination of brain tissue for characteristic changes associated with the disease. While other diagnostic tests such as EEG, PET scans, and MRIs may be used in conjunction with clinical assessments, they are not conclusive on their own.

Question 9

A nurse is caring for an older patient diagnosed with acute depression.What action by the nurse is most important to help prevent delirium in this patient?
A)Reorienting the patient to the day,time,and place frequently
B)Being physically present to help the patient with eating meals
C)Providing the patient with opportunities to discuss depression
D)Administering antidepressive medication as prescribed

Accepted Answer

Ensuring proper nutrition and hydration by assisting with meals can help prevent delirium, as malnutrition and dehydration are risk factors for delirium in older patients.

Question 10

An 89-year-old patient diagnosed with dementia was until recently responding well to cognitive cueing techniques.What statement by the nurse to the care team shows an understanding of dementia?
A)"We will implement new interventions that address the disease's progression."
B)"It's important that we frequently recue the patient to improve her quality of life."
C)"The patient's family needs to be made aware of this decline."
D)"This poor response to cueing is likely a result of advanced aging."

Accepted Answer

Dementia is a progressive disease, meaning that it worsens over time. This statement shows an understanding that new interventions may be necessary as the disease progresses.

Question 11

A home care nurse is visiting a patient with moderate cognitive impairment from Alzheimer's disease.The patient's partner expresses concern about difficulty getting the patient "to eat properly." The nurse suggests which of the following? (Select all that apply. )
A)Serving meals at the same time each day
B)Offering liquids in place of solid foods when possible
C)Offering a calorie-dense snack at bedtime
D)Cutting food into bite-sized pieces that will fit into the patient's hand
E)Asking the patent to identify favorite foods

Accepted Answer

The answer of A home care nurse is visiting a...

Question 12

Which of the following statements,when made by family members caring for an older patient with dementia,indicates peaceful acceptance of the situation?
A)"I'm so pleased that Mother had a good day today.I'm really very hopeful."
B)"The hospice nurses are so helpful when I need time for myself."
C)"I promised Mother I would take care of her and I'll never leave her."
D)"It's the least I can do for Mother since she cared for us all these years."

Accepted Answer

Choice B indicates that the family member has accepted the situation and is seeking help from hospice nurses to take care of the patient while also taking care of themselves. This shows a peaceful acceptance of the situation and a willingness to seek help. Choices A, C, and D show either hopefulness or a sense of obligation, which are not indicative of peaceful acceptance.

Question 13

A 72-year-old patient is prescribed lithium.The nurse educates the patient on the importance of biannual evaluation of which of the following? (Select all that apply. )
A)Renal function
B)Serum glucose level
C)Liver function
D)Thyroid function
E)Red blood cell count

Accepted Answer

Lithium can affect renal, liver and thyroid function, hence biannual evaluation of these functions is important. Serum glucose level and red blood cell count are not directly affected by lithium therapy.

Question 14

The nurse is conducting an admission assessment on a mildly confused older patient.The nurse best assures an accurate history by first
A)scoring the client's cognitive responses.
B)focusing on the client to respond.
C)directing the questions to both patient and family.
D)arranging a Mini-Mental State Examination (MMSE).

Accepted Answer

Directing the questions to both the patient and family will ensure a more accurate history, as family members may provide additional information or clarification. Scoring cognitive responses or conducting a MMSE may be helpful in assessing the patient's cognitive status, but do not necessarily ensure an accurate history. Focusing solely on the patient may not produce a complete picture of their medical history.

Question 15

To help manage the potential side effects of prescribed antipsychotic medications,amantadine may be prescribed.Which statement best indicates that the nurse understands the appropriateness of this medication for the older adult patient?
A)"This medication produces few anticholinergic effects."
B)"Symmetrel is an effective dopamine agonist."
C)"Extrapyramidal symptoms are best controlled by Symmetrel."
D)"Older patients seem to have the fewest side effects on this medication."

Accepted Answer

Antipsychotic medications commonly cause anticholinergic side effects, such as dry mouth, constipation, and urinary retention. Amantadine is known to produce fewer of these side effects compared to other medications. The other options are incorrect: B is not relevant to the use of amantadine in managing antipsychotic side effects, C implies that amantadine is the best medication for controlling extrapyramidal symptoms (which is not necessarily true), and D is not supported by evidence as the side effect profile for amantadine can vary among individuals.

Question 16

A 78-year-old patient was admitted with dehydration.The nurse assesses and documents observations that support a finding of dementia.Which of the following observations are related to dementia? (Select all that apply. )
A)Forgetting what she ate for lunch today
B)Crying frequently when alone
C)Inability to find her way back to her room from the dayroom
D)Being impatient with the nursing staff for not closing her door
E)Repeatedly asking to call her son

Accepted Answer

The answer of A 78-year-old patient was admitted with dehydration.The...

Question 17

The nurse familiar with the older adult population recognizes that the patient who has the greatest potential for successfully committing suicide is the
A)63-year-old Asian female.
B)86-year-old Caucasian male.
C)76-year-old Hispanic female.
D)67-year-old African American male.

Accepted Answer

Research has shown that older Caucasian males have the highest rate of completed suicide out of any demographic group. They are also less likely to seek help for mental health issues and more likely to have access to lethal means such as firearms.

Question 18

When assessing an older patient displaying symptoms of delirium,the nurse focuses the assessment on
A)the degree and duration of the symptoms.
B)the amount of self-care deficiency the symptoms cause.
C)identifying processes that commonly result in the symptoms.
D)physiologic dysfunction resulting from the symptoms.

Accepted Answer

When assessing an older patient displaying symptoms of delirium, the nurse should focus the assessment on identifying processes that commonly result in the symptoms. This may include medication changes, infections, electrolyte imbalances, and other medical conditions. Understanding the underlying cause of the delirium can help guide treatment and management.

Question 19

What education by the nurse is most important to address age-related changes to the senses?
A)Installing auditory smoke alarms
B)Having regular eye checkups
C)Being aware that hearing acuity decreases with age
D)Checking the expiration dates on foods such as dairy

Accepted Answer

The answer of What education by the nurse is most...

Question 20

When planning care for the older adult with advanced dementia,the nurse recognizes that the best way to implement reality orientation is to
A)place printed labels on important items,such as the telephone.
B)place a clock and calendar in the patient's immediate environment.
C)use hand gestures instead of verbal communications to demonstrate meaning.
D)show the patient a picture of a toothbrush when it is time for oral hygiene.

Accepted Answer

The answer of When planning care for the older adult...

Quiz 24: Cognitive and Neurologic Function

An older adult patient being treated for chronic obstructive pulmonary disease (COPD) is exhibiting signs of memory loss and confusion.What is the priority for the nurse when planning care for this patient?

An older patient is anxious about an upcoming diagnostic test and requests something to calm the nerves.What medication does the nurse prepare to administer?

A 65-year-old adult who recently lost his spouse is admitted to the hospital after a failed suicide attempt.He presents with a sad affect and is reluctant to interact within the milieu.The nursing diagnosis with priority is

An older adult has been recently diagnosed with type 2 diabetes and mild retinal deterioration.What action by the nurse is best in order to address the patient's potential for developing situation depression?

An 80-year-old patient is exhibiting signs of dementia representative of Alzheimer's disease (AD) .The nurse supports that possibility when determining that the patient

While collecting a health history for an older adult patient,the nurse learns that the patient had been prescribed Elavil 3 weeks ago and wants to stop taking it because "It didn't make me feel any better." What information does the nurse share with the patient?

The nurse is caring for an older adult patient admitted to the hospital.What assessment findings place the patient at risk for developing delirium during the hospitalization? (Select all that apply. )

The son of a patient with possible Alzheimer's disease (AD) asks the nurse if there is a diagnostic test that can confirm the diagnosis.Which response by the nurse is best?

A nurse is caring for an older patient diagnosed with acute depression.What action by the nurse is most important to help prevent delirium in this patient?

An 89-year-old patient diagnosed with dementia was until recently responding well to cognitive cueing techniques.What statement by the nurse to the care team shows an understanding of dementia?

A home care nurse is visiting a patient with moderate cognitive impairment from Alzheimer's disease.The patient's partner expresses concern about difficulty getting the patient "to eat properly." The nurse suggests which of the following? (Select all that apply. )

Which of the following statements,when made by family members caring for an older patient with dementia,indicates peaceful acceptance of the situation?

A 72-year-old patient is prescribed lithium.The nurse educates the patient on the importance of biannual evaluation of which of the following? (Select all that apply. )

The nurse is conducting an admission assessment on a mildly confused older patient.The nurse best assures an accurate history by first

To help manage the potential side effects of prescribed antipsychotic medications,amantadine may be prescribed.Which statement best indicates that the nurse understands the appropriateness of this medication for the older adult patient?

A 78-year-old patient was admitted with dehydration.The nurse assesses and documents observations that support a finding of dementia.Which of the following observations are related to dementia? (Select all that apply. )

The nurse familiar with the older adult population recognizes that the patient who has the greatest potential for successfully committing suicide is the

When assessing an older patient displaying symptoms of delirium,the nurse focuses the assessment on

What education by the nurse is most important to address age-related changes to the senses?

When planning care for the older adult with advanced dementia,the nurse recognizes that the best way to implement reality orientation is to