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?

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?

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

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?

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

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?

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. )

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?

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?

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?

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. )

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?

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. )

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

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?

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. )

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

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

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?

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

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?