Question 1

An older, emaciated client is brought to an emergency department by the client's caregiver. The client has bruises and abrasions on shoulders and back in multiple stages of healing. When the client is directly asked about these symptoms, which type of client response would the nurse anticipate?

Accepted Answer

Older emaciated clients who have bruises and abrasions on shoulders and back in multiple stages of healing may be victims of physical abuse. It is common for victims to deny or minimize injuries due to fear of the abuser or because they feel ashamed or embarrassed. In some cases, the victim may have forgotten how the injuries occurred or be unable to communicate due to cognitive impairment. However, it is important for the nurse to assess and report any suspected elder abuse to the appropriate authorities. The option of the client asking to be placed in a nursing home is not related to the assessment of elder abuse.

Question 2

Which would be the initial nursing intervention for an older adult attending an adult day care program suddenly reporting dizziness, weakness, and confusion?

Accepted Answer

The initial nursing intervention for an older adult reporting dizziness, weakness, and confusion should be to complete a physical assessment to determine the possible cause of the symptoms. This could include checking vital signs, assessing for dehydration or infection, or performing cognitive assessments. Implementing complete bedrest or addressing self-esteem needs would not address the immediate symptoms or potential underlying health issues, and advocating for individual psychotherapy is not appropriate as it is not clear that mental health concerns are contributing to the reported symptoms.

Question 3

Which therapeutic intervention would a nurse anticipate will be ordered for an older client with major depressive disorder not responding to antidepressant medications?

Accepted Answer

Electroconvulsive therapy (ECT) is often considered as a next step for older clients with major depressive disorder who have not responded to antidepressant medications. ECT has been found to be safe and effective for this population, with some studies showing a higher response rate compared to medication alone. Neuroleptic therapy, an antiparkinsonian agent, and anxiolytic agent are not typically used as first-line therapies for major depressive disorder and would not be the best choice in this scenario.

Question 4

Which statement(s) by the nurse indicates that teaching has been effective regarding the environmental theory? (Select all that apply.)

Accepted Answer

The environmental theory suggests that external factors such as carcinogens, trauma, and sunlight can influence the aging process. These statements reflect an understanding of how environmental factors impact aging.

Question 5

For which physiological problem would the nurse question the order for an antidepressant for an older client with symptoms of major depressive disorder?

Accepted Answer

Antidepressants are metabolized in the liver and excreted by the kidneys. Altered liver and kidney functioning in an older client could affect the metabolism and excretion of the medication, potentially leading to toxicity or decreased effectiveness. Therefore, the nurse would question the order for an antidepressant if the client has altered liver and kidney functioning.

Question 6

A student nurse asks the instructor, "Which psychiatric disorder is most likely initially diagnosed in the elderly?" Which instructor response gives the student accurate information?

Accepted Answer

According to research, major depressive disorder is the most common psychiatric disorder initially diagnosed in the elderly. Schizophrenia usually develops in adolescence or early adulthood, phobic disorder can develop at any age, and dependent personality disorder is a long-standing, pervasive pattern of behavior that is typically diagnosed earlier in life.

Question 7

A client has recently been placed in a long-term care facility because of marked confusion and inability to perform most activities of daily living. Which nursing intervention is most appropriate to maintain the client's self-esteem?

Accepted Answer

Allowing the client to choose between two different outfits when dressing for the day provides an opportunity for the client to make a decision and maintain a sense of control and independence, which can help to maintain self-esteem. Leaving the client alone in the bathroom could actually decrease self-esteem if the client is unable to perform self-care tasks, while assigning a variety of caregivers may cause confusion and disrupt the client's routine. Modifying the daily schedule often may also cause confusion and increase disorientation.

Question 8

A family asks why their father is attending activity groups at the long-term care facility. The son states, "My father worked hard all of his life. He just needs some rest at this point." Which is the appropriate nursing response?

Accepted Answer

The nursing response should be to educate the family on the benefits of activity groups for their father, including social interaction, sensory stimulation, and reality orientation. It is important to promote and encourage participation in these groups to improve quality of life and prevent cognitive decline.

Question 9

An older client who lives with a caregiver is admitted to an emergency department with a fractured arm. The client is soaked in urine and has dried fecal matter on lower extremities. The client is 6 feet tall and weighs 120 pounds. Which condition would the nurse suspect?

Accepted Answer

The signs observed in this scenario could indicate abuse and/or neglect by the caregiver. The urine and fecal matter suggest that the client has not been properly cared for and the discrepancy between the client's height and weight could indicate malnutrition or dehydration, both of which are signs of neglect. The fracture could also be a result of physical abuse. It is important for the nurse to assess for signs of abuse and report any suspicions to the appropriate authorities.

Question 10

An aging client has difficulty communicating because of decreased sensory capabilities. Which nursing intervention is appropriate to improve communication during assessment?

Accepted Answer

Looking directly at the client when communicating can help them read lips and pick up on non-verbal cues, which can improve communication despite decreased sensory capabilities. Discouraging attempts at verbal communication or increasing volume may not be effective solutions, and encouraging the client to communicate by writing may not be practical for all clients.

Question 11

Which individual is most likely to be below the poverty level in the United States based on statistics?

Accepted Answer

According to statistics, elderly women (especially those who are widowed or living alone) and minorities (especially Hispanics) are more likely to be below the poverty level in the United States. Therefore, a 70-year-old Hispanic woman living alone is the most likely individual to be below the poverty level.

Question 12

According to the U.S. Census Bureau, which term would the nurse use to describe a 70-year-old client?

Accepted Answer

The U.S. Census Bureau defines "elderly" as people aged 65 and older.

Question 13

The discipline of ____________________ is the branch of clinical medicine specializing in psychopathology of the elderly population.

Accepted Answer

The answer of The discipline of ____________________ is the branch...

Question 14

A son who recently brought his extremely confused parent to a nursing home for admission reports feelings of guilt. Which is the appropriate nursing response?

Accepted Answer

Offering information about support groups specifically for children of nursing home residents in similar situations can provide validation and emotional support, as well as practical advice and tips for coping with feelings of guilt.

Question 15

A couple resides in a long-term care facility. The husband is admitted to the psychiatric unit after physically abusing his wife. He states, "My wife is having an affair with a young man, and I want it investigated." Which is the appropriate nursing response?

Accepted Answer

The appropriate nursing response is to acknowledge the patient's feelings and offer to talk about it, rather than dismissing or challenging his belief. Empathy and active listening are crucial in establishing a trusting relationship and promoting the patient's well-being. The other options are all examples of invalidating the patient's feelings or denying his experience, which can escalate his agitation and potentially worsen his behavior.

Question 16

Which student statement indicates that learning has occurred regarding reminiscence therapy?

Accepted Answer

Option B correctly describes reminiscence therapy as a group therapy in which members share both positive and negative significant memories to promote resolution. Options A, C, and D do not fully or accurately describe reminiscence therapy.

Quiz 24: The Aging Individual