Question: A student nurse visiting a senior center tells the instructor, “It’s so depressing to see all these old people. They are so weak and frail. They are probably all confused.” The student is expressing what attitude?
Answer Choices: a. Reality b. Ageism c. Empathy d. Distrust
Answer: b. Ageism
Question: A community mental health nurse plans an educational program for staff members at a home health agency that specializes in the care of older adults. What topic is of high priority?
Answer Choices: a. Recognizing depression in older adults b. Providing cost-effective foot care for older adults c. Identifying nutritional deficiencies in older adults d. Psychosocial stimulation for those who live alone
Answer: a. Recognizing depression in older adults
Question: Which is the best statement for a nurse to use when beginning an interview with an older adult patient?
Answer Choices: a. “Hello, [call patient by first name]. I am going to ask you some questions to get to know you better.” b. “Hello. My name is [nurse’s name]. I am a nurse. Please tell me how you would like to be addressed by the staff.” c. “I am going to ask you some questions about yourself. I would like to call you by your first name if you don’t mind.” d. “You look as though you are comfortable and ready to participate in an admission interview. Shall we get started?”
Answer: b. “Hello. My name is [nurse’s name]. I am a nurse. Please tell me how you would like to be addressed by the staff.”
Question: What information should a nurse include in the success of discharge planning for a patient diagnosed with severe and persistent mental illness? (Select all that apply.)
Answer Choices: a. Access to housing b. Individual psychotherapy c. Income to meet basic needs d. Availability of health insurance e. Ongoing interdisciplinary evaluation
Answer: a. Access to housing c. Income to meet basic needs d. Availability of health insurance
Question: Which statements most clearly indicate that the speaker views mental illness with stigma? (Select all that apply.)
Answer Choices: a. “Everyone is a little bit crazy.” b. “If people with mental illness would go to church, their problems would be solved with faith.” c. “Many mental illnesses are genetically transmitted. It is no one’s fault that the illness occurs.” d. “Anyone can have a mental illness. War or natural disasters can be too stressful for healthy people.” e. “People with mental illness are lazy. They expect the government to take care of everything they need.”
Answer: a. “Everyone is a little bit crazy.” b. “If people with mental illness would go to church, their problems would be solved with faith.” e. “People with mental illness are lazy. They expect the government to take care of everything they need.”
Question: A 75-year-old patient comes to the clinic reporting frequent headaches. After an introduction at the beginning of the interview, what should the nurse address?
Answer Choices: a. Initiate a neurological assessment. b. Assess if the patient can hear the spoken word clearly. c. Suggest that the patient lie down in a darkened room to rest. d. Administer medication to relieve the patient’s pain prior to the assessment.
Answer: b. Assess if the patient can hear the spoken word clearly.
Question: Which statement about aging provides the best rationale for focused assessment of older adult patients?
Answer Choices: a. As people age, they become more rigid in their thinking. b. The majority of older adults sleep more than 12 hours per day. c. The senses of vision, hearing, touch, taste, and smell decline with age. d. Only the correct answer is true and cues the nurse to assess carefully the sensory functions of the older adult patient. The incorrect options are myths about aging.
Answer: c. The senses of vision, hearing, touch, taste, and smell decline with age.
Question: A nurse asks the following questions while assessing an older adult. The nurse will add the Geriatric Depression Scale as part of the assessment if the patient answers “yes” to which question?
Answer Choices: a. “Would you say your mood is often sad?” b. “Are you having any trouble with your memory?” c. “Have you noticed an increase in your alcohol use?” d. “Do you often experience moderate-to-severe pain?”
Answer: a. “Would you say your mood is often sad?”
Question: A 78-year-old nursing home resident diagnosed with hypertension and cardiac disease is usually alert and oriented. This morning, however, the resident says, “My family visited during the night. They stood by the bed and talked to me.” In reality, the patient’s family lives 200 miles away. The nurse should first suspect what as the trigger for the resident’s experience?
Answer Choices: a. A side effect associated with medications. b. Early Alzheimer’s disease associated with advanced age. c. A transient ischemic attack and developed sensory perceptual alterations. d. Previously unidentified alcohol abuse and is beginning alcohol withdrawal delirium.
Answer: a. A side effect associated with medications.
Question: A health care provider writes these new prescriptions for a resident in a skilled care facility: “2 g sodium diet; restraint as needed; limit fluids to 2000 mL daily; 1 dose milk of magnesia 30 mL orally if no bowel movement occurs for 3 days.” Which prescription should the nurse question?
Answer Choices: a. Restraint b. Fluid restriction c. Milk of magnesia d. Sodium restriction
Answer: a. Restraint
Question: If an older adult patient must be physically restrained, who is responsible for the patient’s safety?
Answer Choices: a. Nurse assigned to care for the patient. b. Nursing assistant who applies the restraint. c. Health care provider who ordered the application of the restraint. d. Family member who agrees to the application of the restraint.
Answer: a. Nurse assigned to care for the patient.
Question: An older adult patient brings a bag of medication to the clinic. The nurse finds one bottle labeled “Ativan” and one labeled “lorazepam,” and both are labeled “Take two times daily.” Bottles of hydrochlorothiazide, Inderal, and rofecoxib, each labeled “Take once daily,” are also included. Which conclusion is accurate?
Answer Choices: a. Rofecoxib should not be taken with Ativan. b. The patient’s blood pressure is likely to be very high. c. This patient should not self-administer any medication. d. Lorazepam and Ativan are the same drug; consequently, the dose is excessive.
Answer: d. Lorazepam and Ativan are the same drug; consequently, the dose is excessive.
Question: A patient who has severe and persistent mental illness comes to health care providers demonstrating what characteristic?
Answer Choices: a. Aggression b. Dehydration c. Ineffective verbally communicate d. Unable to make health care decisions
Answer: d. Unable to make health care decisions
Question: A patient asks the nurse, “I already have a living will. Why should I have a durable power of attorney for health care also?” The nurse should provide what as the truth related to a durable power of attorney for health care?
Answer Choices: a. It gives your agent the authority to make decisions about your care if you are unable to during any illness. b. It can be given only to a relative, usually the next of kin, who has your best interests at heart. c. It authorizes your physician to make decisions about your care that are in your best interest. d. It can be used only if you have a terminal illness and become incapacitated.
Answer: a. It gives your agent the authority to make decisions about your care if you are unable to during any illness.
Question: Recognizing the risk for acquired immunodeficiency syndrome (AIDS) among older adults, nurses should provide health teaching focused on what?
Answer Choices: a. Discouraging sexual expression b. Using birth control measures c. Avoiding blood transfusions d. Encouraging condom use
Answer: d. Encouraging condom use
Question: An older adult says, “There’s no reason to live. Everyone I’ve ever loved is gone. My family and friends are all dead. My money is running out, and my health is failing.” How should the nurse analyze this comment?
Answer Choices: a. Normal negativity of older adults b. Evidence of suicide risk c. A cry for sympathy d. Normal grieving
Answer: b. Evidence of suicide risk
Question: A patient tells the nurse of the recent deaths of a spouse of 50 years as well as an adult child in an automobile accident. The patient has no other family and only a few friends in the community. What is the priority nursing diagnosis?
Answer Choices: a. Spiritual distress, related to being angry with God for taking the family b. Risk for suicide, related to recent deaths of significant others c. Anxiety, related to sudden and abrupt lifestyle changes
Answer: b. Risk for suicide, related to recent deaths of significant others
Question: A clinic nurse interviews four patients between 70 and 80 years of age. Which patient should have further assessment regarding the risk of alcohol addiction?
Answer Choices: a. One with a history of intermittent problems of alcohol misuse early in life and who now consumes one glass of wine nightly with dinner. b. One with no history of alcohol-related problems until age 65 years, when the patient began to drink alcohol daily “to keep my mind off my arthritis.” c. One who drank socially throughout adult life and continues this pattern, saying, “I’ve earned the right to do as I please.” d. One who abused alcohol between the ages of 25 and 40 years but now abstains and occasionally attends Alcoholics Anonymous.
Answer: b. One with no history of alcohol-related problems until age 65 years, when the patient began to drink alcohol daily “to keep my mind off my arthritis.”
Question: A 77-year-old patient who is receiving tricyclic antidepressants is diagnosed with major depressive disorder. Nursing assessment should include careful collection of information regarding what focus?
Answer Choices: a. Use of other prescribed medications and over-the-counter products. b. Evidence of pseudoparkinsonism or tardive dyskinesia. c. A history of psoriasis and any other skin disorders. d. A current immunization status.
Answer: a. Use of other prescribed medications and over-the-counter products.
Question: An older adult with a history of major depressive disorder has taken an antidepressant daily for 3 years. The patient tells the nurse, “I want to stop taking this medication. I don’t think I need it anymore.” What is the nurse’s best response to assure safety the patient’s safety?
Answer Choices: a. “Why do you think you don’t need this medication anymore?” b. “Have you talked with your family members about this decision?” c. “If you stop the medication, your depression will return worse than ever.” d. “Let’s talk with your healthcare provider about your decision.”
Answer: d. “Let’s talk with your healthcare provider about your decision.”