Answer Options:
a. Implement the order as written but document the concern.
b. Hold the medication and then notify the health care provider.
c. Consult a drug reference if a pharmacist is not available.
d. Give the usual geriatric dosage at the scheduled times.
Answer: b. Hold the medication and then notify the health care provider.
Question: A nurse wants to perform a preliminary assessment for suicidal ideation in an older adult patient. Which question would obtain the desired data?
Answer Options:
A. “What thoughts do you have about a person’s right to take his or her own life?”
B. “If you felt suicidal, would you communicate your feelings to anyone?”
C. “Do you have any risk factors that potentially contribute to suicide?”
D. “Do you think you are vulnerable to developing a depressed mood?”
Answer: A. “What thoughts do you have about a person’s right to take his or her own life?”
Question: A nurse reports to the interdisciplinary team that a patient diagnosed with an antisocial personality disorder lies to other patients, verbally abuses a patient diagnosed with dementia, and flatters the primary nurse. This patient is detached and superficial during counseling sessions. Which behavior most clearly warrants limit setting?
Answer Options:
a. Flattering the nurse
b. Lying to other patients
c. Verbal abuse of another patient
d. Detached superficiality during counseling
Answer: C. Verbal abuse of another patient
Question: A nurse assesses a confused older adult. The nurse experiences sadness and reflects, “The patient is like one of my grandparents, so helpless.” What feelings does the nurse describe?
Answer Options:
a. Transference
b. Countertransference
c. Catastrophic reaction
d. Defensive coping reaction
Answer: B. Countertransference
Question: Which is the best statement for a nurse to use when beginning an interview with an older adult patient?
Answer Options:
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: 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 Options:
a. Side effects 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. Side effects associated with medications.
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 Options:
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.”
Answer: A. “Why do you think you don’t need this medication anymore?”
Question: A patient is demonstrating signs of dementia. The health care provider wants to make a differential diagnosis between Alzheimer’s disease and multiple infarctions. Which diagnostic procedure should a nurse expect to prepare the patient for first?
Answer Options:
a. Computed tomography (CT) scan
b. Positron emission tomography (PET) scan
c. Functional magnetic resonance imaging (fMRI)
d. Single-photon emission computed tomography (SPECT) scan
Answer: a. Computed tomography (CT) scan
Question: If an older adult patient must be physically restrained, who is responsible for the patient’s safety?
Answer Options:
a. Nurse assigned to care for the patient.
b. Nursing assistant who applies the restraint.
c. Health care provider who ordered the restraint.
d. Family member who agrees to the application of the restraint.
Answer: a. Nurse assigned to care for the patient.
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 Options:
a. Reality
b. Ageism
c. Empathy
d. Distrust
Answer: b. Ageism
Question: A patient diagnosed with schizophrenia is hospitalized after arguing with coworkers and threatening to harm them. The patient is aloof and suspicious and says, “Two staff members I saw talking were plotting to assault me.” Based on data gathered at this point, which nursing diagnoses relate? (Select all that apply.)
Answer Options:
a. Risk for other-directed violence
b. Disturbed thought processes
c. Risk for loneliness
d. Spiritual distress
e. Social isolation
Answer: a. Risk for other-directed violence
b. Disturbed thought processes
Multiple Choice Question 1013
An older adult takes digoxin and hydrochlorothiazide daily, as well as lorazepam as needed for anxiety. Over 2 days, this adult developed confusion, slurred speech, an unsteady gait, and fluctuating levels of orientation. These findings are most characteristic of which adverse reaction to the medication therapy?
Answer Options
a. Delirium
b. Dementia
c. Amnestic syndrome
d. Alzheimer’s disease
a. Delirium
Question: When admitting older adult patients, health care agencies receiving federal funds must provide written information about what topic?
Answer Options:
A. Advance health care directives
B. The financial status of the institution
C. How to sign out against medical advice
D. The institution’s policy on the use of restraints
Answer: A. Advance health care directives
Question: What is the highest priority for assessment by nurses caring for older adults who self-administer medications?
Answer Options:
A. Overuse of medications for acute cystitis
B. Misuse of antihypertensive medications
C. Trading medications with others
D. Anticholinergic effects
Answer: D. Anticholinergic effects
Question: A nurse an older adult patient for depression should include questions about mood as well as which other symptoms? (Select all that apply.)
Answer Options:
A. Increased appetite
B. Sleep pattern changes
C. Anhedonia and anergia
D. Increased social isolation
E. Increased concern with bodily functions
Answer: B. Sleep pattern changes
C. Anhedonia and anergia
D. Increased social isolation
E. Increased concern with bodily functions
Question: When a nurse assesses an older adult patient, the patient’s answers seem vague or unrelated to the questions. The patient also leans forward and frowns, listening intently to the nurse. What would be an appropriate question for the nurse to ask in this situation?
Answer Options:
a. “Are you having difficulty hearing when I speak?”
b. “How can I make this assessment interview easier for you?”
c. “I notice you are frowning. Are you feeling annoyed with me?”
d. “You’re having trouble focusing on what I’m saying. What is distracting you?”
Answer: A. “Are you having difficulty hearing when I speak?”
Question: A nurse leads a staff development session about ageism among health care workers. What information should the nurse include about the consequences of ageism? (Select all that apply.)
Answer Options:
A. Failure of older adults to receive necessary medical information
B. Development of public policy that favors programs for older adults
C. Staff shortages because caregivers prefer working with younger adults
Answer: A. Failure of older adults to receive necessary medical information
C. Staff shortages because caregivers prefer working with younger adults
Question: When making a distinction as to whether a patient is experiencing confusion related to depression or dementia, what information would be most important for the nurse to consider?
Answer Options:
A. The patient with dementia is persistently angry and hostile.
B. Early morning agitation and hyperactivity occur in dementia.
C. Confusion seems to worsen at night when dementia is present.
D. A patient who is depressed is preoccupied with somatic symptoms.
Answer: C. Confusion seems to worsen at night when dementia is present.
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 Options:
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: What is the priority nursing intervention for a patient diagnosed with delirium who has fluctuating levels of consciousness, disturbed orientation, and perceptual alterations?
Answer Options:
a. Avoidance of physical contact
b. High level of sensory stimulation
c. Careful observation and supervision
d. Application of wrist and ankle restraints
Answer: c. Careful observation and supervision
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 Options:
a. Identifying 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. Identifying depression in older adults
Question: An older patient reports drinking a six-pack of beer daily. The patient tells the community health nurse, “I’ve been having trouble with my arthritis lately, so I take acetaminophen four times a day for pain.” What are the nurse’s priority interventions? (Select all that apply.)
Answer Options:
A. Inquiring about sleep disturbances caused by mixing alcohol and analgesic medications
B. Determining the safety of the daily acetaminophen dose the patient is ingesting
C. Advising the patient of harmful effects of alcohol and acetaminophen on the liver
D. Suggesting an increase in the acetaminophen dose because alcohol produces faster excretion
E. Assessing the patient for declining functional status associated with medication-induced dementia
Answer: B. Determining the safety of the daily acetaminophen dose the patient is ingesting
C. Advising the patient of harmful effects of alcohol and acetaminophen on the liver
Question: Which beliefs facilitate provision of safe, effective care for older adult patients? (Select all that apply.)
Answer Options:
A. Sexual interest declines with aging.
B. Older adults are able to learn new tasks.
C. Aging results in a decline in restorative sleep.
D. Older adults are prone to become crime victims.
E. Older adults are usually lonely and socially isolated.
Answer: B. Older adults are able to learn new tasks.
C. Aging results in a decline in restorative sleep.
D. Older adults are prone to become crime victims.