Chapter 18 Prep U

A nurse is conducting a presentation for a local senior center on factors that protect an older adult's mental health. The nurse determines that additional teaching is needed based on which statement by the participants?

"Being underweight is a good thing when you're older."

The nurse is giving a presentation to the community on healthy aging. At the conclusion, she asks each group member to state one health-promoting action he or she can take. Which of the following responses indicates the need for clarification?

"I should walk for 1 hour each day."

An older adult asks the nurse, "What can I do to reduce my chances of having emotional problems, like dementia?" Which response by the nurse would be most appropriate?

"Leisure activities that stimulate your brain and use your brain skills are a good start."

A nurse is working with the family of an older adult patient who no longer is able to live alone at home. The family is discussing options for residential care. When assisting the family with decision making, which aspect would be most important for the nurse to emphasize?

"Make sure that the facility you choose can provide the care that is needed based on the patient's current abilities."

A nurse is assessing an older adult client's risk for suicide. Which statement by the client would the nurse interpret as placing the client at increased risk? Select all that apply.

-"I'm pretty much a homebody and stick to myself." -"I've been having some major health problems for the past several years." -"I'm still mourning the loss of my spouse who died over two years ago."

A nurse is preparing a presentation for a local senior center on sexuality, sexual activity, and the older adult. When describing the physical changes that occur in an older adult male, which information would the nurse most likely include? Select all that apply.

-Decreased urgency for ejaculation -Increased time to achieve an erection -Longer refractory period

The nurse working in a psychiatric facility for the older adult identifies which of the following to be among the most common mental disorders in the older adult? Select all that apply.

-Depression -Anxiety -Dementia

Which communication technique is appropriate for the nurse to use when conducting a health history interview with an older adult client? Select all that apply.

-Face the client -Repeat and revise questions, as needed

A nurse is reading a journal article about aging and the physiological changes associated with it. Which change would the nurse most likely read about? Select all that apply.

-Increase in body fat -Decrease in muscle mass -Reduction in renal tubular secretion

A nurse is developing a plan of care for an older adult with a chronic illness. Which intervention would be most appropriate for the nurse to include when communicating with the older adult? Select all that apply.

-Keeping the discussion focused on one topic at a time -Allowing the client enough time to answer the question

A nurse is conducting a program for a local senior center about older adults, depression and suicide. When describing factors that are strongly linked to an increased rate of suicide in older adults, which factor would the nurse most likely identify? Select all that apply.

-Lack of social support -Substance abuse

Adequate nutrition is an important factor in maintaining mental health. Which are problems that can result from undernutrition? Select all that apply.

-Pressure sores -Mental problems -Fatigue

A nurse is assessing several older adult patients. When reviewing each patient's medical record, which patient would the nurse most likely identify as being at greatest risk for functional decline?

A 78-year-old with cognitive impairment

While studying older adults and challenges they face with age, the nursing student learns that all five senses decline in acuity. Which of the following is correct in regard to the decline in senses?

All five senses decline with age, usually beginning in the fourth and fifth decades of life.

As the nurse is providing care for an older adult client the client's child states, "I tell my mom things and she does not even acknowledge what I say to her. I think she is developing dementia." Which is the priority assessment based on this observation?

Auditory

Significant biologic changes occur in later adulthood. The physiological changes refer to ...

Blood flow in the liver decreases

While interviewing an older adult client, the client states, "Even though I'm getting a small pension, I'm still working four days a week." The nurse interprets this statement as reflecting which concept?

Bridge employment

A nurse is conducting an information session at a local senior center about mental health problems and the older adult. Which information would the nurse most likely include?

Depression is often untreated in this population.

A nursing student is discussing with an older client change in how older adults process and respond to questions. During this discussion the student explains "speed-accuracy shift" as older adults doing which of the following?

Focus more on accuracy than speed in responding

How quickly an older adult responds to questions has been termed speed-accuracy shift, which refers to ...

Focusing on accuracy rather than speed of answering

All five of the senses gradually decline in acuity with age. The gradual decline may begin in which decade of life?

Fourth

Recently Joan Serson, Erik Erikson's wife, published an extension of his theory that included old age. This ninth stage is known as which of the following?

Gerotranscendence

A nurse is teaching an older adult about the normal physical changes that occur with aging. The nurse determines that the teaching was successful when the older adult identifes which change as an expected finding?

Glomerular filtration declines

A protective factor in older adults' mental health against suicide and despair in later life is ...

Having a sense of meaning or purpose

A nurse is assessing an older adult client who has come to the clinic for an evaluation. The client has several chronic illnesses and voices concerns about finances. When reviewing the client's history, which component would the nurse identify as the primary contributor to the client's concerns?

Health care costs

A nurse notes that an older adult client takes a little longer to respond when asked a question. The nurse interprets this as indicating a change in which function?

Mental processing speed

A nurse is assessing an older adult in the clinic. During the assessment, the older adult says, "Time sure does seem to fly much faster now than when I was younger. Any idea why this is so?" Which information would the nurse most likely integrate into the response?

Older adults experience a more stable life than younger adults.

Which population is more likely to live in poverty?

Older women

A nurse is presenting a program for a group of older adults about emotional health. Which statement would the nurse most likely include about emotional health?

Personality remains fairly stable across adulthood.

Risk factors for suicide in older adults include ...

Poor health

An elderly client comes to the clinic and reports poor sexual performance. After a thorough examination and laboratory tests, the physician diagnoses erectile dysfunction. Which of the following should the nurse anticipate in this client?

Poor self-esteem

A nurse is preparing a presentation for a local community group about retirement and strategies to promote a successful retirement. When describing the major source of income with retirement, which source would the nurse most likely include?

Social Security

A nurse is evaluating responses to cognition in a mental status examination for a 78-year-old male. It is necessary to consider the client's ...

Socioeconomic status and occupation

A nurse is working with an older adult client and teaching the client about their condition. When implementing the teaching plan with the client, which strategy would be most appropriate to use?

Summarize important points periodically.

In order to engage in therapeutic communication with an older adult, which of the following should the nurse consider?

The nurse should assess for hearing and visual deficits.

The nurse provides care for an older adult client who is prescribed venlafaxine HCl for the treatment of depression. Which priority assessment does the nurse include in the client's plan of care based on this pharmacologic therapy?

blood pressure

The older adult consumes two to six prescription medications and two to three over-the counter medications each day. This use of numerous medications that sometimes leads to drug abuse and adverse drug reactions is known as which of the following?

polypharmacy

Many cognitive abilities are preserved or even enhanced during aging. What is impaired with normal aging?

reaction time