Topic 14: Mental Health and Elder Abuse - ML5

An older adult client is brought the emergency department with acute confusion, agitation, and personality changes. While identification of the cause is occurring, which action(s) will the nurse take to manage the symptoms? Select all the apply.

- Limit the number of care team members. - Frequently reorient the client. - Keep noise level to a minimum.

When conducting a mental health assessment for the older adult client, which principle(s) will guide nursing care for the client? Select all that apply.

- Strengthen the client's capacity to manage the condition. - Eliminate or minimize limitations. - Act for the client only when absolutely necessary. - Do for the client only when absolutely necessary.

A late-middle-aged client reports anxiety after being told by their boss that it seemed the client was experiencing difficulty completing routine work-related tasks over the past several months. The client also reports feeling stressed about playing cards with friends because the client sometimes forgets how to play. Which stage of Alzheimer disease does the nurse suspect this client is experiencing?

3

Which client is at highest risk for developing delirium?

78-year-old client diagnosed with dementia and cardiovascular disease who had surgery this morning for a hip fracture

An older adult client was diagnosed with dementia 2 weeks ago and is brought to the local emergency department. The family member states, "My parent recently told me about thoughts of hurting themselves." Which action will the nurse take?

Ask the client if there is a plan for hurting themselves.

A client's adult child reports their parent has been having short-term memory issues and has trouble problem-solving for the past few months. Which intervention by the nurse is appropriate?

Document the findings and inform the primary health care provider.

A nurse is providing ongoing care for an older adult client with a diagnosis of dementia. Which nursing goal will the nurse prioritize when conducting ongoing assessment of this client?

Identify factors affecting the client's functioning and quality of life.

The nurse is caring for a client following hip replacement surgery 2 days ago. The client becomes confused and appears drowsy and lethargic. The nurse informs the health care provider. Which prescription from the primary health care provider will the nurse perform first?

Obtain vital signs.

The nurse in the gerontology clinic is developing a plan of care for an 88-year-old male client with moderately severe Alzheimer disease who lives with their family in a two-story house. The family reports that the client needs assistance to safely climb stairs to their bedroom, assistance with dressing and toileting, and much prompting to eat a meal.

The highest priority for care for this client is maintaining safety. as evidenced by needing assistance with climbing stairs.

During an assessment the nurse asks an older client to pick up a cup, pour water into the cup, and then take a drink. What is the nurse assessing in this client?

comprehension

A nurse is caring for an older adult client residing in a long-term care facility. Which symptom assessed by the nurse indicates the client may be experiencing depression?

diminished appetite

The nurse documents stuporous as an older adult client's level of consciousness. What did the nurse assess in this client?

responds slowly and needs to be repeatedly aroused

Which modified communication technique will facilitate activity for the older adult client with dementia?

simple sentences that contain only one idea

A client, diagnosed 3 years ago with a cognitive impairment, worsened and recently died. An autopsy revealed numerous infarcted brain regions resulting from vessel occlusions. This client likely suffered from which condition?

vascular dementia

An older adult client recently diagnosed with stage IV breast cancer is brought to the health care provider's office by a family member. The family member thinks the client is depressed. Which question(s) by the nurse are appropriate to ask the client? Select all that apply.

"Do you experience headaches or indigestion frequently?" "Have your sleeping habits changed?" "Do you have interest in seeing your family or friends?" "Have you experienced any changes in eating habits?" "Do you feel tired most of the day?"

Which statement demonstrates a nurse's understanding of the appropriate use of electroconvulsive therapy (ECT)?

"ECT is reserved for clients who have shown little or no improvement with other therapies."

A nurse leads a healthy aging class at a community health center. Which question should the nurse use to generate discussion among participants in this setting?

"How did you adjust to your move from your house to the assisted living facility?"

A client reports symptoms associated with depression. The nurse provides education concerning the effect certain medications have on triggering or worsening depression. What statement by the client demonstrates an understanding of that education?

"I am going to ask my health care provider about prescribing something other than a beta-blocker for my hypertension."

What statement made by an older adult client is associated with a problem identified as the greatest source of concern among members of that population?

"I do not have much control over my life anymore."

A nurse is reviewing the side effects of fluoxetine with an older adult client being treated for depression. Which statement by the client indicates that the nurse's teaching has been effective?

"I need to maintain my fluid intake while on this medication."

An older adult client has been prescribed paroxetine. Which teaching will the nurse provide about this medication? Select all that apply.

"It may take up to 1 month to start seeing an effect of the medicine." "You should take this medicine before bed." "Take precautions to reduce the risk for falls when starting this medicine."

A nurse teaches a client and care partner about cholinesterase inhibitors. Which statement will the nurse include in the teaching?

"Nausea, vomiting, diarrhea, and loss of appetite can be prevented or reduced by starting with a low dose."

A nurse is conducting a class at a senior citizens' center on factors that protect against dementia. Which statement by an older adult in the class indicates a need for further teaching by the nurse?

"No healthy lifestyle is going to ward off dementia."

The unlicensed assistive personnel (UAP) cares for a client with dementia. The UAP tells the nurse, "The client fights me when I try and bathe them and they have not had a shower in 2 months!" Which response by the nurse is appropriate?

"Tell me the ways you have tried to get the client to take a bath."

An older adult client was recently started on escitalopram. Which teaching by the nurse is appropriate based on this medication?

"This medicine may cause increased appetite."

A nurse performs a psychosocial assessment on an older adult in the hospital. Which statement made by the client may suggest low self-esteem?

"When I was younger, I worked around the clock and now I cannot even make it to the toilet."

An 81-year-old client has recently become widowed and has been diagnosed with severe depression. The client is being prescribed paroxetine. Which teaching by the nurse is appropriate for this client?

"You may feel sleepy in the beginning when starting this medication."

An older adult client has been diagnosed with major depressive disorder and has been prescribed paroxetine. Which teaching will the nurse provide regarding antidepressants?

"You should take precautions to prevent falls during the first few days because sedation can occur."

Which nursing action is most important when caring for an older adult client with dementia?

Speak in a calm manner.

A nurse who works with the older adult population is aware that elder abuse takes many forms. Which behavior most clearly constitutes elder abuse?

An adult child is waiting until the incontinence brief is soaked through before changing to save money.

Which action is best for determining nursing care for the older adult client with functional incontinence related to altered cognition?

Assess the client's specific urinary elimination pattern.

An older adult client admitted to the hospital for congestive heart failure will be discharged to an assisted living facility. Which intervention by the nurse best creates a wellness opportunity?

Assist the client to discuss the feelings associated with a potential move to assisted living.

The nurse plans actions to improve communicating to a client with dementia. Which intervention should the nurse include in this plan of care?

Avoid arguing with the client.

A nurse observes the unlicensed assistive personnel (UAP) ask a client what the client wants for breakfast, lunch, and dinner while assisting the client to toilet. Which action by the nurse is appropriate?

Direct the aide to present only one idea at a time.

The nurse is caring for a client with dementia. Which communication technique is best for dealing effectively with this client?

Maintain good eye contact and use a relaxed and smiling approach.

The nurse is assessing an older adult client in the long-term care facility and identifies that the client is demonstrating impaired psychosocial functioning. Which action by the nurse can be beneficial in promoting psychosocial functioning?

Promote a sense of control by allowing the client to choose activities and menu items.

An older adult client admitted to a geriatric unit in the hospital is oriented to person only. Which action(s) will the admitting nurse perform? Select all that apply.

Reassess orientation status. Repeat orientation as needed. Post a calendar with dates crossed off. Orient the client to the room, unit, and plan of care.

An older adult client states, "I have been feeling very anxious and paranoid lately. I feel as if people are always talking about me behind my back." Which action will the nurse take?

Recommend an audiometric examination.

The older adult client expresses the wish to engage in a reminiscence activity. What activity will the nurse encourage to best support the client's request?

making a scrapbook of past holiday photos for a grandchild