Ch.31 mental health disorders of older adults

As part of a follow-up home visit to an client age 80 years who has had surgery, a nurse discusses the client's risk for delirium with his family members. Which of the following would the nurse include as placing the client at increased risk? Select all that apply.

Urinary tract infection Acute stress Bone fractures Dehydration

A nurse makes a home visit to a family caring for a client with Alzheimer's disease. The client's wife tells the nurse that she hasn't been out of the house for more than 2 weeks because her sister has been unable to help care for the client. Which nursing diagnosis would the nurse identify as the priority?

Caregiver Role Strain related to social isolation

A son brings his mother to the clinic for an evaluation. The son's mother has moderate Alzheimer's disease without delirium. The nurse assesses the client for which of the following as the priority?

Catastrophic reactions

A group of nursing students is reviewing information about delirium and dementia. The students demonstrate a need for additional review when they identify which of the following as a characteristic of dementia?

Fluctuating changes within a 24-hour period

A client with Alzheimer's disease is admitted to an acute care facility for treatment of an infection. Assessment reveals that the client is anxious. When developing the client's plan of care, which of the following would be least appropriate for a nurse to include?

Frequently provide reality orientation

A daughter brings her mother, who has Alzheimer's disease, to the clinic. The client has been taking a cholinesterase inhibitor medication for 1 month. When assessing the client, the nurse would be alert for the possibility of which side effect?

Gastrointestinal distress

A nurse is caring for a client diagnosed with delirium who has been brought for treatment by his son. While taking the client's history, which question would be most appropriate for the nurse to ask the client's son?

"Has your father taken any medications recently?"

A nurse is assessing a client who has received a tentative diagnosis of delirium. The nurse is explaining to the family about the major cause of the client's condition. Which statement by the nurse would be most appropriate?

"His diagnosis is primarily based on the rapid onset of his change in consciousness."

A nurse is assessing a client age 78 years who lives alone in his own home. To assess the client's instrumental activities of daily living, which question would be most appropriate to ask?

"How often do you go to the store to buy groceries?"

While caring for a client age 88 years suspected of having dementia, the nurse assesses the client for a common delusional thought. Which of the following would the nurse interpret as a common delusion?

"My roommate keeps stealing my clothes."

A group of nursing students is reviewing information about age-related changes occurring in cognition and intellectual performance. The students demonstrate understanding of the concepts when they identify which of the following as a cognitive change for a patient diagnosed with delirium?

Inability to recognize familiar objects

A nursing instructor is preparing a presentation on the etiology of Alzheimer's disease (AD). When discussing the role of neurotransmitters in the course of the disease, which of the following would the instructor most likely emphasize?

Acetylcholine

A nurse is assessing a client diagnosed with Alzheimer's disease. As part of the assessment, the nurse asks the client to identify common objects. The nurse is assessing for which of the following?

Agnosia

A client is admitted to the hospital with dementia related to Parkinson's disease. The client is being treated for a fractured tibia from a recent fall. The nurse should assess the client's history for use of which type of medication?

Anticholinergics

Assessment of an older adult diagnosed with dementia with Lewy bodies reveals that the client is receiving psychiatric medications. The client states, "I get dizzy periodically and have trouble walking." Which of the following should the nurse do first?

Assess for development of orthostatic hypotension.

A nurse is caring for a client age 78 years who is taking an anticholinergic medication and complains of dry mouth. Which of the following would be most appropriate for the nurse to suggest? Select all that apply.

Chew hard candies. Rinse the mouth with a glycerol mouthwash.

A nurse is preparing a presentation for a group of colleagues about suicide and the older adult population. Which of the following would the nurse include in this presentation?

Depression is greatest risk factor for suicide in this population group.

A nurse is providing care to a client with Alzheimer's disease who is exhibiting suspiciousness and delusional thinking. Which of the following would be most important for the nurse to do with this client?

Determine the trigger for the distorted thinking.

A nurse is providing an in-service educational program for beginning nurses regarding mental health assessment needs of older adults. One of the topics addressed is the importance of interviewing family members in addition to the older adult client. The nurse tells the audience that family members are sometimes able to give a more accurate history than the client himself if the client has memory impairment. The nurse also emphasizes that interviewing family members provides which of the following?

Evaluation of the family's ability to effectively care for the older client

A nurse is talking with the husband of a female client diagnosed with Alzheimer's disease. During the conversation, the husband tells the nurse that "she often begins to scream and curse for no apparent reason." The nurse interprets this as which of the following?

Hypervocalization

While reviewing the medical record of a client with moderate dementia of the Alzheimer type, a nurse notes that the client has been receiving memantine. The nurse identifies this drug as which type?

NMDA receptor antagonist

A client is brought to the emergency department by his wife. The wife states that over the past few hours, the client has become disoriented and confused. "He didn't know where he was and didn't seem to recognize me or be able to carry on a coherent conversation." The nurse suspects delirium. When reviewing the client's medication history with the wife, which of the following medications would alert the nurse to a potential cause? Select all that apply.

Propranolol Diphenhydramine Quinidine

While a nurse is caring for a hospitalized client in the advanced stages of Alzheimer's disease, the client begins to have a catastrophic reaction to feeding himself. Which of the following should the nurse do first?

Remain calm and reassuring

After educating a group of nursing students on Alzheimer's disease and appropriate nursing care, the instructor determines that the education was successful when the students identify which of the following as the foundation for providing care to the client and family?

Therapeutic relationship

When assessing a client with dementia, a nurse identifies that the client is experiencing hallucinations. Based on the nurse's understanding of this disorder, which type of hallucination would the nurse expect as most common?

Visual