17

An older adult comes to the clinic for an evaluation. The nurse suspects that the client may be experiencing depression. Which statement would the nurse most likely interpret as most commonly associated with depression in this age group?

" I just don't seem to feel very well lately."

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."

Current research supports the mental health nurse's confidence that interventions to help support the memory of an older client are effective when the client reports

"I always remember to attend my weekly sewing and exercise classes."

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."

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'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." "I'm pretty much a homebody and stick to myself."

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 nursing instructor is teaching students in a gerontology class about changes in the psychological domain. The teacher recognizes a need for further instruction when a student states:

"Normal aging impairs consciousness, alertness, and attention."

A nurse is assessing several older adults. Which older adult would the nurse identify as belonging to the young-old stage?

71-year-old male

A nurse working on a gerontology unit in a large city hospital understands that the frequency of acute conditions declines with advancing age, but a large percentage of older adults have at least one chronic health condition. The nurse would anticipate finding a chronic health condition in aout which percentage of older adults?

80%

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

Mary is a 71-year-old woman whose husband just died from cancer. The nurse is concerned for Mary due to the following relationship between loss and health

A lack of social support tends to affect health and may lead to increased mortality.

A nurse is teaching an older adult group about normal changes in the body that occur with aging. The nurse determines that the teaching was successful when the group identifies which area as being unaffected? Select all that apply.

Alertness Attention Consciousness

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 regards to the decline in senses?

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

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.

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

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

Blood flow in the liver decreases

A nurse is teaching a group of older adults about physical changes that occur with aging. Which change would the nurse most likely include in the discussion? Select all that apply.

Body fat increases Total body water decreases Muscle mass 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 discussing the process of aging with a group of community health nurses. When describing the concept of positive mental aging, which concept would the nurse most likely emphasize as crucial?

Capacity to be resilient

A preventative intervention for development of risk factors for suicide is associated with developing

Community-based projects

Which of the following interventions would be most effective in helping an older adult living alone to manage his medication regimen?

Create a medication administration record so that the client can check off his medications as he takes them each day.

Interventions to promote health promotion in the older adult in their process towards gerotranscendence include

Create and introduce new types of activities

A nurse is working with an older adult client to enhance the client's self-care. When developing the plan of care for this client, which aspect would be the priority?

Decision-making support

Physiological changes related to sexuality in older men include which of the following?

Decreased urgency for ejaculation

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 stigma of mental illness can lead to the use of which defense mechanism?

Denial

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

A nurse is providing care to an older adult client who is undernourished. Based on the nurse's understanding about the effects of undernutrition, the nurse would be alert for the development of which mental health problem? Select all that apply.

Depression Dementia Agitation

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 nurse is making a home visit to an older adult. The client lives alone and has a history of chronic heart failure and osteoarthritis. Assessment reveals that the client needs assistance with performing activities of daily living due to the chronic conditions. The nurse arranges for a home health aide to visit the person three times a week. When reviewing the plan of care with the home health aide, which aspect would the nurse emphasize as most important to promote the client's functional status?

Ensuring that the client feels in control of the situation

Mr. Tan is an 81-year-old man who resides in a long-term care facility. The nurse recognizes that a primary developmental task for Mr. Tan is to resolve the potential conflict between integrity and despair. The nurse is referring to which theorist's psychological theory of aging?

Erikson

When communicating with older adults, which action by the nurse would be most appropriate? Select all that apply.

Face the person when speaking to him or her. Minimize distractions in the room. Use short, simple sentences.

During support sessions for an older adult following the death of a loved one, on which area would the nurse most likely focus?

Financial planning

A nursing student is discussing with an older client changes 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 is providing care to a sedentary older adult patient with osteoarthritis. The nurse is planning a structured exercise program for this client based on the understanding that research about this type of intervention has been shown to lead to which outcome? Select all that apply.

Improvement in physical functioning Reduction in anxiety symptoms Prevention of the onset of depression

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 working to address the problem of undernutrition in older adults. The nurse would prioritize interventions focusing on older adults living in which environment?

Institutionalized setting

Nurses working with older adults may use Erikson's eight stages to assess level of development. Which of the following developmental tasks is specific for late adulthood?

Integrity versus despair

The nurse is working in a long-term care facility providing care to a group of older adults. When assessing the clients' personalities and intelligence, which information would be most important for the nurse to keep in mind?

Intelligence and personalities are stable across the lifespan in the absence of disease.

The nurse working with older adults in a psychiatric facility knows that many changes occur in vital biologic structures and processes over time, which can lead to compromised physiologic reserves. For this reason, older adults cannot always manage everyday stresses. Which physiologic change would the nurse identify as impacting the older adult? Select all that apply.

Loss of neurons in the brain Decreased blood flow to the liver Decreased amount of total body water Dulling of the sense of smell

A nurse is reviewing an older adult's history for possible factors that would increase the client's risk for maltreatment. Which factor would the nurse most likely identify as placing the client at risk? Select all that apply.

Lower income Poor health Inadequate social support

A nurse is assessing an older adult who says, "My memory is a real problem. There are times my memory just fails me. It's so frustrating." The nurse reviews the client's history related to threats to the client's memory. Which condition would the nurse most likely identify as a possible contributing factor?

Lung disease

A lack of social support and substance use are linked to the high rates of suicide in older adults. Which age population for men has the highest rate of suicide?

Males 75 years of age and older

Which of the following is not a normal part of aging?

Memory loss

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

With regard to developmental stages, which of the following is true about older age?

Old age is a period of continued growth and development with its own tasks.

A nurse is conducting a program at a community center about elder abuse. When describing where this type of abuse most likely occurs, the nurse would identify which location?

Older adult's home

A nurse is preparing a presentation for a local community center on elder abuse. Which environment would the nurse most likely include as the primary site where elder abuse occurs?

Older adult's home

A nursing student correctly identifies members of which age group to be at increased risk for the development or recurrence of mental health problems?

Older adults

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.

A nurse is working as a member of a team tasked with developing appropriate programs to address poverty in older adults. When deciding on the types of programs, which information would be most important for the team to integrate into the decision process?

Older adults living alone have the highest poverty rates.

Which population is more likely to live in poverty?

Older women

Because retirement and widowhood are common events in late life and usually involve a decline in financial resources, older adults are at high risk for poverty. What is an accurate statement regarding the older population and poverty?

Older women are more likely to live in poverty than older men.

Which of the following are characteristics associated with resilience? Select all that apply.

Optimism Emotional well-being Social engagement

A nurse is developing a teaching plan for an older adult related to self-care and mental health promotion. Which area would be most important for the nurse to address when teaching the older adult? Select all that apply.

Pace of learning Educational level Visual deficits Hearing deficits

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.

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

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

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

Individuals transitioning from young old to old undergo a gradual biopsychosocial, as well as spiritual, process. Looking at this as a positive perspective refers to

Providing time for personal growth and development

A nurse who works at a local center for senior citizens is assessing several older adults. Which change would the nurse most likely identify as affecting their social roles ? Select all that apply.

Retirement Loss of partner Changes in residence

A nurse working on the gerontology floor of a local community hospital has seen many older adults with mental and physical disorders. The nurse has come to realize that poor physical health can serve as which of the following in relation to mental disorders? Select all that apply.

Risk factor Outcome

An elderly client reports that she lives alone and can care for herself and function independently. She appears to the nurse to be very much in control of her life. This is an example of which domain?

Social

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 psychiatric-mental health nurse is reading an article about gerotranscendence. Growth in which dimension would the nurse most likely find being described?

Spirituality

An older adult client is prescribed a new medication. When initiating this new drug therapy, which action would be most important?

Start with a low dose and gradually increase it.

A psychiatric-mental health nurse is reviewing the medical record of an older adult who has come to the community mental health center for a follow-up visit. The nurse determines that the client is at an increased risk for suicide based on which factor in the medical record?

State of bereavement

A nurse is part of a team working on developing programs to promote an increase in the willingness of older adults to seek treatment. Which area would the team need to address? Select all that apply.

Stigma associated with mental illness Ease of access to services

A nurse who works in a retirement community has identified which of the following as key to a happy retirement?

Successful aging

A 78-year-old man was admitted for depression. It is imperative that the nurse's assessment must include information regarding

Suicide thoughts

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.

The nurse is planning a presentation to a group of older adults on the topic of suicide in the elderly. Which of the following should be included in the nurse's education plan?

Widowed white males living alone are more likely to commit suicide.

A nursing instructor is teaching about mental health promotion for older adults and informs students that older adulthood is a gradual biopsychosocial process divided into which of the following groups? Select all that apply.

Young old (65 to 74 years) Middle old (75 to 84 years) Old old (85 years and older)

A nurse is conducting an in-service program for a group of nurses working in long-term care facilities. When describing the most common mental disorders affecting this population, which condition would the nurse most likely include? Select all that apply.

depression anxiety disorders dementia

A psychiatric-mental health nurse is assessing an older adult's memory. The nurse understands that memory loss is not a normal part of aging, identifying that memory problems later in life are believed to result from which issue?

encoding problems

While assessing an older adult, the nurse observes that the client is slow in providing answers to the nurse's questions. The client apologizes for being slow to respond. The nurse should explain to the client that older adults often:

focus more on accuracy than speed in responding.

A nurse is assessing an older adult's crystalized intelligence. Which area would the nurse evaluate? Select all that apply.

language skills topical knowledge

A nurse is reading a journal article about substance abuse in the older population. Which information would the nurse identify as being associated with this issue in this population? Select all that apply.

poor health outcomes higher health care utilization increased disability

A nurse is working as part of a team tasked with developing programs for the older adult population in the community. Adults between the ages of 65 to 74 years of age account for the largest segment of the community's older adult population. Which type of program would be most appropriate for this group?

post-retirement activities

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

reaction time