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An older adult patient was diagnosed schizophrenia at age 18. A nurse at the outpatient medication clinic interviews this pt. Which communication stratefy will be most helpful? A. Ask questions that can be answered with "yes" or "no." B. Ask clear, simple questions using concrete language C. Use of silence often and let the pt take lead. D. Use open-ended, indirect questions
B
When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value? a. Evidence of spasticity or flaccidity b. The patient's level of motor activity c. Medications the patient has recently taken d. Level of preoccupation with somatic symptoms
c
A nurse assesses an elderly pt. The nurse should complete the Geriatric Depression Scale if the pt answers which question affirmatively? 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?"
A
A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include? a. Pain assessment techniques for older adults b. Psychosocial stimulation for those who live alone c. Preparation of psychiatric advance directives in the elderly d. Ways to manage disinhibition in elderly persons with dementia
A
A patient asks, "What advantage does a durable power of attorney for health care have over a living will?" The nurse should reply, "A durable power of attorney for health care A. gives your agent authority to make decision during any illness if you are incapacated." B. can be given only to a relative, usually the next of kin, who has your best interests at heart." C. can be used only if you havce terminal illness and become incapacitated." D. cannot be implemented until 30 days after the documents are signed."
A
A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient's needs? a. Adult day care program b. Skilled nursing facility c. Partial hospitalization d. Group home
A
An elderly patient must be physically restrained. Who is responsible for the pt's safety? A. The nurse assigned to care for the pt B. Unlicensed assistive personnel who apply the restraint C. Family member who afrres to application of restraint D. Health care provider who proscribed application of restraint
A
In a sad voice, an elderly patient tells the nurse of the recent deaths of a spouse and close friend. The patient has no other family and only a few acquaintances in the community. The nurse's priority is to determine whether which nursing diagnosis applies to this patient? a. Risk for suicide related to recent deaths of significant others b. Anxiety related to sudden and abrupt lifestyle changes c. Social isolation related to loss of existing family d. Spiritual distress related to anger with God
A
The highest priority for assessment by nurses caring for older adults who self-administer medciations is A. use of multiple drugs with anticholinergic effects B. overuse of medications for erectile disfunction C. Missed doses of medications for arthritis D. trading medications with aquaintences
A
Which information is most important to obtain during assessment of an older adult diagnosed with health problems? A. Functional ability and emotional status' B. Chronological age and sexual function C. Economic status and sources of income D. Development hx, interests, and activities
A
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. a. Failure of the elderly to receive necessary medical information b. Development of public policy that discriminates against the elderly c. Staff shortages because caregivers prefer working with younger adults d. The perception that elderly consume a smaller share of medical resources e. More ancillary than professional personnel discriminate with regard to age
A, B, C
Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? Select all that apply. a. "Lately I have had a lot of aches and pains and just haven't felt very well." b. "People are in and out of my room all day and all night taking my things." c. "Don't ask me to eat. I can't because my stomach is upset all the time." d. "I'm eating more than usual, and I am sleeping about 6 hours a night." e. "Life seems more organized now that I don't live in my own home."
A, B, C
A nurse assessing an elderly pt for depression and suicide potential should include questions about mood as well as (select all that apply) A. personal hygeine B. increased appetite C. sleep pattern changes D. evidence of grandiosity E. increase concerns with bodily functions
A, C, E
A 75-year-old man comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is the most important? A. Complete a neurological assessment B. Determine whether the patient can hear as the nurse speaks. C. Suggest that the patient lie down in the darkened room for a few minutes D. Administer medication to relieve the pt's pain before continueing the assessment
B
A 79-year-old white male tells a nurse, "I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing." The nurse should analyze this comment as: a. normal pessimism of the elderly. b. evidence of risks for suicide. c. a call for sympathy. d. normal grieving.
B
A health care provider writes these new presciptions for a resident in a skilled nursing facility: 2g sodium diet, restraint as needed, limit fluids to 1800mL daily, continue antihypertensive medication, milk of magnesia 30mL PO once of no BM for 3 days. The nurse should A. question the fluids restriction B. question the order for the restraint C. transcribe the prescriptions as written D. Assess the resident's bowel elimination
B
A nurse and social worker co-lead a reminiscence group for eight old-old and centerarian adults. Which activity is most appropriate to include in the group? a. Mild aerobic exercise b. Singing a song from World War II c. Discussing national leadership during the Vietnam War d. Identifying the most troubling story in today's newspaper
B
A nurse assesses four patients between the ages of 70 and 80. Which pt has the highest risk for alcohol abuse? The patient who A. consumes 1 glass nightly with dinner. B. began drinking alcohol daily after retirement and says, " A few drinks keep my mind off arthiritis." C. drank socially throughout adult life and continues thsis pattern, saying, "I've eared the right to do as i please." D. abused alcohol between the ages of 25 and 40 but now anstains and occasionally attends Alcholics anonymous (AA).
B
A nurse plans a staff education program for employees of a senior living community. Which topic has priority? a. Late-onset schizophrenia b. Depression and suicide c. Dementia d. Delirium
B
A nurse wants to assess ideation in an elder pt. select the best question to begin this assessment. A. "Are there any things going on in your life that would cause you to consider suicide?" B. "What are your beliefs about a person's right to take his or her life?" C. "Do you think you are vulnerable to developing depressed mood?" D. "If you felt suicidal, would you tell someone about your feelings?"
B
A patient living in community housing for the elderly says, "I don't go to the senior citizens club. They play cards and talk about the past because that's all they can do." The nurse analyzes these remarks to represent: a. failure to achieve developmental tasks. b. thinking associated with ageism. c. hypercritical behavior. d. paranoid thinking.
B
A student nurse visiting a senior center says, "It's depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion." The student is expressing: a. reality. b. ageism. c. empathy. d. vulnerability.
B
An 85 year old has difficulty walking after a knee replacement. The pt tells the nurse, "It's awful to be old. Everyday is a struggle. No one cares about old people." Select the nurse's best response. A. "Everyone here cares about old people. That's why wer work here." B. "It sounds like you're having a difficult time. Tell me about it." C. "Let's not focus on the negative. Tell me something good." D. "You are still able to ger around, and your mind is alert."
B
Which statement about aging provides the best rationale for focused assessment of elderly patients? A. The elderly are usually socially isolated and lonely. B. Vision, hearing, touch, taste, and smell decline with age C. The majority of elderly pt's have some form of early dementia D. As people age, thinking becomes more rigid and learning is impaired.
B
Which beliefs by a nurse facilitate provision of safe, effective care for older adult patients? Select all that apply. 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.
B, C, D
Which assessment findings would alert the nurse than an older pt may have an increased risk for development of geriatric alcohol abuse? (select all that apply) A. mild recent memory impairment B. Eighth grade education C. death of spouse D. retirement E. loneliness
B, C, D, E
A new nurse asks, "My elderly patient has Lewy body disease. What should I do about assessing for pain?" Select the best response from the nurse manager. a. "Ask the patient's family if they think the patient is experiencing pain." b. "Use a visual analog scale to help the patient determine the presence and severity of pain." c. "There are special scales for assessing patients with dementia. Let's review how to use them." d. "The perception of pain is diminished by this type of dementia. Focus your assessment on the patient's mental status."
C
A nurse and social worker co-lead a reminiscence group for eight young-old adults. Which activity is most appropriate to include in the group? a. Mild aerobic exercise b. Singing a song from World War II c. Discussing national leadership during the Vietnam War d. Identifying the most troubling story in today's newspaper
C
An advance directive gives legally binding direction for health care interventions when a patient A.has a new dx of cancer B. is diagnosed with parkinson's disease C. Is unable to make decisions for self bacause of illness D. Diagnosed with amyotrophic lateral sclerosis in unable to speak
C
An elderly patient brings a bad of medications to the clinic. The nurse finds bottles of medications as well as assorted pills in no container in the bag. What is the nurse's priority action? A. Dispose of all meds that are not properly labeled bottles. B. Confer with a family member about safe storage and labeling of medications C. Engage the pt in education about safe storage and labeling of medicaiton D. Ask the pt to name the purpose and date of expiration of each medication not in bottle
C
Discharge planning begins for an elderly pt hospitalized for 2 weeks diagnosed with major depressive disorder. The pt needs ongoing assessment and socialization oppotunities as well as education about medication and relapse prevention. The pt lives with a dtr, who works during the week. Select the best referral for this pt. A. Behavioral HHC B. A skilled nursing facility C. Partial hospitalization D. A halfway house
C
A 76 year old is indifferent and responds to others only when they initiate an interaction. What form of group therapy would be most useful to promote resocialization? A. Orientation B. Activity Therapy. C. Psychotherapy D. Reminiscence
D
A community health nurse visits an elderly person whose spouse died 6 months ago. Two vodka bottles are in the trash. When the nurse asks about alcohol use, this person says, "I get lonely and drinka little to help me forget." Select the nurse's most therapeutic intervention. A. Assess whether this pt is drinking and driving. B. Advise the person not to drink alone because the risks for injury increase. C. Teach the person about risks for alcoholism and suggest other coping strategies. D. Arrange for the person to attend an AA metting for older adults.
D
Select the best comment for a nurse to begin an interview with an elderly patient. a. "I am a nurse. Are you familiar with what nurses do?" b. "Hello. I am going to ask you some questions to get to know you better." c. "You look comfortable and ready to participate in an admission interview. Shall we get started?" d. "Hello. My name is _______ and I am a nurse. How you would like to be addressed by staff?"
D
