Question 1

A nurse plans a staff education program for employees of a senior living community. Which topic has priority?

Accepted Answer

A)  Late-onset schizophrenia 
B)  Depression and suicide 
C)  Dementia 
D)  Delirium

Question 2

A new nurse says, "My elderly patient has Lewy body disease. What should I do about assessing for pain?" Select the best response from the nurse manager.

Accepted Answer

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."

Question 3

A student nurse visiting a seniors centre 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 which of the following?

Accepted Answer

A)  Reality 
B)  Ageism 
C)  Empathy 
D)  Vulnerability

Question 4

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?

Accepted Answer

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

Question 5

What is considered the most common mental health disorder in the elderly?

Accepted Answer

A)  Depression 
B)  Anxiety 
C)  Chronic pain 
D)  Sleep disorders

Question 6

A 75-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important?

Accepted Answer

A)  Complete a neurological assessment. 
B)  Determine whether the patient can hear as the nurse speaks. 
C)  Suggest that the patient lie down in a darkened room for a few minutes. 
D)  Administer medication to relieve the patient's pain before continuing the assessment.

Question 7

Discharge planning begins for an elderly patient hospitalized for 2 weeks and diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient.

Accepted Answer

A)  Behavioural health home care 
B)  A nursing home 
C)  Partial hospitalization 
D)  A halfway house

Question 8

Which of the following is the highest priority for assessment by nurses caring for older adults who self-administer medications?

Accepted Answer

A)  Use of multiple drugs with anticholinergic effects 
B)  Overuse of medications for erectile dysfunction 
C)  Missed doses of medications for arthritis 
D)  Trading medications with acquaintances

Question 9

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 drink a little to help me forget." Select the nurse's most therapeutic intervention.

Accepted Answer

A)  Assess whether this patient 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 Alcoholics Anonymous meeting for older adults.

Question 10

Which assessment findings would alert the nurse that an older patient may have an increased risk for development of geriatric alcohol abuse?

Accepted Answer

A)  Mild recent memory impairment 
B)  Chronic pain 
C)  Death of spouse 
D)  Retirement 
E)  Loneliness

Question 11

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 which nursing diagnosis applies to this patient?

Accepted Answer

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

Question 12

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?

Accepted Answer

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

Question 13

For which of the following reasons is it difficult to diagnosis alcohol abuse in the older adult?

Accepted Answer

A)  They have built up an alcohol tolerance. 
B)  They remain alone a lot of time. 
C)  Personality changes are frequently unrecognized. 
D)  It is usually masked by mental illness.

Question 14

An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, "It's awful to be old. Every day is a struggle. No one cares about old people." Select the nurse's best response.

Accepted Answer

A)  "Everyone here cares about old people. That's why we 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 get around, and your mind is alert."

Exam 28: Psychosocial Needs of the Older Adult