Nokea
A 74-year-old patient is regressed and apathetic. This patient responds to others only when they initiate the interaction. Which therapy would be most useful to promote resocialization?
- A. Medication
- B. Re-motivation
- C. Group psychotherapy
- D. Individual psychotherapy
Correct Answer: B
Rationale: Re-motivation therapy is designed to re-socialize patients who are regressed and apathetic by focusing on a single topic, creating a bridge to reality.
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A health care provider writes these new prescriptions for a resident in a skilled care facility: '2 g sodium diet; restraint as needed; limit fluids to 2000 mL daily; 1 dose milk of magnesia 30 mL orally if no bowel movement occurs for 3 days.' Which prescription should the nurse question?
- A. Restraint
- B. Fluid restriction
- C. Milk of magnesia
- D. Sodium restriction
Correct Answer: A
Rationale: Restraints may be applied only on the written order of the health care provider that specifies the duration during which the restraints can be used. The Joint Commission guidelines and Omnibus Budget Reconciliation Act regulations also mandate a number of other conditions that must be considered and documented before restraints are used.
An older adult with a history of major depressive disorder has taken an antidepressant daily for 3 years. The patient tells the nurse, 'I want to stop taking this medication. I don't think I need it anymore.' What is the nurse's best response to assure the patient's safety?
- A. Why do you think you don't need this medication anymore?'
- B. Have you talked with your family members about this decision?'
- C. If you stop the medication, your depression will return worse than ever.'
- D. This medication should be gradually stopped. Let's talk to your health care provider about a plan.'
Correct Answer: D
Rationale: A gradual discontinuation is needed to avoid discontinuation symptoms, ensuring patient safety.
A nurse caring for an older adult patient population should be familiar with which legal and ethical issues that are common concerns for this group?
- A. Physical abuse
- B. Autonomous decision making
- C. Emotional abuse
- D. Financial abuse
- E. Need for medication therapy
Correct Answer: A,C
Rationale: Among the most important legal and ethical issues are decision-making about health care and various forms of elder abuse, including physical and emotional abuse.
A 78-year-old nursing home resident diagnosed with hypertension and cardiac disease is usually alert and oriented. This morning, however, the resident says, 'My family visited during the night. They stood by the bed and talked to me.' In reality, the patient's family lives 200 miles away. The nurse should first suspect what as the trigger for the resident's experience?
- A. A side effect associated with medications.
- B. Early Alzheimer's disease associated with advanced age.
- C. A transient ischemic attack and developed sensory perceptual alterations.
- D. Previously unidentified alcohol abuse and is beginning alcohol withdrawal delirium.
Correct Answer: A
Rationale: A resident taking medications is at high risk for becoming confused because of medication side effects, drug interactions, and delayed excretion.
A nurse wants to perform a preliminary assessment for suicidal ideation in an older adult patient. Which question would obtain the desired data?
- A. What thoughts do you have about a person's right to take his or her own life?'
- B. If you felt suicidal, would you communicate your feelings to anyone?'
- C. Do you have any risk factors that potentially contribute to suicide?'
- D. Do you think you are vulnerable to developing a depressed mood?'
Correct Answer: A
Rationale: The correct response is clear, direct, respectful, and open-ended, producing information relative to the acceptability of suicide as an option.