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A clinic nurse interviews four patients between 70 and 80 years of age. Which patient should have further assessment regarding the risk of alcohol addiction?
- A. One with a history of intermittent problems of alcohol misuse early in life and who now consumes one glass of wine nightly with dinner.
- B. One with no history of alcohol-related problems until age 65 years, when the patient began to drink alcohol daily 'to keep my mind off my arthritis.'
- C. One who drank socially throughout adult life and continues this pattern, saying, 'I've earned the right to do as I please.'
- D. One who abused alcohol between the ages of 25 and 40 years but now abstains and occasionally attends Alcoholics Anonymous.
Correct Answer: B
Rationale: The geriatric problem drinker is defined as someone who has no history of alcohol-related problems but develops an alcohol-abuse pattern in response to the stresses of aging.
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A 79-year-old white man tells a visiting nurse, 'I've been feeling sad lately. My family and friends are all dead. My money is running out, and my health is failing.' How should the nurse analyze this comment?
- A. Normal negativity of older adults
- B. Evidence of suicide risk
- C. A cry for sympathy
- D. Normal grieving
Correct Answer: B
Rationale: The patient describes the loss of significant others, economic insecurity, and declining health, which are risk factors for suicide, especially in older adult white men.
A 75-year-old patient comes to the clinic reporting frequent headaches. After an introduction at the beginning of the interview, what should the nurse address?
- A. Initiate a neurological assessment.
- B. Assess if the patient can hear the spoken word clearly.
- C. Suggest that the patient lie down in a darkened room to rest.
- D. Administer medication to relieve the patient's pain prior to the assessment.
Correct Answer: B
Rationale: Before proceeding, the nurse should assess the patient's ability to hear questions. Hearing ability often declines with age. Impaired hearing could lead to inaccurate answers.
Recognizing the risk for acquired immunodeficiency syndrome (AIDS) among older adults, nurses should provide health teaching focused on what?
- A. Discouraging sexual expression
- B. Using birth control measures
- C. Avoiding blood transfusions
- D. Encouraging condom use
Correct Answer: D
Rationale: Safe sex continues to be important and should be taught to the older adult population. Condom use is diminished in postmenopausal women, which places older adults at risk for AIDS and other sexually transmitted diseases.
Which statement about aging provides the best rationale for focused assessment of older adult patients?
- A. Older adults are often socially isolated and lonely.
- B. As people age, they become more rigid in their thinking.
- C. The majority of older adults sleep more than 12 hours per day.
- D. The senses of vision, hearing, touch, taste, and smell decline with age.
Correct Answer: D
Rationale: Only the correct answer is true and cues the nurse to assess carefully the sensory functions of the older adult patient. The incorrect options are myths about aging.
What is the highest priority for assessment by nurses caring for older adults who self-administer medications?
- A. Use of multiple drugs with anticholinergic effects
- B. Overuse of medications for erectile dysfunction
- C. Misuse of antihypertensive medications
- D. Trading medications with others
Correct Answer: A
Rationale: Anticholinergic effects are cumulative in older adults and often have adverse consequences related to accidents and injuries.