Nokea
A community mental health nurse plans an educational program for staff members at a home health agency that specializes in the care of older adults. What topic is of high priority?
- A. Identifying depression in older adults
- B. Providing cost-effective foot care for older adults
- C. Identifying nutritional deficiencies in older adults
- D. Psychosocial stimulation for those who live alone
Correct Answer: A
Rationale: Depression is the most common, most debilitating, and also most treatable psychiatric disorder in the older adult. Home health staff are often better versed in the physical aspects of care and less knowledgeable about mental health topics. Statistics show that older adult patients with mental health problems are less likely than young adults to be diagnosed accurately.
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A patient tells the nurse of the recent deaths of a spouse of 50 years as well as an adult child in an automobile accident. The patient has no other family and only a few friends in the community. What is the priority nursing diagnosis?
- A. Spiritual distress, related to being angry with God for taking the family
- B. Risk for suicide, related to recent deaths of significant others
- C. Anxiety, related to sudden and abrupt lifestyle changes
- D. Social isolation, related to loss of existing family
Correct Answer: B
Rationale: The patient appears to be experiencing normal grief, but due to age and social isolation, the risk for suicide is a high-priority nursing diagnosis.
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.
An older adult patient brings a bag of medication to the clinic. The nurse found one bottle labeled 'Ativan' and one labeled 'lorazepam,' and both are labeled 'Take two times daily.' Bottles of hydrochlorothiazide, Inderal, and rofecoxib, each labeled 'Take one daily,' are also included. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan.
- B. The patient's blood pressure is likely to be very high.
- C. This patient should not self-administer any medication.
- D. Lorazepam and Ativan are the same drug; consequently, the dose is excessive.
Correct Answer: D
Rationale: Lorazepam and Ativan are generic and trade names for the same drug, creating an accidental overdose situation.
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.
A tricyclic antidepressant is prescribed for an older adult patient diagnosed with major depressive disorder. Nursing assessment should include careful collection of information regarding what focus?
- A. Use of other prescribed medications and over-the-counter products
- B. Evidence of pseudoparkinsonism or tardive dyskinesia
- C. A history of psoriasis and any other skin disorders
- D. A current immunization status
Correct Answer: A
Rationale: Drug interactions, with both prescription and over-the-counter products, can be problematic for the geriatric patient taking tricyclic antidepressant medications.